• Title/Summary/Keyword: Patient-centered outcome

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Preliminary Findings on the Effectiveness of Meaning-Centered Psychotherapy in Patients with Pancreatobiliary Cancer

  • Ryu, Jin Sun;Choi, Sun Woo;Yun, Sung Su;Koo, Bon Hoon;Choi, In Seok;Kim, Seung Jun;Park, Joon Seong;Seok, Jeong-Ho;Yoon, Dong-Sup
    • Yonsei Medical Journal
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    • v.59 no.9
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    • pp.1107-1114
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    • 2018
  • Purpose: This study investigated the effectiveness of meaning-centered psychotherapy (MCP), which is known to be a helpful psychotherapeutic intervention in distressing conditions, for patients with pancreatobiliary cancer. Materials and Methods: We recruited 37 patients with pancreatobiliary cancer from three university general hospitals and assessed their psychological characteristics. Patients who reported clinically significant emotional distress were recommended to undergo MCP. Patients who consented to MCP were provided four sessions of the therapy. Patient psychological characteristics were assessed again 2 months after MCP. For statistical comparison, outcome variables included anxiety, depression, mental adjustment to cancer, and quality of life (QoL), as well as the degree of stress and physical symptoms. Results: Sixteen patients completed the MCP and the final assessment 2 months later. In the initial assessment, the patients receiving MCP showed higher levels of anxiety and depression than those not receiving MCP, and QoL was also lower in terms of role function, emotional function, social function, and global QoL. At the 2-month follow-up, the MCP group showed a significant improvement in anxiety (p=0.007), depression (p=0.010), and anxious preoccupation (p<0.001). In addition, QoL significantly improved in the MCP group, while there was no significant change in the non-MCP group. Conclusion: In this study, MCP showed potential therapeutic benefits against emotional distress in patients with pancreatobiliary cancer, improving their QoL.

Job Performance by Advanced Practice Nurses in Korea (한국 전문간호사의 업무 성과)

  • Kim, Mijung;Kim, Yeong Kyeong;Shin, Sujin
    • Korean Journal of Adult Nursing
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    • v.26 no.6
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    • pp.630-641
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    • 2014
  • Purpose: The purpose of current study was to explore the positive outcomes of advanced practice nurse who have experienced the roles in their clinical settings. Methods: This study adopted a qualitative research design based on conventional content analysis. Participants were 16 nurse practitioners have been worked at hospitals or community centers. Data were collected via focus group interviews and analyzed using thematic analysis method. Results: Patients' aspect outcomes were "client-centered care in providing continuity", "providing trust based on expertise", "promoting skilled intervention in patient recovering", "blocking the negative consequences", "quality improvement: nursing becoming tighter", "providing total care for cases that require intensive care", "improving patients outcomes by total management", "increasing confidence in evidence-based professional nursing", "rising the satisfaction by cost-effective services", "providing skilled professional practice", and "providing comprehensive care related to covering various aspects". Other themes elicited also included "promoting efficacy by inter-related health professions supervising", "the expansion of specialized practice areas increase business efficiency", "formation of outside customers due to increasing the satisfaction with skilled nursing care", "filling in the emptying spaces of doctors by practicing reliable role to bridge", "attracting external customers through successful management of subjects", "increasing staff's satisfaction on the role to make a bridge between inside and outside doctors", "24 hours medical expertise of professional staff ready secured", and "low cost, same results, that is, cost-effective" in reference to health care resources aspect. Conclusion: These findings suggested that advanced practice nurses perceived various positive outcomes and provided basic data for outcome indicators of advanced practice nurses' role.

