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Effectiveness of Mental Practice on EMG Activity of the Quadriceps during Sit-to-Stand and Stand-to-Sit Tasks in a Hemiplegic Patient (상상연습이 일어서기와 앉기 과제를 수행하는 동안 편마비 환자의 대퇴사두근 활성도에 미치는 영향)

  • Kim, Jin-Seop;Kim, Suhn-Yeop;Oh, Duck-Won
    • Journal of Korean Physical Therapy Science
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    • v.15 no.3
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    • pp.43-54
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    • 2008
  • Background : We aimed to determine the effect of a mental practice on the electromyography (EMG) activity of the quadriceps femoris muscle of the affected side in a hemiplegic patient during sit-to-stand and stand-to-sit tasks. Methods : We recruited a male patient who had suffered from right hemiplegia. A single-subject experimental A-B-A design was used. The reliability of visual analysis, which was primarily employed in this study design, was supported by using the "2- standard-deviation band" method. The target motions consisted of two activities: sit-to-stand and stand-to-sit. The EMG measurements of the quadriceps femoris muscles of the affected and unaffected sides were made in 8 sessions in the baseline (A), mental-practice (B), and follow-up (A) phases. During the mental practice phase, the 10-min mental practice was performed, and the mental practice was withdrawn in the follow-up phase in order to identify the carry-over effects of the treatment. Data was calculated as the percentage of the ratio of the quadriceps EMG activity values of the affected side on unaffected side. Result : The percentage EMG-activity ratio showed a greater increase in the mental-practice phase than in the baseline, and it was maintained during the follow-up phase. Most of the data points in the mental-practice and follow-up phases were positioned above the "2-standard-deviation band." Conclusion : These findings suggest that mental practice can be used to improve the physical function of hemiplegic patients.

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The Burden and Social Support of Mothers of Nephrotic Syndrome Patients (신증후군 환아 어머니의 부담감과 사회적지지)

  • 성미혜
    • Journal of Korean Academy of Nursing
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    • v.29 no.1
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    • pp.84-96
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    • 1999
  • This study was conducted to identity the degree of burden and social support perceived by mothers of nephrotic syndrome patients. Also, relations between burden and social support were investigated to provide basis data for their family health and nursing intervention. The study subjects were mothers of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pusan from Jun. 1, 1998 to Jun. 30, 1998. Burden measurement Instrument for this study was designed by the researcher and its basis in one developed by Montgomery et al.(1985) and the reliability was .78. Also. P.R.Q. Part I, II by Brandt and Weinert(1981) was used as social support measurement instrument and the reliability .71. The data analysis was done by SPSS, t-test, ANOVA Pearson correlation. The result were as follows. 1. Burden felt by mothers shows an average value of 60.82 (Maximum 86, Standard deviation 1.244). 2. Of the mother characteristics, the score of burden was high in case of no religion and low income. Of the patient characteristics, the score burden ranked as high MCNS, doing oral therapy, injection therapy at the same time and negative perceived patients condition. 3. The mean score of support was 77.54(Maximum 96, Standard deviation 1.096). 4. The main supporters were husband (the highest), brother, sister, health speciality and the subject expressed the highest satisfaction toward supporters in chronic disease. 5. Of the patient characteristics, the higher age group and the elder group showed high support. Also, positive perceived patient's condition, high support. 6. The relationship between burden and social support is not significant. In conclusion to the above study, the researcher suggests. 1. The Qualitative research to investigate influential factors on burden of family of nephrotic syndrome patients is needed.

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The Implementation of Real-Time Vital Sign Information Transmission Monitoring System using TMO (TMO를 이용한 실시간 생체정보 전송 모니터링 시스템 구현)

  • Lim, Se-Jung;Kim, Gwang-Jun
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.1 no.3
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    • pp.33-40
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    • 2008
  • The TMO may contain two types of methods, time-triggered methods(also called the spontaneous methods of SpMs) which are clearly separated from the conventional service methods (SvMs). The SpM executions are triggered upon design time whereas the SvM executions are triggered by service request message from clients. In this paper, we describes the application environment as the patient monitor telemedicine system with TMO structure. Vital sign information web viewer systems is also the standard protocol for medical image and transfer. In order to embrace new technologies as telemedicine service, it is important to develope the standard protocol between different systems in the hospital, as well as the communication with external hospital systems. It is able to apply to remote medical examination and treatment. Through the proper data exchange and management of patient vital sign information, real time vital sign information management will offer better workflow to all hospital employee.

