• Title/Summary/Keyword: clinical management

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Individualized Sleep Management for Each Sasang Type Using Stress and Digestive Function (스트레스와 소화기능을 활용한 체질별 맞춤 수면관리)

  • Seul Lee;Han Chae;Jieun Park;Kukhwa Kim;Jeongyun Lee
    • Journal of Sasang Constitutional Medicine
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    • v.36 no.1
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    • pp.13-30
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    • 2024
  • Objectives This study aimed to analyze the influence of various sleep-related factors that affect sleep quality by each Sasang type. Methods A total of 400 subjects were included for this study, 108 males and 292 females. Sasang type was diagnosed using the SCAT. Then, the characteristics of each Sasang type were analyzed using HRV, DITI, and PSQI, PSS, and SDFI questionnaires. Logistic regression analysis was used to predict sleep-related factors that affect sleep disorders by Sasang types. Results This study shows that the pathophysiological characteristics for stress and digestive function of each Sasang type can differentiate sleep management through a logistic regression model including subscales of PSS and SDFI. Stress had no effect on the occurrence of sleep disturbance within only So-Eum, since the stress level is originally high in the So-Eum regardless of sleep quality. Rather, decreased appetite and poor eating habits had a significant impact on the decline in sleep quality. In addition, poor digestion and eating habits in So-Yang had a greater impact and poor digestion in Tae-Eum had a greater impact on the decline in sleep quality. Conclusion The stress and subscales of digestive function provide differentiated sleep management in So-Yang, Tae-Eum, and So-Eum types. The individualized sleep management for each Sasang type with statistically validated PSS and SDFI would be useful for sleep-related experts planning safe and effective person-centered health care as well as for Western clinicians who want to incorporate Sasang typology into their treatments as integrative medical technique in the future.

An Investigation of Factors Which Influence Physical Therapy Students' Satisfaction with Their Clinical Practice (물리치료학 전공 학생들의 임상실습 만족도에 영향을 미치는 요인 조사)

  • Kim, Suhn-Yeop;Kim, Chi-Hyok;Song, Ju-Young;Ahn, Duck-Hyun;Chae, Jung-Byung
    • Physical Therapy Korea
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    • v.11 no.3
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    • pp.71-84
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    • 2004
  • This study analyzes the factors involving clinical practice which have an influence on the satisfaction of students majoring in physical therapy at colleges or universities located in the Pusan and Kyungnam area. We investigated using a self-reporting method 305 students receiving a grade point average between 2.0 and 4.0 and who had finished their clinical practice. We also investigated the characteristics of clinical settings which make up the clinical practice, the general characteristics of the students involved and the characteristics of a clinical teaching method performed by physical therapists versus a teaching method by a professor of a university. The number of students divided according to educational background are as follows: 149 people (48.9% of the total group) were 4 year students, 156 people were 3 year students (51.1% of the total group). Sixty-nine students' or 22.6% of the group were men while women consisted of 236 persons or 77.4% of the group. Four year students had a longer clinical practice period than that of the 3 year students (p<.05). An average satisfaction score of students with their clinical practice was 3.84. The satisfaction scores showed no significant difference between genders, educational backgrounds, and grades. (p>.05). There were no significant differences in the satisfaction score of students with their clinical practice was 3.84. The satisfaction scores showed no significant difference between genders, educational backgrounds, and grades. (p>.05). There were no significant differences in the satisfaction scores regarding the student management system among varying gender or educational backgrounds between the 3 year and 4 year programs. The average satisfaction score with the environment of the physical therapy room was 3.35. And there were no significant differences in the physical therapy room satisfaction score based on sex or educational system (p>.05). The most influential factor of determining clinical practice satisfaction was a student management system of the clinical practice (p<.01). The next most influential factors were the clinical practice period (p<.05), size of facilities (p<.01) and relationship with physical therapists (p<.01) ($R^2$=.554).