Brain Hypoxia Imaging (뇌 저산소증 영상)

  • Song, Ho-Chun
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.91-96
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    • 2007
  • The measurement of pathologically low levels of tissue $pO_2$ is an important diagnostic goal for determining the prognosis of many clinically important diseases including cardiovascular insufficiency, stroke and cancer. The target tissues nowaday have mostly been tumors or the myocardium, with less attention centered on the brain. Radiolabelled nitroimidazole or derivatives may be useful in identifying the hypoxic cells in cerebrovascular disease or traumatic brain injury, and hypoxic-ischemic encephalopathy. In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. $^{18}F-MISO$ PET and $^{99}mTc-EC-metronidazole$ SPECT in patients with acute ischemic stroke identified hypoxic tissues and ischemic penumbra, and predicted its outcome. A study using $^{123}I-IAZA$ in patient with closed head injury detected the hypoxic tissues after head injury. Up till now these radiopharmaceuticals have drawbacks due to its relatively low concentration with hypoxic tissues associated with/without low blood-brain barrier permeability and the necessity to wait a long time to achieve acceptable target to background ratios for imaging in acute ischemic stroke. It is needed to develop new hypoxic marker exhibiting more rapid localization in the hypoxic region in the brain. And then, the hypoxic brain imaging with imidazoles or non-imidazoles may be very useful in detecting the hypoxic tissues, determining therapeutic strategies and developing therapeutic drugs in several neurological disease, especially, in acute ischemic stroke.

Efficacy of submucosal injection of hyaluronidase after mandibular third molar surgery: a randomized controlled trial

  • Sanghoon, Lee;Hyounmin, Kim;Woong, Nam
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.6
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    • pp.363-370
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    • 2022
  • Objectives: This study aimed to investigate the efficacy of postoperative submucosal injection of hyaluronidase (HUD) for reducing sequelae and quality of life (QOL) after mandibular third molar (M3M) surgery. Materials and Methods: Participants with bilateral impacted M3M underwent surgical extraction with a split-mouth randomized controlled study design. M3M were removed by the same surgeon in 2 sessions, one a control and the other experimental. Submucosal injection of HUD was performed in the experimental session and submucosal injection of saline in the control session. Mouth opening, facial swelling, and pain intensity were measured before surgery, and then 2 and 7 days after surgery. The QOL of participants following surgery was evaluated by means of a patient-centered outcome questionnaire (PCOQ). Results: A total of 36 patients was included in the final data analysis. There was a significant reduction in the maximal mouth opening and postoperative pain in the experimental side at the 2 and 7 days after surgery (P<0.05), and a remarkable difference in facial swelling was reported on the experimental side 7 days after surgery (P<0.05). The PCOQ demonstrated that participants reported less pain and swelling on the experimental side. Conclusion: The present study provides clinical evidence that submucosal administration of HUD immediately after M3M surgery reduced postoperative discomfort and improved patients' QOL.

Shared decision-making in Patients with Chronic Disease : Concept Analysis (만성질환자의 공유의사결정 개념분석)

  • Yoo, Ji Yeon
    • Journal of the Korea Convergence Society
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    • v.10 no.11
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    • pp.543-555
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    • 2019
  • The purpose of this study was to define and clarify the concept of Shared decision-making (SDM) in patients with chronic disease. Walker and Avant's concept analysis process was used to analyze interdisciplinary convergence in SDM. SDM in patients with chronic disease can be defined by the following attributes: acknowledgment patients as 'self-care experts', the rights of self-determination, reversible negotiation, and patient-centered care. The antecedents of SMD consisted of situations where there is a need to make a decision from several treatment options of similar efficacy, decisional conflict, patient, family, and health provider's willingness to participate in the decision-making process, enough time and opportunity for SDM. The consequences occurring as a result of SMD were decrease decisional conflict, improvement health outcome, satisfaction, quality of life, enhancement self-management and self-efficacy with long-term, and living acceptably with the illness. Based on these results, a scale measuring SDM in patients with chronic disease is needed.

