• Title/Summary/Keyword: Patients Value

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Analysis of Decision-Making in Ethical Dilemma Cases among Clinical Nurses (윤리적 딜레마 사례에 대한 간호사의 의사결정 분석)

  • Kim, Hyun-Gyung
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.3
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    • pp.459-480
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    • 2003
  • Purpose: This study was done to analyze the contents of nurses' ethical decision-making in four of hypothetical dilemma cases using the Cameron's Ethical Decision-Making Model of 'Value, Be, Do'. Method: Sixteen nurses who work at ICU at present or worked before, participated from April 10 to May 10 in 2002. The participants were interviewed three times each and for 40 minutes at once, with a structured questionnaire at their working places and locker rooms. The data was analyzed by a procedure of qualitative content analysis into three categories; what should I value, who should I be, what should I do. Result: 1) In consistency, most of subjects showed a unified voice in 'Value, Be, Do'. Exceptionally 8 subjects showed inconsistency such as 3 in active treatment to the incurable patients(case 1), 1 in treatment truth-telling to the terminally ill patients(case 2), 3 in conflict with uncooperative doctors(case 3), 3 in dying patients and euthanasia(case 4). Only one subject showed inconsistency in 3 dilemma cases. 2) Closing the interview procedure, the subjects evaluated Cameron's Model as it would help them build consistent value, carry right action, and cope to conflicts. Conclusion: On the basis of the results, it is recommended that nursing ethics should adopt the ethical decision-making model, and be applied to the curriculum of nursing colleges and continuing education program for clinical nurses.

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A Clinical Study of administration of Mushroom yogurt on The Taeumin Diabetes Mellitus Patients (태음인(太陰人) 당뇨병(糖尿病) 환자에게 버섯 요구르트를 투여한 임상보고)

  • Lee, Hynn-Min;Jo, Hoon-Seuk;Jeun, Su-Hyung;Kim, Jong-Won
    • Journal of Sasang Constitutional Medicine
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    • v.16 no.2
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    • pp.139-151
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    • 2004
  • 1. Objectives The purpose of this study was to investigate the effects of administration of Mushroom yogurt on the Diabetes Millitus paitients. 2. Methods We collected 24 Taeumin patients with glycosurea in Dongeui Oriental Hospital, and then adminisrtation of Mushroom yogurt, medical examinations and questionnaire test of symptons for 13 weeks. 3. Results (1) At the symptoms change : Subjects of glycosurea clincal symptoms questionnarie which showed improvement above 50 percents were 'I have to urinate frequently' and 'I feel severe thirst'. (n=22) (2) Level of FBS significantly decreased at the inspection of 5 weeks 9 weeks 11 weeks afterwards(P-value=0.008, P-value=0.002, P-value=0.022), Level of HbA1c significantly decreased at the inspection of 13weeks afterwards(P-value=0.000).(n= 24) 4. Conclusions We have concluded that these effects must be useful in the clincal study of the Sasang constitutional treatment on Diabetes Mellitus Patients.

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Diagnostic Value of MRI in Schwannoma (신경초종 진단에 있어 자기공명영상촬영(MRI)의 진단적 가치)

