• 제목/요약/키워드: clinical questions

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The Roles of Critical Care Advanced Practice Nurse

  • Sung, Young-Hee;Yi, Young-Hee;Kwon, In-Gak;Cho, Yang-Ae
    • 대한간호학회지
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    • 제36권8호
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    • pp.1340-1351
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    • 2006
  • Purpose. To determine and compare the perception among nurses and doctors of the roles and tasks of critical care advanced practice nurses (APNs) in order to establish standardized and formally agreed role criteria for such critical care APNs. Method. This study measured and analyzed the necessity of each of the roles and tasks of critical care APNs, as perceived by nurses and doctors, through a survey of 121 participants: 71 nurses in 7 intensive care units (ICUs) at a general hospital in Seoul, and 50 doctors who used ICUs. Data collection utilized a questionnaire of 128 questions in the following fields: direct practice (79), leadership and change agent (17), consultation and collaboration (15), education and counseling (11), and research (6). Results. Both the nurses' and the doctors' groups confirmed the necessity of critical care APNs, with doctors who frequently used ICUs indicating a particularly strong need. As for the priority of each role of critical care APNs, the nurses considered direct practice to be the most critical, followed by education and counseling, research, consultation and collaboration, and leadership and change agent. The doctors also considered direct practice to be the most critical, followed by education and counseling, consultation and collaboration, research, and leadership and change agent. There was a statistically significant difference between how the two groups regarded all the roles, except for the consultation and collaboration roles. As for the necessity of each role of critical care APNs, the nurses considered research to be the most necessary, followed by education and counseling, consultation and collaboration, leadership and change agent, and direct practice. The doctors, on the other hand, considered education and counseling to be the most necessary, followed by research, consultation and collaboration, leadership and change agent, and direct practice. The responses of the two groups to all the roles, except for education and counseling roles, were significantly different. Conclusion. Nurses and doctors have different perceptions of the roles and tasks of critical care APNs. Thus, it is necessary for the combined nursing and medical fields to reach an official agreement on a set of criteria to standardize for the roles and tasks of critical care APNs.

KAAACI Evidence-Based Clinical Practice Guidelines for Chronic Cough in Adults and Children in Korea

  • Song, Dae Jin;Song, Woo-Jung;Kwon, Jae-Woo;Kim, Gun-Woo;Kim, Mi-Ae;Kim, Mi-Yeong;Kim, Min-Hye;Kim, Sang-Ha;Kim, Sang-Heon;Kim, Sang Hyuck;Kim, Sun-Tae;Kim, Sae-Hoon;Kim, Ja Kyoung;Kim, Joo-Hee;Kim, Hyun Jung;Kim, Hyo-Bin;Park, Kyung-Hee;Yoon, Jae Kyun;Lee, Byung-Jae;Lee, Seung-Eun;Lee, Young Mok;Lee, Yong Ju;Lim, Kyung-Hwan;Jeon, You Hoon;Jo, Eun-Jung;Jee, Young-Koo;Jin, Hyun Jung;Choi, Sun Hee;Hur, Gyu Young;Cho, Sang-Heon;Kim, Sang-Hoon;Lim, Dae Hyun
    • Allergy, Asthma & Immunology Research
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    • 제10권6호
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    • pp.591-613
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    • 2018
  • Chronic cough is common in the community and causes significant morbidity. Several factors may underlie this problem, but comorbid conditions located at sensory nerve endings that regulate the cough reflex, including rhinitis, rhinosinusitis, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease, are considered important. However, chronic cough is frequently non-specific and accompanied by not easily identifiable causes during the initial evaluation. Therefore, there are unmet needs for developing empirical treatment and practical diagnostic approaches that can be applied in primary clinics. Meanwhile, in referral clinics, a considerable proportion of adult patients with chronic cough are unexplained or refractory to conventional treatment. The present clinical practice guidelines aim to address major clinical questions regarding empirical treatment, practical diagnostic tools for non-specific chronic cough, and available therapeutic options for chronic wet cough in children and unexplained chronic cough in adults in Korea.