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A Development and Effects of Simulation-based Education Program on Emergency Airway Management (시뮬레이션 기반 응급기도관리 교육 프로그램 개발 및 효과)

  • Lee, Hyun Ah;Kim, Sung Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.11
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    • pp.282-293
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    • 2019
  • Purpose: After developing and imparting knowledge of a simulation-based emergency airway management education program for nursing students, this study identified the effects of the education by evaluating emergency airway management knowledge, Clinical Performance Ability, self-efficacy, and critical thinking disposition. Method: The participants were 30 nursing students. Data were collected from October 14 to November 11, 2017, and analyzed using IBM SPSS Version 22.0. Results: The simulation-based nursing education program was developed and applied based on the ADDIE model involving five stages: analysis, design, development, implementation and evaluation. Comparing the pre-and post-education results, we observed statistically significant improvement when considering emergency airway management knowledge (t=-9.98, p<0.001), Clinical Performance Ability (t=-23.90, p<0.001), self-efficacy (t=-16.77, p<0.001), and critical thinking disposition (t=-5.04, p<0.001). Conclusions: Simulation-based emergency airway management training program is an effective educational program that enhances the emergency airway management knowledge, Clinical Performance Ability, self-efficacy, and critical thinking disposition of nursing students. We believe that the program developed in this study contributes towards improvement of patient nursing quality by enhancing the ability of nursing students to cope with emergencies in practice. Furthermore, it can be applied for educating new nursing students, and contribute to the development of nursing practices.

A Literature Review of the East-West Medical Combined Treatment (한양방 병용치료에 대한 문헌고찰)

  • Kim, Chang-Seok;Kim, Sang-Kyun;Kim, Young-Eun;Kim, Chul;Yea, Sang-Jun;Jang, Hyun-Chul;Song, Mi-Young
    • Korean Journal of Oriental Medicine
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    • v.18 no.2
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    • pp.101-116
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    • 2012
  • Objectives : This study aims to analyze the papers of the east-west medical combined treatment and suggest the research direction. Methods : 183 research papers were collected by using 25 keywords including combination(in korean words, 병용), collaborative practice(in korean words, 협진) in Korean Medical Database(KMbase) and Oriental Medicine Advanced Searching Integrated System(OASIS). We analysed the type of studies, the kind of diseases, the treatment method, the kind of herbs and drugs in frequent use, and the result of research. Results : Among the analysed 183 papers, clinical studies are 89 cases and experimental studies are 94. 5 cases of clinical studies are Randomized Controlled Trial(RCT). The cancer(50 papers) and diseases of the circulatory system(25 papers) occupied mostly in treatment studies. Because Combined treatment was actively progressed in oriental medicine, treatment was mainly applied the combined oriental medical treatment with herbs and western drugs. In herbal medicine, Mahwangyounpae-tang(麻黃潤肺湯) and Eunkyo-San(銀翹散) were frequently used in the papers. In western drugs, Cyclophosphamide, Cisplatin, and Mitomycin C were frequently used in the papers. 154 papers introduced the treatment effect, 14 papers announced the safety, and 4 papers mentioned the side effect. Conclusions : We suggested several future research direction as follows. Clinical studies based on experiment studies must be more activated and many RCT shoud be shown. Experimental group in clinical studies should be clearly separated to confirm the treatment method is effective or isn't effective. Studies about the side effect must be expanded, and every study should be confirmed both the treatment effect and safety.

The Study on Application of Activity-Based Costing System on the Department of Clinical Pathology (임상병리과의 활동기준원가 관리 적용에 관한 연구)