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The Influence of Health Perception on Shoulder Outcome Measure Scores

  • Hardy, Richard E.;Sungur, Engin;Butler, Christopher;Brand, Jefferson C.
    • Clinics in Shoulder and Elbow
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    • v.22 no.4
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    • pp.173-182
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    • 2019
  • Background: Patient reported outcome measures assess clinical progress from the patient's perspective. This study explored the relationship between shoulder outcome measures (The Disability of the Arm, Shoulder and Hand [DASH], American Shoulder and Elbow Surgeons Standard Shoulder Assessment score [ASES], and Constant score) by comparing the best possible scores obtained in an asymptomatic population compared to overall perception of health, as measured by the SF-36 outcome measure. Methods: Volunteers (age range, 20-69 years) with asymptomatic shoulders and no history of shoulder pain, injury, surgery, imaging, or pathology (bilaterally) were included. The DASH and ASES measures were completed by 111 volunteers (72 female, 39 male), of which 92 completed the Constant score (56 female, 36 male). The SF-36 was completed by all volunteers (level of evidence: IV case series). Results: The mean (${\bar{x}}$) score for ASES measure on the right shoulder was higher for the left-hand dominant side (${\bar{x}}=100.00$ vs. 95.02, p-value<0.001); no other significant differences. Better SF-36 scores were associated with better DASH scores. Our prediction models suggest that perception of overall health affects the DASH scores. Sex affected all three shoulder measures scores. Conclusions: Comparing scores of shoulder outcome measures to the highest possible score is not the most informative way to interpret patient progress. Variables such as health status, sex, and hand dominance need to be considered. Furthermore, it is possible to use these variables to predict scores of outcome measures, which facilitates the healthcare provider to deliver individualized care to their patients.

Patient′s Preferances for Nurse′s Nonverbal Expressions of Warmth During Nursing Rounds and Administration of Oral Medication (간호회진과 경구투약시 환자가 선호하는 간호사의 비언어적 온정행위에 관한 연구)

  • 김형선;김문실
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.381-398
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    • 1990
  • Nursing involves deep human interpersonal relationships between nurses and patients. But in modem Korea, the nurse - patient relationship tends to be ritualistic and mechanestic. Patients usually express the hope that nurses be more tender and kind. Patients expect nurses to express their warmth especially through nonverbal behaviour. This study was conducted to identify patients' preferences for nurse's nonverbal expressions of warmth. Through the confirmation of these preferences, nurses may learn how to enhance their interpersonal relationships with patients. Subjects for the study were 73 patients who had been admitted to a university teaching hospital for at least three days and agreed to be interviewed by the investigator. The interactions were studied nonverbal expressions of warmth during nursing rounds and administration of oral medication. The interview schedule was expecially designed by the investigator to measure the nurse's posture, the distance between the nurse and the patient, the nurse's eye contact, facial expression, hand motion and head nodding. Data analysis included frequencies, percentages and X²-test. The results of this study may be summerized as follows : 1. Patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds. Preferred nurse's posture was sitting(50.7%) or standing(49.3%) opposite the patient. Preferred distance between the nurse and the patient was close to the bed(93.2%), less than 1m. Preferred eye contact was directed to the patient's eyes or their affected part (41.1%). Preferred facial expression was a smile(97.3%). Preferred hand motions were light gestures(41.1%). Patients preferred head nodding which approved their own opinions(69.9%). 2. Patient's preferences for nurse's nonverval expressions of warmth during administration of oral medication. Preferred nurse's posture was standing and waiting to confirm that the medication had been taken(58.9%). Preferred distance from the patient was at arm's length, 0.5-1m(64.4%). Patients preferred direct eye contact(58.9%) and a smile(94.5%). Patients preferred that the nurse put the medicine directly the patient's hand(64.4%). Whether the nurse nodded her head or not was not considered important. 3. The relation of general characteristics and patient's preferences for nurse's nonverbal expressions of warmth during nursing rounds and administration of oral medication. During nursing rounds, the age of subjects(p=0.010) and the standard of education(p=0.026) related to the distance between the nurse and the patient. The sick hospital ward related to the eye contact(p=0.017) and facial expression(p=0.010). During administration of oral medication, the age of subjects(p=0.044) and days of hospital treatment (p=0.043) and the sick hospital ward(p=0.0004) related to the facial expression. From this study, nurses can learn what kind nonverbal expressions of warmth are preferred by patients during rounds and administration and thus will enhance nurse- patient interpersonal relationships.