위식도역류질환 변증도구의 신뢰도 및 타당도 평가 (A Study of the Reliability and Validity of Standard Tools for the Pattern Identification of Gastroesophageal Reflux Disease)

  • 조윤재;하나연;고석재;박재우;김진성
    • 대한한방내과학회지
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    • 제43권1호
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    • pp.1-21
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    • 2022
  • Purpose: The standard tool for the pattern identification is used for identifying patterns in patients using a questionnaire. The purpose of this study is to reorganize the standard tool for the pattern identification of gastroesophageal reflux disease (GERD) developed in 2017 and to analyze the reliability and validity of the standard tool for pattern identification by applying it to GERD patients. Methods: To reorganize the standard tool for the pattern identification of GERD developed in the previous study, we searched the literature in the main databases, OASIS (Oriental Medicine Advanced Searching Integrated System) and CNKI (China National Knowledge Infrastructure). We added the search results to the data used in the previous study and went through the reorganizing courses, such as evaluating the validity of the translation, the Delphi technique, and a small survey. After reorganization, the patients who visited the Kyunghee University Korean Medicine Center for GERD symptoms were provided the questionnaire, including the reorganized standard tool for pattern identification. We analyzed the survey results to evaluate their reliability and validity. Results: Fifty patients completed the questionnaire. Reliability analysis results showed a pattern identification match rate of 86%, Cronbach's α coefficient of 0.834, and intraclass correlation coefficient of 0.907. The Mann - Whitney U test and logistic regression were implemented to check the relations between the survey questions and pattern identification results; the Pearson correlation, compared with other scales, showed a moderate score. Conclusion: We reorganized the standard tool for the pattern identification of GERD to be updated on current issues and so that it is easily used. The analysis results of the questionnaire showed that the reorganized standard tool had high reliability and moderate validity.

2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology

  • Soon Ho Yoon;Sang Min Lee;Chul Hwan Park;Jong Hyuk Lee;Hyungjin Kim;Kum Ju Chae;Kwang Nam Jin;Kyung Hee Lee;Jung Im Kim;Jung Hee Hong;Eui Jin Hwang;Heekyung Kim;Young Joo Suh;Samina Park;Young Sik Park;Dong-Wan Kim;Miyoung Choi;Chang Min Park
    • Korean Journal of Radiology
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    • 제22권2호
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    • pp.263-280
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    • 2021
  • Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.

치료견 매개프로그램이 자폐아동의 사회성 향상에 미치는 영향 (A Study on the Effectiveness of Therapy Dog Assisted Program(TDAP) for the Autistic Children)

  • 신성자;권신영
    • 한국사회복지학
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    • 제43권
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    • pp.157-192
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    • 2000
  • This Study concerns therapeutic effects of the Therapy Dog Assisted Program (TDAP) on autistic children. Subjects participating in the study are two groups of Korean elementary schoolboys of the same age (twelve years old) : an experimental group and a control1ed group of equal number of children (sex children in total). Thirteen different sessions of TDAP interventions were performed over a three-month period. Evidence from the present study indicates that the children participating in the TDAP program achieved a greater degree of improvement in their social interactions as well as in their individual activities in comparison with the preTDAP counterparts. The present study also demonstrates significant changes in the TDAP group in comparison with those in the non-participating control group. The results from this study supports that the proposition that the Therapy Dog Assisted Program can be applied effectively in treating people experiencing severely damaged social functioning. Such a program may serve as an effective treatment modality in a variety of clinical social work settings. The questions of long-term effects of the TDAP intervention and possible interference with other behavioral side-effects on the part of the intervened subjects need to be addressed in future studies.

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Lung Cancer Detection by Screening - Presenting Circulating miRNAs as a Promising Next Generation Biomarker Breakthrough

  • Ramshankar, Vijayalakshmi;Krishnamurthy, Arvind
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2167-2172
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    • 2013
  • Lung cancer remains a major cause of morbidity and mortality worldwide, accounting for more deaths than any other cause. All the clinical practice guidelines recommended against routine screening for lung cancer have cited lack of robust evidence, at least until a few years back. However, the potential to screen lung cancers has received renewed interest due to superior performance of low dose CT (LD-CT) in detecting early stage cancers. The incremental costs and risks involved due to the invasive procedures in the screened population due to a high false positivity rate questions the use of LD-CT scan as a reliable community based screening tool. There is therefore an urgent need to find a less invasive and a more reliable biomarker that is crucial to increase the probability of early lung cancer detection. This can truly make a difference in lung cancer survival and at the same time be more cost and resource utilization effective. Sampling blood serum being minimally invasive, low risk and providing an easy to obtain biofluid, needs to be explored for potential biomarkers. This review discusses the use of circulatory miRNAs that have been able to discriminate lung cancer patients from disease free controls. Several studies conducted recently suggest that circulating miRNAs may have promising future applications for screening and early detection of lung cancer.

