• Title/Summary/Keyword: clinical questions

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A Study on Human Rights Sensitivity in Korean Occupational Therapist (국내 작업치료사의 인권감수성에 관한 연구)

  • Hong, Ki-Hoon
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.3
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    • pp.49-57
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    • 2018
  • Objective : The purpose of this study was to investigate the level of human rights sensitivity of occupational therapist and to compare the difference of the human rights sensitivity according to their characteristics and to provide basic data for the development of human rights education programs for occupational therapists in the future and to emphasize their role as human rights advocates. Methods : The subjects for this study were occupational therapists who chosen by snowball sampling method. The questionnaire consisted of 5 episodes and 30 questions to measure the level of occupational therapist's human rights sensitivity and 7 questions for identifying general characteristics of subjects. We distributed the questionnaire by on-line. 165 copies were collected and used to final data analysis. Results : The average of occupational therapists' human rights sensitivity was $33.52{\pm}14.96$. According to the subcategories, the average of perception of situation was $20.44{\pm}2.32$, perception of result was $19.85{\pm}2.32$, and the perception of responsibility was $19.14{\pm}2.21$. Among 5 episodes, The highest score was the right to pursue one's happiness of the elderly($12.72{\pm}1.56$), and the lowest score was the right to personal freedom in disabled ($11.04{\pm}2.23$). There were significantly differences of the subjects' age, educational level, organization type, and the level of clinical experiences. Conclusion : Occupational therapists' human rights sensitivity increased with age and the level of clinical experiences. And the human rights sensitivity increased as they were exposed to various human rights related circumstances. The reason of the highest score for situational awareness was that empathy for the client-centered intervention is important. This study confirmed that it is necessary to have human rights education and various educational programs.

Current Trends in the Treatment of Acute Achilles Tendon Rupture: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (급성 아킬레스건 파열의 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Jaeho;Cho, Byung-Ki;Chung, Hyung-Jin;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.2
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    • pp.88-94
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    • 2022
  • Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the epidemiology, diagnosis, and management of acute Achilles tendon rupture (AATR) over the past few decades. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in October 2021. The questions were mainly related to the clinical experience and preferred management of patients with AATR. Answers with a prevalence ≥50% of the respondents were considered a tendency. Results: Seventy-one (12.9%) of the 550 members responded to the survey. The male sex ratio in AATR was answered mean 78%, and the most common age groups were 30~40 years (n=49; 69.0%), and 40~50 years (n=37; 52.1%), in that order. The most common seasons for the occurrence of AATR were spring (37 cases; 52.1%) and autumn (27 cases; 38.0%). Also, sports-related rupture had an average occurrence of 76.2%. The most important clinical factor to determine the type of treatment was the history of previous injuries, and 75.9% of respondents started conservative treatment in the 2010s. The most preferred protocol of conservative treatment was an orthosis capable of ankle range of motion after casting (68.5%), and 53.7% 'satisfied' and 1.9% 'very satisfied' with conservative treatment. The most preferred surgical method was open repair (80.3%), and the Krackow method (60.6%), and 49.3% of treated patients responded 'satisfied' and 45.1% 'very satisfied' with this treatment. Conclusion: This study gives updated information concerning the current trend of epidemiology, diagnosis, and treatment of AATR in Korea. Both consensus and variation in the approach to AATR were identified using this survey study. This study may raise the awareness of various possible approaches toward AATR and should be used to further establish a standard protocol for the management of this injury.