THE PATIENTS' SATISFACTION FOLLOWING IMPLANT TREATMENT

  • Heo, Yoon-Young;Heo, Seong-Joo;Chang, Myung-Woo;Park, Ji-Man
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.6
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    • pp.569-576
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    • 2008
  • STATEMENT OF PROBLEM: While patient-centered outcomes are usually not reported, these may represent major aspects of the implant success for the patient. Use of a well-designed patient survey form can be an invaluable asset to the implant practitioners. PURPOSE: The objective of this study was to investigate patient satisfaction after implant therapy by means of a questionnaire. MATERIAL AND METHODS: South Korean patients (n = 100), who visited the dental examination center of Soon Chun Hyang university hospital, were asked to fill out the satisfaction questionnaire regarding aspects of cost, comfort, esthetics, chewing, gingival health, food impaction, phonetic aspect, screw loosening, and general satisfaction. Responses to statements were given on the Likert response scale. Four experimental groups of patients were distinguished with various location ($A_1,\;A_2,\;A_3$), year ($B_1,\;B_2,\;B_3$), number of implant replacements ($C_1,\;C_2,\;C_3$), and treatment cost ($D_1,\;D_2,\;D_3$). The reliability of the response scales was measured by calculation of its internal consistency, expressed as Cronbach's ${\alpha}$. The scales were distinguished by means of factor analysis method. Possible differences in scale scores among the groups were assessed by One-way ANOVA (${\alpha}$= 0.05). RESULTS: Patients responded to most of the statements with high satisfaction. But the mean scale score of statement about cost was low. After the verification of internal consistency and factor analysis, five components, e.g. general satisfaction, comfort, chewing efficiency, esthetics, and phonetic aspect were grouped together. These components could be explained with common meaning and the first factor was named as 'general satisfaction'. Differences in patient satisfaction on the scale with esthetics were present between patients who have been wearing the implant prosthesis less than three years and those more than seven years ($B_1<B_3$). CONCLUSION: The patients were generally satisfied with the outcome of implant treatment. But the patients' major complaint was high cost and while the statistically significant difference was not shown, the satisfaction scale about food impaction and esthetics was low. So the continuing efforts to make improvements about these problems are needed for the implant practitioners.

Short-Term Effects of an Self-Management Support Intervention on Patient Activation, Joint Flexibiltiy and Health-related Quality of Life among Korean Medical Aid Beneficiaries with Osteoarthritis (지역사회기반의 자기관리지지중재가 골관절염 의료급여수급자의 환자활력, 관절유연성 및 건강 관련 삶의 질에 미치는 단기효과)

  • Ahn, Yang Heui;Hur, Jae Bock;Choi, Eun Hee
    • 한국노년학
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    • v.36 no.3
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    • pp.595-609
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    • 2016
  • The purpose of this study was to test the effectiveness of an eight session self-management support program for improvement of patient activation, joint flexibility and health-related quality of life among medical aid beneficiaries with osteoarthritis. This study was part of a randomized and controlled research of a self-management support intervention. Participants were 60 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=30) or control group (n=30). The 8-session and tailored program led by a trained case manager with the patient-centered approaches and cognitive-emotional-behavioral skills. Analysis included change in scores, ${\chi}^2-test$, Fisher's exact test, t-test and ANCOVA. The results showed significant increase in patient activation, joint flexibility (shoulder and right knee) except health-related quality of life in the experimental group compared to the control group. The self-management support program indicated an effect on patient activation and joint flexibility. Further research is needed to examine the outcome in the long term(9 and 12-month follow up).

Development of Secure Healthcare Protocol using RFID (RFID를 이용한 안전성 있는 헬스케어 프로토콜 개발)

  • Baek, Jang-Mi;Jeon, Byung-Chan;Choi, Gyoo-Seok
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.9 no.6
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    • pp.201-210
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    • 2009
  • Studies on human-centered services are approaching their highest peak with the emergence of a new concept of the network environment, a ubiquitous environment. Among these ubiquitous service technologies, services related to health care are very closely related to the current social environment. In this paper, With social aging and changes in ubiquitous IT environment, studies on health care, which is among the essential application services and which has been defined as a key application technology, and studies related to it have been conducted. In addition, healthcare services, which are essentially applicable to the ubiquitous environment, were suggested by analyzing existing healthcare studies and drawing from them the requirements for such. This paper proposes management protocol for serious case except from health care research. This system is constructed database using RFID, it has location information. It provides procedures to consistently monitor the status of patients and process the outcome in real-time.