  • Kim, Jeung Il;Kim, Um Ji;Moon, Tae Yong;Lee, In Sook;Song, You Seon;Choi, Kyung Un
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.60-65
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    • 2014
  • Purpose: To diagnose soft tissue tumor, such as lipoma and Schwannoma, magnetic resonance imaging (MRI) is sufficient in most cases. However, various characteristics are found in MRI images of Schwannoma, thus other type of tumors are often misdiagnosed as Schwannoma with MRI images. In this study, we evaluate the diagnostic value of specific MRI findings of Schwannoma. Materials and Methods: From January 2002 to May 2013, 104 patients who are suspected as Schwannoma rith MRI images are included in data, and the final diagnosis is confirmed with biopsy. Patients are divided into group 1 and group 2 who are confirmed as Schwannoma and other disease with biopsy, respectively. Results: 92 patients were diagnosed as Schwannoma (group 1) and 12 patients were diagnosed as other disease (group 2). We investigate the diagnostic value of specific MRI findings of Schwannoma. 41 patients of group 1 (45%) and 0 patients of group 2 (0%) showed target sign, 47 patients of group 1 (51%) and 2 patients of group 2 (17%) showed fascicular sign, 44 patients of group 1 (48%) and 5 patients of group 2 (42%) showed fat split sign, 28 patients of group 1 (30%) and 1 patients of group 2(9%) showed nerve entering and exiting sign, and 8 patients of group 1 (9%) and 6 patients of group 2 (50%) showed none of four specific findings on their MRI images. 52 patients of group 1 (57%) and 5 patients of group 2 (42%) have tumors on the pathway of nerve. Target sign could be considered as the best diagnostic value of the sign we investigate (p<0.05). Conclusion: Although specific MRI findings have powerful diagnostic value, patients are often misdiagnosed as Schwannoma with MRI findings. Therefore, if patients who are suspected as Schwannoma based on MRI findings have no target sign on their MRI images, we should consider the possibility of other disease.

Clinical Value of Procalcitonin in Patients with Spinal Infection

  • Jeong, Deok-Ki;Lee, Hyun-Woo;Kwon, Young-Min
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.271-275
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    • 2015
  • Objective : This study was designed to evaluation the diagnostic value of procalcitonin (PCT) in patients with spinal infection, compare to the classical biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count. Methods : All patients who were diagnosed as a spinal infection between January, 2013 and July, 2014 were included in this study. Serum PCT, CRP, ESR, and WBC count were checked at initial hospital visit and once a week serially until they were discharged. Patient's medical history, causes and pathogens of spinal infection were reviewed. Results : Total 34 (16 men, 18 women) patients were included in this study. Mean age of the patients was 65.6 year-old. Causes of spinal infection were pain block procedure (14, 41.2%) and post-operation (5, 14.7%). Out of 25 patients who showed elevated initial serum PCT level, 20 patients (80%) had a combined systemic infection. 14 patients (6.7%) had a sepsis, 3 patients (14.2%) had a urinary tract infection and 2 (9.6%) had a pneumonia. 14 patients (41.2%) showed elevation of serum PCT level during treatment. Among them, 9 patients (64.3%) had a combined infection such as sepsis and urinary tract infection. Conclusion : Serum CRP showed more sensitivity compared to serum PCT in patients with spinal infection. Patients with spinal infection who showed elevated serum PCT level should be investigated for combined infection and proper antibiotics should be applied.

A Systematic Review of Risk Factors for Brain Metastases and Value of Prophylactic Cranial Irradiation in Non-Small Cell Lung Cancer

  • Sun, Dian-Shui;Hu, Li-Kuan;Cai, Ying;Li, Xiao-Mei;Ye, Lan;Hou, Hua-Ying;Wang, Cui-Hong;Jiang, Yu-Hua
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1233-1239
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    • 2014
  • Background: The incidence of brain metastases (BM) varies in patients with non-small cell lung cancer (NSCLC), calls into question the value of prophylactic cranial irradiation (PCI). It is possible that clinicopathologic characteristics are associated with the development of BM, but these have yet to be identified in detail. Thus, we conducted the present meta-analysis on risk factors for BM and the value of PCI in patients with NSCLC. Methods: Eligible data were extracted and the risk factors for BM and the value of PCI in patients with NSCLC were analyzed by calculating the pooled odds ratio (OR). Heterogeneity was detected using Q and I-squared statistics, and publication bias was tested by funnel plots and Egger's test. Results: Six randomized controlled trials with a focus on the value of PCI and 13 eligible studies with a focus on risk factors for BM were included. PCI significantly reduced the incidence of BM in patients with NSCLC (p=0.000, pooled OR=0.34, 95% confidence interval = 0.37-0.59). Compared with non-squamous cell carcinoma, squamous cell carcinoma was associated with a low incidence of BM in patients with NSCLC (p=0.000, pooled OR=0.47, 95% confidence interval =0.34-0.65). The funnel plot and Egger's test suggested that there was no publication bias in the current meta-analysis. Conclusions: This meta-analysis provides statistical evidence that compared with non-squamous cell carcinoma, squamous cell carcinoma can be used as a predictor for BM in patients with NSCLC, and PCI might reduce the incidence of BM in patients with NSCLC, but does not provide a survival benefit.