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Patient's Right of Self-determination and Informed Refusal: Case Comments (환자 자기결정권과 충분한 정보에 근거한 치료거부(informed refusal): 판례 연구)

  • Bae, Hyuna
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.105-138
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    • 2017
  • This is case comments of several representative legal cases regarding self- determination right of patient. In a case in which an intoxicated patient attempted suicide refusing treatment, the Supreme Court ruled that the medical team's respect for the patient's decision was an act of malpractice, and that in particular medical situations (medical emergencies) the physician's duty to preserve life supersedes the patient's rights to autonomy. Afterwards, at the request of the patient's family, and considering the patient's condition (irrecoverable death stage, etc.) consistent with a persistent vegetative state, the Supreme Court deduced the patient's intention and decide to withdraw life-sustaining treatment. More recently, regarding patients who refuse blood transfusions or other necessary treatment due to religious beliefs, the Supreme Court established a standard of judgment that can be seen as conferring equal value to the physician's duty to respect patient autonomy and to preserve life. An empirical study of legal precedent with regard to cases in which the physician's duty to preserve life conflicts with the patient's autonomy, grounded in respect for human dignity, can reveal how the Court's perspective has reflected the role of the patient as a decision-making subject and ways of respecting autonomy in Korean society, and how the Court's stance has changed alongside changing societal beliefs. The Court has shifted from judging the right to life as the foremost value and prioritizing this over the patient's autonomy, to beginning to at least consider the patient's formally stated or deducible wishes when withholding or withdrawing treatment, and to considering exercises of self determination right based on religious belief or certain other justifications with informed refusal. This will have a substantial impact on medical community going forward, and provide implicit and explicit guidance for physicians who are practicing medicine within this environment.

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A Study on Burden of Middle Aged Spouses of Rheumatoid Arthritic Patients (류마티스 관절염 환자 배우자의 부담감)

  • Choi, Kyung-Sook;Eun, Young;Ham, Mee-Young
    • Journal of muscle and joint health
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    • v.7 no.2
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    • pp.241-257
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    • 2000
  • Rheumatoid arthritis as one of the chronic illness requiring management in long period of time puts great burden to patients, their family and society. For patients with chronic illnesses, providing a social support is important and the most important source comes from spouses. Therefore we assessed burden of husbands of female rheumatoid arthritic patients and also found out the factors affecting burden. The sample of study was 107 female rheumatoid arthritic patients and their spouses. The tool of assessing spouses' burden was the revised version of subjective and objective parameters developed by Montgomery et al.(1985). The results are as follows: 1. General characteristics of patients and spouses: The mean age of the patients was 48 years. Educational level of patients was high school 41.1%. The mean age of the spouses was 51years. Educational level of spouses was mostly high school(40.2%) and college(29.9%) graduate. The mean marital period was 23.4years. Average income per month was 1,609,000 won. The average duration since diagnosis was 9.4years. As a therapy, 67.3% chose standard drug therapy. Average rating of discomfort by patient was 3.05(range 1-5) and that of severity was 3.48 and that of dependency was 2.58. The husband's rating of their spouses disease severity was 3.68. 2. Husbands' burden: The average burden in subjective items was 21.61(range 6-36) and objective items was 35.24(range 10-60). The average of total burden was 56.59(range 16-96). 3. Husband's total burden correlated with patient's age, educational level of patients, therapy method, patient's level of discomfort, patient's severity, patient's level of dependence, husband's recognition of level of severity in statistical level. Husband's objective burden correlated with patient's age, educational level of patient, patient's level of discomfort, husband's recognition of level of severity. Husband's subjective burden correlated with patient's age, educational level of patients, therapy method, patient's severity, patient's level of dependence, husband's recognition of level of severity. 4. Linear correlation analysis on burden: The husbands' total burden is explained in 37 7% by husband's recognition of level of severity and husband's age. The husbands' objective burden is explained in 31.2% by patient's level of dependence, husband's age, husband's recognition of level of severity. The husbands' subjective burden is explained in 26.7% by husband's recognition of level of severity and patient's age. In conclusion, husbands' level of burden is affected by many factors and therefore nursing strategy for relieving burden of middle aged husbands should be individualized taking these factors into consideration.

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Study on Pediatric Nurses' Attitudes and Compliance with Hospital Infection Standard Precautions (아동병동 간호사의 병원감염 표준주의에 대한 인지도와 이행도)