A Method for Estimating the Lung Clinical Target Volume DVH from IMRT with and without Respiratory Gating

  • J. H. Kung;P. Zygmanski;Park, N.;G. T. Y. Chen
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.53-60
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    • 2002
  • Motion of lung tumors from respiration has been reported in the literature to be as large as of 1-2 cm. This motion requires an additional margin between the Clinical Target Volume (CTV) and the Planning Target Volume (PTV). While such a margin is necessary, it may not be sufficient to ensure proper delivery of Intensity Modulated Radiotherapy (IMRT) to the CTV during the simultaneous movement of the DMLC. Gated treatment has been proposed to improve normal tissues sparing as well as to ensure accurate dose coverage of the tumor volume. The following questions have not been addressed in the literature: a) what is the dose error to a target volume without gated IMRT treatment\ulcorner b) what is an acceptable gating window for such treatment. In this study, we address these questions by proposing a novel technique for calculating the 3D dose error that would result if a lung IMRT plan were delivered without gating. The method is also generalized for gated treatment with an arbitrary triggering window. IMRT plans for three patients with lung tumor were studied. The treatment plans were generated with HELIOS for delivery with 6 MV on a CL2100 Varian linear accelerator with a 26 pair MLC. A CTV to PTV margin of 1 cm was used. An IMRT planning system searches for an optimized fluence map ${\Phi}$ (x,y) for each port, which is then converted into a dynamic MLC file (DMLC). The DMLC file contains information about MLC subfield shapes and the fractional Monitor Units (MUs) to be delivered for each subfield. With a lung tumor, a CTV that executes a quasi periodic motion z(t) does not receive ${\Phi}$ (x,y), but rather an Effective Incident Fluence EIF(x,y). We numerically evaluate the EIF(x,y) from a given DMLC file by a coordinate transformation to the Target's Eye View (TEV). In the TEV coordinate system, the CTV itself is stationary, and the MLC is seen to execute a motion -z(t) that is superimposed on the DMLC motion. The resulting EIF(x,y)is inputted back into the dose calculation engine to estimate the 3D dose to a moving CTV. In this study, we model respiratory motion as a sinusoidal function with an amplitude of 10 mm in the superior-inferior direction, a period of 5 seconds, and an initial phase of zero.

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Development of Korean Occupational Balance Assessment(K-OBA) Tool (한국형 작업균형 평가도구 개발)

  • Hong, So-Young;Hong, Deok-Gi
    • The Journal of Korean society of community based occupational therapy
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    • v.9 no.2
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    • pp.43-58
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    • 2019
  • Objective : The purpose of this study was to develop an assessment tool to measure Korean occupational balance. Methods : From March 2017 to July 2019, preliminary questionnaire was prepared through analysis of previous research and expert focus meeting, and preliminary questions were selected through the Delphi survey. In order to verify the validity of the items, Rash analysis was conducted to analyze the persons and items fitness, the distribution of item difficulty, separation reliability, and the appropriateness of the rating scale. Results : Among 141 subjects, 9 (6.38%) in time use and 11 (7.80%) in the occupation area were inappropriate subjects. As a result of analyzing the appropriateness of the items except for the inappropriate subjects, the 3 items were judged as ineligible items, but 1 item of the occupation characteristics was finally deleted based on the theoretical and clinical grounds. In the analysis of the scale, 4 points were more appropriate than the 5 point scale, and the separation reliability was .86~.94. Finally, 3 categories (time use, occupation area, occupation characteristics) and 18 items were selected. Conclusion : The occupational balance assessment tool was selected three categories and 18 questions finally, three categories and 18 questions, and was developed on a four-point Likert scale. Further research needs to prove the concurrent validity of the K-OBA and to analyze the factors that influence the occupational balance.

Survey Research about Student Support Programs In Korean Medicine College (한의과대학 학생지원프로그램에 대한 한의대생 인식도 연구 - 1개 한의과대학을 중심으로 -)