  • Jung, Soo-Kyung;Jung, Key-Sun;Choi, Hwang-Gue;Rhyu, Kyu-Soo
    • Korea Journal of Hospital Management
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    • v.5 no.1
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    • pp.129-155
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    • 2000
  • This empirical study, activity-based costing, a newly introduced approach that has proved to be an improvement over the conventional costing system in product or service costing, is applied at department of clinical pathology in K university hospital. The study subjects were 233 test procedures done in clinical laboratory of K university hospital. Activity analysis was done by interview, questionnaires, and time study, and the amount of resources consumed by each activity and their costs are then traced and applied to the laboratory tests. The main purpose of this study were to compare the test costs of activity-bases costing with those of conventional costing, and test fees of medical insurance, and to provide accurate cost informations for the decision makers of hospital. The major findings of this study were as belows. 1. The cost drivers for application of activity-based costing at clinical laboratory were cases of sample collection, case of specimen, cases of test, and volume-related allocation bases such as direct labor hours and total revenue of each test. 2. The profits of each clinical laboratory fields analyzed by conventional costing were different from the profits analyzed by activity-based costing, especially in the field of Urinalysis(approximately over estimated 750%). 3. The standard full costs by conventional costing were quite different from the costs computed by using activity-based costing, and the difference is most significant with the tests of long labor time. 4. From the comparison between costs computed by using activity-based costing and medical insurance fees, some test fees were significantly lower than the costs, especially in the non-automated fields. As described in this study, activity-based costing provides more accurate cost information than does conventional costing system. The former approach is especially important in the health care industry including hospitals in which planning and controlling the costs services provided are the key to maintaining a healthy financial status for the organization. Despite the contribution of activity-based costing the economic as well as technical feasibilities of implementing such a cost accounting system in an organization must be evaluated. In the development of activity-based costing systems, an activity analysis has to be conducted to identify activities that consume resources. This involves a detailed study of the organization's logistics and accounting information systems, and it is an expensive project in itself. Besides, it can be quite difficult and time consuming to identify and trace resource consumption to a specific activity. Thus the activity-based costing system should be implemented only when the decrease in cost of error far exceeds the increase in cost of measurement. By combining activity-based costing with standard costing, health care administrators can better plan and control the costs of health services provided while ensuring that the organization's bottom line is healthy.

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The Assessment of Management Practices on Foodservice , Clinical Nutrition Service in Hospital Foodservice Operations (병원 급식소의 급식 및 임상영양 서비스 업무 실태 조사)

  • Hong, Wan-Su;Kim, Hye-Jin;Jang, Eun-Jae
    • Journal of the Korean Dietetic Association
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    • v.6 no.2
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    • pp.136-147
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    • 2000
  • The aim of this research was to examine the management practices related to foodservice.clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25-29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52 $m^2$, with 133.63$m^2$ for modified diet space and 18.13$m^2$ for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals. The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.

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Kidney-sparing Management Versus Nephroureterectomy for Upper Tract Urothelial Carcinoma: a Systematic Review and Meta-analysis

  • Luo, You;She, Dong-Li;Xiong, Hu;Fu, Sheng-Jun;Yang, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5907-5912
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    • 2015
  • Purpose: To evaluate and update evidence for prognostic effects of kidney-sparing (KS) management and nephroureterectomy (NU) for upper tract urothelial carcinomas. Materials and Methods: Pubmed, Embase and the Cochrane Library were retrieved for the identification of comparative studies of kidney-sparing procedure and nephroureterectomy for upper tract urothelial carcinoma prior to December 2014. The data were extracted independently by 2 reviewers and the quality of the included studies was assessed. Review Manager 5.3 and STATA 13 were used to perform the meta-analysis. Results: Twenty-three observational studies including 1,587 KS and 3,996 NU were evaluated. The results of the meta-analysis showed that nephroureterectomy had no significant benefit with regard to intravesical recurrence (IRFS), metastasis (MFS), cancer specific survival (CSS) and overall survival (OS) except the total tumor recurrence (RFS) when compared with kidney sparing management. The respectively pooled outcomes were HR 1.36 (0.69-2.68, P=0.38) for IRFS, 1.09 (0.59-2.01, P=0.78) for MFS, 1.17 (0.77-1.79, P=0.47) for CSS, 1.50 (0.90-2.48, P=0.12) for OS and 1.61 (1.03-2.51, P=0.04) for RFS. Conclusions: On the whole, kidney-sparing management had equivalent prognostic effect on upper tract urothelial carcinoma as the standard nephroureterectomy except in tumor recurrence. However, the results should be interpreted with caution for lack of stage and grade stratification and multi-center randomized controlled trials are still needed to verify our results.