Prognostic Value of a CYP2B6 Gene Polymorphism in Patients with Acute Myeloid Leukemia

  • Alazhary, Nevin M;Shafik, Roxan E;Shafik, Hanan E;Kamel, Mahmoud M
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4583-4587
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    • 2015
  • Background: The objectives of this study aimed to detect a CYP2B6 polymorphism in de novo cases of acute myeloid leukemia patients and identify any role in disease progression and outcome. Materials and Methods: DNA was isolated from peripheral blood of 82 newly diagnosed acute myeloid leukemia cases and the CYP2B6 G15631T gene polymorphism was assayed by PCR restriction fragment length polymorphism (PCR-RFLP). Results: The frequency of the GG genotype (wild type) was 48 (58.5%) and that of the mutant type T allele was 34 (41.9%). GT genotype heterozygous variants were found in 28 (34%), and TT genotype homozygous variants in 6 (7.3%) cases. We found no significant association between the CYP2B6 G15631T polymorphism and complete response (CR) (p-value=0.768), FAB classification (p-value=0.51), cytogenetic analysis (p-value=0.673), and overall survival (p-value=0.325). Also, there were no significant links with early toxic death (p-value=0.92) or progression-free survival (PFS) (p-value=0.245). Conclusions: Our results suggest that the CYP2B6 polymorphism has no role in disease progression, therapeutic outcome, patient free survival, early toxic death and overall survival in acute myeloid leukemia patients.

The Effects of Gel-type Insole on Patients with Knee Osteoarthritis during Gait (겔-타입 인솔이 무릎 골관절염 환자의 보행에 미치는 영향)

  • Eun, Seon-Deok;Yu, Yeon-Joo;Shin, Hak-Soo
    • Korean Journal of Applied Biomechanics
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    • v.17 no.3
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    • pp.181-188
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    • 2007
  • The purpose of this study was to investigate the biomechanical effects of wearing different type of insole shoes on gait characteristics in patients with knee osteoarthritis. Seven patients with knee osteoarthritis (Grade 3 & 4 by Kellgren & Lawrence) were participated in the study. They wore two different type of shoes (with Gel-type Insole: GIS, with Normal insole: NIS) during gait. Three dimensional cinematography and Ground Reaction Force(GRF) data were used to get the maximal value of horizontal distance between the center of pressure in GRF and knee joint center, GRF in mediolateral direction, peak value of GRF in frontal plane, vertical compressive force and adduction moment in knee joint. The results were as follows: The maximal value of horizontal distance between the center of pressure in GRF and knee joint center was smaller in GIS than NIS. The peak value of GRF in mediolateral direction was found in 30% of gait cycle, five subjects wearing GIS showed lower value of peak GRF in mediolateral direction than wearing NIS. The peak value of GRF in frontal plane and vertical compressive force in knee joint did not show any difference between GIS and NIS. The adduction moment in GIS decreased in the late stance of gait and the mean value of the adduction moment in GIS smaller than that in NIS. GIS may help to move quickly knee joint center to the center of pressure in GRF, therefore it may prevent increasing the adduction moment in knee joint.