  • So, Ui-Ji;Mok, Tae-Young;Park, Bu-Chang;Bae, Ji-Yong;Lee, Ji-Young;Lee, Hyun-Ho;Chae, Ji-Won;Hwang, Sung-Ho;Park, Sun Young;Jo, Hak Jun;Lee, Ju Ah;Park, Jeong-Su;Kim, Young-Ji;Sung, Hyun-Kyung;Kong, Kyung-Hwan;Go, Ho-Yeon
    • Journal of Society of Preventive Korean Medicine
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    • v.20 no.3
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    • pp.9-20
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    • 2016
  • Background and objectives : Student support programs in Korean Medicine (KM) college have been not much activated as compared to other colleges. So, this research is aim to offer a baseline data to plan and run any kind of student support programs by understanding Korean Medicine students' preference and satisfaction. Methods : The survey was taken for 4 weeks from 2nd may 2016 to 27th may 2016, asking 162 out of a total of 255 students from $1^{st}$ grade to $6^{th}$ grade (pre-med to med). 3 Korean medicine doctors and 8 general students in Korean medicine college made the questionnaire by reviewing and modifying used questionnaire for student support programs. It consists of 13 questions (3 questions of demographic characteristics, 10 questions of overall awareness about student support programs). Results : 'Advanced clinical training course' was the most preferred with 23.4% among 13 different student support programs when multiple voting was allowed. 'Chinese Medicine college tour' got 21.6%, and 'Major training in Chinese Medicine college (for 17 days)' followed next with 19.4%. Expected satisfaction score to student support programs was 7.30 on average out of 10. Conclusions : Expected satisfaction to student support program was likely to be high. This research can be utilized as a significant assessment and analysis when developing new student support program for Korean Medicine college students.

Current Trends in the Treatment of Ankle Arthritis: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (족관절 관절염 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Gwak, Heui-Chul;Kim, Hak Jun;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.3
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    • pp.111-116
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    • 2021
  • Purpose: Variations in the preferred conservative and operative treatment methods for ankle arthritis may be observed in the practice of orthopedic surgeons. This study is based on the Korean Foot and Ankle Society (KFAS) member survey and aims to report the current trend and changes in the management of ankle arthritis over the last few decades. Materials and Methods: A web-based questionnaire containing 24 questions was sent to all KFAS members in July 2021. The questions were mainly related to the preferred techniques and clinical experience in osteotomy, arthrodesis, and total ankle arthroplasty (TAA) for patients with ankle arthritis. Results: Sixty-three out of 550 surgeons (11.5%) responded to the survey. The responses to 6 out of the total of 24 questions (25.0%) achieved the levels needed to reflect a tendency. Answers that showed a tendency were related to the following: a surgical approach for arthrodesis (anterior approach), use of auto-bone graft for arthrodesis (iliac bone), a nonunion rate of more than 10% following arthrodesis, main reason related to unsatisfactory results after arthrodesis (nonunion or delayed union), the main reason to change total ankle prosthesis (unstable supply of prosthesis), the unusualness of revision TAA and conversion of fusion to TAA. Diversity was found in several aspects of treatment (degree of experience and satisfaction in supramalleolar osteotomy, fixation method for arthrodesis, preferred TAA prosthesis and longevity, degree of experinece, annual number of TAA operation. Conclusion: This study proposes updated information with regard to the current trends in the management of ankle arthritis in Korea. Both consensus and variations in the approach to patients with ankle arthritis were identified through this survey. With an increasing preference for TAA, the need for the development of a prosthesis optimized for Koreans and a stable supply of prostheses were the suggestions made by the study.

Application and Effectiveness of a Preceptorship for the Improvement of Clinical Education (임상실습 교육개선을 위한 일 실습지도자 활용모델 (preceptorship model)의 적용 및 효과에 관한 연구 -암센타, 재활센타, 중환자실 실습을 중심으로-)