A Bibliometric Analysis of Acupuncture Research Trends in Clinical Trials (침 치료 임상연구 동향에 대한 계량서지학적 분석)

  • Jeon, Sang-Ho;Lee, In-Seon;Lee, Hyangsook;Chae, Younbyoung
    • Korean Journal of Acupuncture
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    • v.36 no.4
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    • pp.281-291
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    • 2019
  • Objectives : As acupuncture treatment has been widely practiced in many countries around the world, clinical trials of acupuncture treatments also have become popular. The objective of the study was to explore the trends of research investigating the effect of acupuncture treatment in clinical trials using a bibliometric approach, a quantitative analytical methods. Methods : Publications related to clinical trials using acupuncture from 2000 to 2019 were retrieved from the Web of Science database. Extracted articles were analyzed in terms of publication year, country, journal, research area, organizations and authors. Trends in research on acupuncture in clinical trials were visualized using the VOSviewer program. Results : A total of 3,166 articles of acupuncture clinical trials published from 2000 to 2019 were identified and analyzed. The country producing the most articles in this field was USA followed by China, England, South Korea, and Germany. A network analysis based on the co-occurrence of keywords showed following three clusters: clinical studies, pain management studies, and methodology studies. Conclusions : This study provided a macroscopic overview of research in acupuncture clinical trials. These findings provide an expansive strategy for researchers in this field to cooperate with other researchers or organizations.

Nursing Competency And Indicator Development By Emergency Nurse's Clinical Ladder (응급실 간호사의 임상 등급(clinical ladder)에 따른 간호역량 및 행동지표 개발)

  • Youk, Shin-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.3
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    • pp.481-494
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    • 2003
  • Purpose: This study was to develop nursing competencies, sub-competencies and behavior indicators according to the clinical ladder of emergency nurses. Method: index of content validation was used by 21 clinical experts. Results: This study had three phases to develop nursing competencies, sub-competencies and behavior indicators. In first phase: 12 nursing competencies and 33 sub-competencies were developed through the literature review on nursing competency and emergency nurses' job description. The content of 12 competencies and 33 sub-competencies were reviewed by 3 nursing professors. The 12 competencies and 33 sub-competencies were followed: clinical judgement and measures(6 sub-competencies), processing ability of ward works(2 sub-competencies), flexibility(2 sub-competencies), resources management(2 sub-competencies), confidence(3 sub-competencies), cooperation(2 sub-competencies), professional development power(2 sub-competencies), patient service orientation(3 sub-competencies), inclination toward ethical value(5 sub-competencies), influence power(2 sub-competencies), developing others(2 sub-competencies), self control(2 sub-competencies). In second phase, 132 behavior indicators were developed according to nurse clinical ladder: novice, advanced novice, competent, proficient. In Third phase, content validity was examined on 132 behavior indicators by 21 clinical experts. 126 among 132 indicators had over 70% agreement among experts and 6 indicators under 70% were revised. Conclusion: nursing competencies, sub competencies and behavior indicators can be used nurses' clinical performance as well as establishing proper directions for professional growth related to reward system.

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Investigation for the Management Methods of Pure Tar Color Additives for Drugs and Quasi-drugs (의약품과 의약외품에 사용되는 타르순색소의 관리방안을 위한 조사연구)

  • Kim, Kwang Joon;Kim, Ji Yeon;Park, Sunhee;Bang, Joon Seok;Lee, Wonjae
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.97-105
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    • 2013
  • Background: This study was aimed to establish the systematic management methods of tar color additives used in Korea for drugs and quasi-drugs. Although tar color additives have been used in various areas, safety problems are continuously being reported by several studies. For that reason, major countries like US, Japan, Europe are trying to update the safety information of tar color additives and the related management methods, and Korea also need to complement them based on the updated information for their safer use. Method: This report includes the compared information of all legally used tar color additives of each country, such as color additive name, compound name and chemical abstracts service registry number. Conclusion: It is expected that these investigated results will be useful as the basic materials for proper management guidelines of tar color additives in Korea.