Soluble Fiber Effect on Human Serum Leptin and Adiponectin: A Systematic Review and Dose-Response Meta-Analysis

  • Ali Zeinabi;Hadi Ghaedi;Seyed Ali Hosseini
    • Clinical Nutrition Research
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    • v.12 no.4
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    • pp.320-335
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    • 2023
  • Literature showed that soluble fiber has beneficial effects on cardiometabolic risk factors and leptin and adiponectin serum levels. Our aim in this meta-analysis was to determine the effect of soluble fiber supplementation on leptin and adiponectin serum levels. A systematic search was conducted using PubMed, Scopus, and ISI Web of Science for eligible trials up to December 2021. A random-effects model was used to pool calculated effect sizes. Our analysis showed that soluble fiber supplementation did not significantly affect adiponectin (standardized mean difference [SMD], -0.49 Hedges's, 95% confidence interval [CI], -1.20, 0.21, p value = 0.167; I2 = 95.4, p value < 0.001) and leptin (SMD, -0.8 Hedges's, 95% CI, -1.70, 0.08, p value = 0.076; I2 = 94.6, p value < 0.001) concentrations in comparison with placebo. However, in the subgroup, soluble fiber supplementation had a significant improvement in leptin concentration in overweight and obese patients (SMD, -0.22 Hedges's, 95% CI, -0.43, -0.01, p value = 0.048) and a non-significant beneficial effect in adiponectin level in female (SMD, 0.29 Hedges's, 95% CI, -0.13, 0.71, p value = 0.183) and diabetic patients (SMD, 0.32 Hedges's, 95% CI, -0.67, 1.32, p value = 0.526). A non-linear association between soluble fiber dosage and adiponectin (pnon-linearity < 0.001) was observed. Soluble fiber supplementation could not change the circulatory leptin and adiponectin levels. However, beneficial effects were seen in overweight and obese leptin, and increases in adiponectin may also be observed in female and diabetic patients. Further studies are needed to confirm this results.

A Study of the Effects upon Satisfaction, Intention to Revisit and Perceived Value by Cerebrovascular Disease Patients through the Quality of Medical Services (뇌혈관질환 환자가 인지하는 의료서비스 질이 지각하는 가치, 만족도 및 재이용 의도에 미치는 영향)

  • Ji, Kyung-Ja;Park, Chun-Man
    • The Korean Journal of Health Service Management
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    • v.7 no.2
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    • pp.53-67
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    • 2013
  • This study aims to analyze the effect of quality of health care on perceived value, patient satisfaction and revisit intention. Especially, it was focused on outdoor environment, admission procedure, hospital image, service quality of physicians that patients perceived. For inpatients, hospital image and service quality of medical technicians have an effect on perceived value. Service quality of physicians has an effect on the patient satisfaction. For outpatients, hospital image and service quality of physicians and medical technicians have an effect on perceived value. Outdoor environment, hospital image, service quality of physicians and medical technicians, and perceived value have an effect on patient satisfaction. Perceived value and patient satisfaction have an effect on revisit intention. They should evaluate customer satisfaction on their services and analyze various factors that affect on it to improve specialty hospitals.

Relationship between satisfaction of dental service, value quality, and reuse intention (치과 임플란트 환자의 의료서비스 질 만족과 가치만족, 재이용의사의 관계에 관한 연구)

  • Jeon, Ji-Hyun;Min, Hee-Hong;Kim, Young-Suk
    • Journal of Korean society of Dental Hygiene
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    • v.14 no.5
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    • pp.765-773
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    • 2014
  • Objectives : The objective of study is to investigate the relationship between the satisfaction of dental service, value quality, and reuse intention among dental implant patients. Methods : A self-reported questionnaire was filled out by 316 dental implant patients in 4 dental clinics in Daejeon from December, 2013 to March, 2014. Results : The average of dental service satisfaction was 4.14(SD=.562). The average of value satisfaction was 3.88(SD=.648), and that of reuse intention was 3.98(SD=.662). The tangibility was defined as the influence of the quality of medical service on the value satisfaction(t=4.042, p<0.001) and the confidence(t=2.997, p<0.01). The influence of the service value on the intention to reuse was 0.486(t=10.796, p<.001) of path coefficient. Conclusions : The quality of medical service is decided by the value satisfaction and the intention to reuse including the value satisfaction.