  • 이원희;김소선;한신희;이소연;김기연
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.581-596
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    • 1995
  • Clinical practice in nursing education provides an opportunity for students, through the process of ap-plying theoretical knowledge to practice, and to learn nursing skills as well as being socialized into nursing and as such decrease the reality shock of actual nursing practice. Because of a shortage of nursing faculty, the job of achieving the objectives of the clinical practice had been turned over to the head nurses. This resulted in many problems, such as, unclear location of responsibilities and inadequate feedback from head nurses. Therefore this study was done to introduce and evaluate the use of preceptors as a way to minimize the above problems, and to maximize the achievement of the clinical practice objectives. Using an adaptation of Zerbe's (1991) three-tiered team model, clinical practice was done using a preceptor, a head nurse and a clinical instructor, each with different and well defined roles. The subjects of this study were 67 senior students of the College of Nursing of Y University in Seoul whose clinical practice in adult nursing was carried out between May 1, 1994 and December 8, 1994. There were 22 preceptors who had at least two years of clinical experience and who were recommended by their head nurses. They were given additional education on the philosophy and objectives of the College of Nursing, on communication skills, on the theory and practice of education, and on nursing diagnosis and education evaluation. The role of the preceptor was to work one-to-one with students in their practice. The role of the head nurse was to supervise and evaluate the preceptors. The role of the clinical instructor was to provide the education program for the preceptors, to provide ad-vice and suggestions to the preceptors and to maintain lines of communication with the college. With each of these roles in place, it was thought that the effectiveness and efficiency of the clinical practice could be increased significantly. To evaluate the effectiveness of the preceptorship, the three - tiered model, Lowery's Teacher Evaluation Opinion Form translated and adapted to Korea was used to measure student statisfaction. The Clinical Practice Compentency Evaluation Tool developed by Lee et ai was also used to measure student competencies. The results of this study are as follows 1. The satisfaction with clinical practice was higher with the introduction of the perceptors than it was before they were used. (t=-5.96, p=<.005) 2. The clinical practice competencies were higher with the introduction of the preceptors than it was before they were used(t=-5.l3, p<.005) 3. In order to analyze areas not measured by the quantitative tools additional analysis of the open questions was done. The results of this analysis showed that : 1) The students felt positive about their sense of security, confidence, handling of responsbility, and being systematic. They also felt positive about improvements in knowledge, opportunities for direct care, and socialization. 2) The students felt negative about the technical part of their role, lack of knowledge by the preceptor, unprofessional attitudes on the part of the preceptor, difficulty in the role of the professional nurse(student). 3) The preceptors felt positive about their responsibility, motivation, and relationship with the college. 4) The preceptors felt negative about their bur-den. Introduction of the preceptorship model will lead to change and improvement in the negative factors discussed above, solve problems in the present clinical education system, increase continuity in the education of the students, help with socialization of the students and motivation of the preceptors to up-grade their education and increase their confidence. These objectives must be obtained to further the development of professional nursing, and thus, making the preceptorship a reality is our job for the future.

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Current Status of Clinical Dental Hygiene Education Based on Dental Hygiene Process of Care (치위생과정에 근거를 둔 임상치위생학의 교육 실태)

  • Han, Sun-Young;Kim, Nam-Hee;Yoo, Jae-Ha;Kim, Cheoul-Sin;Chung, Won-Gyun
    • Journal of dental hygiene science
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    • v.9 no.3
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    • pp.271-278
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    • 2009
  • The purpose of this study was to investigate the educational status of dental hygiene process of care and to provide foundation for introducing curriculums focused on it. Questionnaire (14 questions) on educational status of clinical dental hygiene based on dental hygiene process of care was distributed in 50 dental hygiene schools with full classes. Research was performed with structured questionnaires on the basis of previous literatures, and interview and email survey was conducted. Collected data were analyzed with Frequency analysis, Descriptive statistics, and Chi-square test using SPSS 12.0, and the results were as follows. The average student to clinical dental hygiene faculty ratio of 22 to one regardless of year of curriculum. Sixty two point five percent of dental hygiene school reported having a curriculum about comprehensive dental hygiene process. Regarding the distribution of lecture and practical curriculums, they were less focused on dental hygiene diagnosis (68.8%), planning (65.6%) and evaluation (68.8%) than on assessment and implementation. Just over half (56.7%) reported having education of dental hygiene process of care during the course of curriculum. In conclusion, it is most desirable to provide integrated education based on dental hygiene process of care by reinforcing dental hygiene diagnosis, planning, and evaluation step.