황련해독탕(黃連解毒湯)이 아토피 피부염에 미치는 영향에 대한 임상적 연구 (A Clinical Study on the Effect of Hwangryunhaedock-tang on Atopic Dermatitis)

  • 고민정;백정한
    • 대한한방소아과학회지
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    • 제26권4호
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    • pp.51-60
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    • 2012
  • Objectives: The purpose of this study is to evaluate the effect of Hwangryunhaedock-tang on Atopic Dermatitis Methods: This study population was 71 pediatric allergic rhinitis patients who had been treated in ${\bigcirc}{\bigcirc}$ hospital. All the patients were asked to answer the questionnaire consisting of 8 questions about symptoms of atopic dermatitis. Results: 1. The total scores from the same questionnaire about atopic dermatitis symptoms were significantly improved after the treatment compared to the scores before the treatment. 2. The score about papule/induration/edema, effusion/furuncle, and subjective symptoms at night were significantly improved in all groups after the treatment compared to the scores before the treatment. 3. The effect of Hwangryunhaedock-tang increase markedly with advancing age. The effect of Hwangryunhaedocktang increases markedly with advancing age. Conclusions Traditional Korean herbal medication; Hwangryunhaedock-tang is effective in treating pediatric atopic dermatitis.

응급실 간호사-환자 상호작용 행위 (Emergency Nurse-Patient Interaction Behavior)

  • 김은정
    • 대한간호학회지
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    • 제35권6호
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    • pp.1004-1013
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    • 2005
  • Purpose: The main purpose of this study was to explore nurse-patient interaction behaviors and patient satisfaction with the interaction in the emergency department. Method: This study used video technology to record complete conversations between the nurse and patient, thus obtaining the interactions naturally occurring in a clinical setting. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data was collected from November, 2002 to April, 2003. The video recordings were observed for 4 hours for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS), which yields frequencies of thirty-six types of interaction behaviors. Result: The information exchange related to therapeutic items including medications, simple orientation, and situational positive talk were characterized in the nurses' interaction behaviors. Giving information about one's own condition, questions about therapeutic regimen, and showing worry were characterized in patient interaction behaviors. The patients' satisfaction with the interaction was 37.75.9 (range 9-45). Conclusion: The emergency nurse-patient interaction behavior was task-related. The results suggest that identification of effective interaction behavior in the Emergency department and an interaction skill training program could increase patient satisfaction.

한국 HIV 감염인의 치료 순응경험 (Experience of Treatment Adherence in Korean Patients with HIV)

  • 박윤희;서민정;김상희;박순영
    • 대한간호학회지
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    • 제44권4호
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    • pp.407-417
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    • 2014
  • Purpose: The purpose of this study was to explore the subjective experience of Highly active Antiretroviral therapy (HAART) adherence in Korean patients with HIV. Methods: A phenomenological methodology was used for the study. Data were collected from March to December, 2013 using open-ended questions during in-depth interviews. Participants were taking HAART for HIV, and were contacted through purposive techniques. Results: Four men and 4 women whose average treatment period was 5.9 years participated in this study. Seven themes emerged from the analysis using Colazzi's method: (a) Seizing life in a deep sense of despair, (b) Struggling with medication, (c) Facing harsh treatment from health care providers, (d) Spoiling healthy pattern, (e) Hungering for communication and emotional support, (f) Turning to accepting HIV, (g) Becoming adherent to HIV treatment. Conclusion: Prejudice from health care providers and lack of emotional support were barriers to HAART in Korea. Intervention strategies are needed to decrease prejudices from health care providers and to increase family support.

통증평가도구에 관한 고찰 (An Overview of Pain Measurements)

  • 심성윤;박히준;이준무;이향숙
    • Korean Journal of Acupuncture
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    • 제24권2호
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    • pp.77-97
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    • 2007
  • Objectives : The aim of this study is to introduce pain measurement tools that are considered suitable for clinical practice and research for Korean Medicine Doctors. Methods : We analysed some widely used and also useful pain measurement tools in terms of their methods and dimensions. Results : Diagrams, scales and questions are usually used to measure pain intensity, temporal pattern, treatment including exacerbating and/or relieving factors, pain location, pain interference, pain quality, pain affect, pain duration, pain beliefs and pain history. Specific pain measurements are also available for specific conditions such as Western Ontario and McMaster Universities Osteoarthritis Index, Oswestry Disability Index and Neck Disability Index. Conclusions : Faces Pain Rating Scale, numeric rating scale, visual analogue scale, McGill Pain Questionnaire and Brief Pain Inventory and commonly used pain measurements. Specific measurements should be considered depending on research topics.

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