  • Shin, Hye-Yeun;Kim, Kyung-Hee;Kim, Ki-Sook
    • Child Health Nursing Research
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    • v.17 no.4
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    • pp.238-246
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    • 2011
  • Purpose: The purpose of this study was to identify pediatric nurses' attitudes to, and compliance with, standard precautions in the prevention of hospital infections by enhancing their practice of standard precautions. Methods: The participants were 206 nurses who worked in pediatric nursing departments of a general medical institution in Seoul. The questionnaire was a modification of Kim (2008) and consisted of 18 questions about hand washing, personal protective equipment, sharps, linen and patient care equipment. Collected data were processed using SPSS 15.0 WIN. Results: Mean scores for attitudes to standard precautions and for compliance with standard precautions were 4.43 (${\pm}0.83$) and 4.22 (${\pm}0.44$) respectively. This difference was statistically significant (t=3.368, p=.001). The nurses' compliance with standard precautions differed significantly according to the general characteristics of age (F=8.705, p<.001), total clinical experience (F=9.426, p<.001), current department experience (F=6.555, p<.001), and education experience (t=0.616, p<.043). There was a positive correlation between attitudes to, and compliance with, standard precautions (r=.156, p=.025). Conclusion: The results of this study indicate that educational programs and policy on infection control and standard precautions for pediatric nurses are needed. Also these results should contribute to baseline data for establishing appropriate clinical policy on infection control.

Survey of Pharmacy Practice for Compounding Parenteral Nutrition in Hospital Setting - 2009 (병원약국 대상으로 정맥영양제 조제 실행에 관한 연구-2009)

  • Sin, Hye-Yeon;Jung, Ki-Hwa
    • YAKHAK HOEJI
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    • v.54 no.4
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    • pp.244-251
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    • 2010
  • Standardized parenteral nutrition is required to improve patient's safety, clinical appropriateness and to increase uniformity between institution and institutions. We assessed the consistency with the American society for parenteral and enteral nutrition (A.S.P.E.N.) practice guideline for PN by evaluating current practice process for parenteral nutrition formulation in inpatients pharmacies in Korea. Each question in this survey was based on 2007 A.S.P.E.N. recommendations of standard parenteral nutrition formulation, the American society of health-system pharmacists (ASHP), and the United State Pharmacopoeia (USP) Chapter 797 guideline for compounding parenteral nutritions. All 90 Korean society of hospital pharmacist (KSHP) member directors of pharmacy were requested to respond to the survey in order to compare the survey results to ASHP national survey of pharmacy practice in hospital settings (2002) in compliance with A.S.P.E.N. guideline. We had final response rate of 35.6%. 25 (100%) hospitals complied with this Garb guideline (response rate was 84.4%) which was the highest compliance. Only 17.9% of hospital pharmacies were actively involved in complications monitoring. Monitoring complications and efficacy were least in compliance with the A.S.P.E.N. guideline. 69.0% of Korean pharmacists adjusted medication dosage based on disease state or monitoring laboratory data in compliance with the A.S.P.E.N. guideline. Over 50% of the hospital pharmacies failed to provide and evaluate staff training in aseptic manipulation skills periodically. Korean hospital pharmacies need to comply with the standard practice guideline for compounding sterile preparation in order to provide better quality of parenteral nutrition service for specific patient population.

Outcome of Childhood Acute Lymphoblastic Leukemia Treated Using the Thai National Protocols

  • Seksarn, Panya;Wiangnon, Surapon;Veerakul, Gavivann;Chotsampancharoen, Thirachit;Kanjanapongkul, Somjai;Chainansamit, Su-On
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4609-4614
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    • 2015
  • Background: In recent decades, the prognosis for childhood leukemia has improved, especially for acute lymphoblastic leukemia (ALL). In Thailand, though, the survival rate for ALL is unimpressive. In 2006, standard national protocols for childhood leukemia treatment were implemented. We herein report the outcome of the ALL national protocols and explanations behind discrepancies in outcomes between institutions. Materials and Methods: Between March 2006 and February 2008, 486 children with ALL from 12 institutions were enrolled in the Thai national protocols. There were 3 different protocols based on specific criteria: one each for standard risk, high risk and Burkitt's ALL. We classified participating centers into 4 groups of institutions, namely: medical schools in Bangkok, provincial medical schools, hospitals in Bangkok and provincial hospitals. We also evaluated supportive care, laboratory facilities in participating centers, socioeconomics, and patient compliance. Overall and event-free survival were determined for each group using the Kaplan Meier method. Statistical differences were determined using the log-rank test. Previous outcomes of Thai childhood ALL treatment between 2003 and 2005 served as the historic control. Results: Five-year overall survival of ALL treated using the Thai national protocol was 67.2%; an improvement from the 63.7% of the 12-institute historical control (p-value=0.06). There were discrepancies in event-free survival of ALL between centers in Bangkok and up-country provinces (69.9% vs 51.2%, p-value <0.01). Socioeconomics and patient compliance were key elements in determining the outcome (65.5% vs 47.5%, 59.4% vs 42.9%) (p-value < 0.02). Conclusions: Implementation of standard national protocols for childhood leukemia in Thailand did not significantly improve the outcome of ALL. Factors leading to better outcomes included (a) improvement of treatment compliance (b) prevention of treatment abandonment and (c) financial support to the family.