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A Study on The Clinical Characteristics and Treatment in Burning Mouth Syndrome (구강 작엽감 증후군 (BMS)의 임상적 특징 및 치료에 관한 연구)

  • Mi-Jung Yeom;Chong-Youl Kim
    • Journal of Oral Medicine and Pain
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    • v.20 no.1
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    • pp.39-52
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    • 1995
  • Burning mouth syndrome is characterized by a burning sensation in oral cavity without clinical signs. There has b een no established theories about the diagnosis and treatment. The purpose of this article is to examine the clinical feature of BMS patients of Korean and to present a treatment protocol that can be helpful in clinical applications. The subjects chosen for the study were 52 patients who had visited Department of Oral Diagnosis at Yonsei University Dental Hospital and were diagnosed as BMS. We did questionnaires and precise oral exam, laboratory exam, grouping of our patients, individual treatment for the groups and classification of responses to the treatment. The following results were obtained: 1. Chief complaints were throbbing (71.2%), pricking, stinging, tingling (30.8%), burning(25a%). The tongue is the most frequently affected site (82.7%), followed by full mouth, gingiva, palate, buccal mucosa, lips, throat, labial mucosa and floor of mouth. 2. The average age of onset was 48.1 year and the male to female ratio was 1 to 3. The average duration of symptom was 11.69 months for male and 23.07 months for female. 3. 32.7% of patients had appealed continuous pain, which was the most cases. Aggravating factors were peppery food, salty food, hot food, fatigue, tension conversation, sour food, cold food and toothpaste. Reducing factors were cold food, diet, going to sleep and smoking. 4. Associated symptoms were dry mouth, other life problem, altered taste perception, bad taste, throat pain, tingle and difficulty in swallowing. 5. Most of patients had appealed that there was not associated event on onset of symptom, and the order of prevalence is as fallow; dental treatment, stress, denture wearing, an attack of a systemic disease. 92.3% of patient appealed that there was no psychological withering and 7.7% of patients appealed positively. 6. There were eight males and four females that had jobs. 7. There was no family history in 100% of patients in questions about presence of family history. 8. 96.2% of patients appealed that there was no oral habits. 13.5% of patients had dryness of oral mucosa in oral exam. A significant relation to dental prosthesis was not observable, but incidence of diseases due to stress appeared high in BMS which had the clinical characteristics as above. A group having low serum iron was 63.5% and in this group period of potential iron deficiency appeared high in incidence just before move to anemia. A group represented positive response was 38.5% in fungus study for Candida albicans. Since we can expect high treatment response by prescription of iron-contained drug and antifungal drug in these patients, diagnosing patients' condition of BMS can be achieved in more various aspects through study for serum iron and Candida albicans. Furthermore, it is expected that treatment protocol can be made.

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The Necessity for End-of-Life Care Education: A Preliminary Analysis with Interns at Two University Hospitals (임종돌봄에 대한 교육의 필요성: 2개 대학병원의 인턴을 대상으로 예비 분석)

  • Kim, Do Yeun;Kim, Kyong-Jee;Shin, Sung Joon;Kwon, Ivo;Nam, Eun Mi;Heo, Dae Seog;Lee, Soon Nam
    • Journal of Hospice and Palliative Care
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    • v.20 no.2
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    • pp.111-121
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    • 2017
  • Purpose: This study was performed to explore the current state of end-of-life (EoL) care education provided to new interns at two university hospitals. Methods: A questionnaire was given to incoming interns (N=64). The levels of acquired knowledge and experience of clinical observation were measured. Seven areas for self-assessment questions were identified and used to analyze the interns' attitudes towards EoL-related education and practice. Results: On average, participants learned five elements (nine in total) from EoL-related classes and two (seven in total) from clinical observation. The most frequently educated element was how to deliver bad news (96.9%) in the classroom setting and how to control physical symptoms (56.5%) in clinical observation. Less than 20% received training on EoL care communication, including discussion of advanced directives. Compared with participants who had no EoL training, those who had EoL training showed positive attitudes in all seven categories regarding overall satisfaction, interest and preparedness in relation to EoL-care classes and practice. Conclusion: Although interns are responsible for caring of dying patients, their EoL training in classroom and clinical settings was very insufficient. Further research should be conducted to establish an education system that provides sufficient knowledge and training on EoL care.