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Treatment Outcomes of Patients with Multidrug-Resistant Tuberculosis: Comparison of Pre- and Post-Public-Private Mix Periods

  • Kang, Yewon;Jo, Eun-Jung;Eom, Jung Seop;Kim, Mi-Hyun;Lee, Kwangha;Kim, Ki Uk;Park, Hye-Kyung;Lee, Min Ki;Mok, Jeongha
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.1
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    • pp.74-83
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    • 2021
  • Background: This study compared the treatment outcomes of patients with multidrug-resistant tuberculosis (MDR-TB) before and after the implementation of public-private mix (PPM). Factors affecting treatment success were also investigated. Methods: Data from culture-confirmed pulmonary MDR-TB patients who commenced MDR-TB treatment at Pusan National University Hospital between January 2003 and December 2017 were retrospectively reviewed. Patients were divided into two groups in terms of PPM status: pre-PPM period, patients who commenced MDR-TB treatment between 2003 and 2010; and post-PPM period, patients treated between 2011 and 2017. Results: A total of 176 patients were included (64 and 112 in the pre- and post-PPM periods, respectively). 36.9% of the patients were resistant to a fluoroquinolone or a second-line injectable drug, or both. The overall treatment success rate was 72.7%. The success rate of post-PPM patients was higher than that of pre-PPM patients (79.5% vs. 60.9%, p=0.008). Also, loss to follow-up was lower in the post-PPM period (5.4% vs. 15.6%, p=0.023). In multivariate regression analysis, age ≥65 years, body mass index ≤18.5 kg/m2, previous TB treatment, bilateral lung involvement, and extensively drug-resistant (XDR)- or pre-XDR-TB were associated with poorer treatment outcomes. However, the use of bedaquiline or delamanid for ≥1 month increased the treatment success. Conclusion: The treatment success rate in MDR-TB patients was higher in the post-PPM period than in the pre-PPM period, particularly because of the low rate of loss to follow-up. To ensure comprehensive patient-centered PPM in South Korea, investment and other support must be adequate.

Effectiveness of Acupuncture for Scoliosis: A Systematic Review

  • Choi, Seong-Kyeong;Jo, Hyo-Rim;Moon, Jeong-Hyun;Jang, Jung-Eun;Park, Seo-Hyun;Sung, Won-Suk;Geum, Dong-Ho;Kim, Eun-Jung
    • Journal of Acupuncture Research
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    • v.39 no.1
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    • pp.17-28
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    • 2022
  • Scoliosis is a 3-dimensional change of the spine, presenting 10° above Cobb angle. Various acupuncture methods are being increasingly performed to correct scoliosis. However, no systematic review has been published. Therefore, we report on the effectiveness of acupuncture on mild scoliosis in this systematic review. We searched various databases for acupuncture treatment for scoliosis published before June 2021. The primary outcome was Cobb angle, and the secondary outcomes were patient-centered scores. Six studies were identified. RCTs that compared combination therapy with acupuncture, and other treatment methods and showed significant improvement in the Cobb angle, and effective rate, but, with low quality evidence. Acupuncture monotherapy resulted in significant improvement in the Cobb angle and had high heterogeneity compared with other treatment methods, but no significant improvement in the effective rate was observed, and the quality of evidence was low. Regardless of the type of scoliosis, acupuncture monotherapy or combination therapy with acupuncture showed significant improvement in the Cobb angle, and the quality of evidence was moderate. No serious adverse events were observed in the 6 studies reviewed. Acupuncture is considered safe, and it is more effective when performed with other conventional treatments.