• Title/Summary/Keyword: clinical scales

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The clinical utility of K-CBCL 6-18 in diagnosing ADHD -focused on children with psychological disorders in child welfare institution- (ADHD 진단에서 K-CBCL 6-18의 임상적 유용성 -아동복지시설 심리장애 아동에의 적용-)

  • Kim, Sang A;Ha, Eun Hye
    • Journal of the Korean Society of Child Welfare
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    • no.56
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    • pp.253-281
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    • 2016
  • The purpose of this study was to verify the clinical utility of th Korea Child Behavior Checklist 16-18(K-CBCL 6-18) in diagnosing ADHD among children with psychological disorders in child welfare institutions. The participants were 509 elementary school children(309 boys and 200 girls) who lived in child welfare institutions. They were assessed using the Korean ADHD Rating Scale(K-ARS) and K-CBCL 6-18. Only five scales of the K-CBCL 6-18 related with attention were used for analysis: syndrom total, externalizing total, aggressive behavior, attention problems and DSM-oriented ADHD scales. The results were as follows. First, K-ARS and K-CBCL 6-18 had significantly positive correlations with all five scales. Second, as a result of a t-test on the ADHD and the non-ADHD groups, which were divided using K-ARS, the mean scores of ADHD group were significantly higher than the non-ADHD group for all five scales of the K-CBCL 6-18. The hit rate of all five scales of the K-CBCL 6-18 was 60 to 70 percent. The syndrom total and externalizing total scales had high sensitivity, whereas the aggressive behavior, attention problems, and the DSM-oriented ADHD scales had high specificity. In addition, all scales had high positive predictive values. Third, as the result of a t-test on the ADHD group and the emotional disorder group, there were significant difference in the mean scores of the attention problems and the DSM-oriented ADHD scales. The attention problems and the DSM-oriented ADHD scales had a similar percentage of hit rate, high specificity and low sensitivity. Especially, the DSM-oriented ADHD scale revealed higher specificity than the attention problems scale. The results of this study suggested that the five scales related to attention of the K-CBCL 6-18 are useful in diagnosing ADHD in child welfare institutions.

The Study For Clinical Measurement of Pain (통증(痛症)의 임상적평가법(臨床的評價法)에 관한 고찰(考察))

  • Shin, Seung-Uoo;Chung, Seok-Hee;Lee, Jong-Soo;Shin, Hyun-Dae;Kim, Sung-Soo
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.25-46
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    • 2000
  • Pain can be evaluated by experimental methods and clinical methods, but due to subjective characteristics of pain, clinical methods are generally used. The clinical pain measurement tools are divided into unidimensional and multidimensional assessment tools. The former include Visual Analogue Scale, Verbal Rating Scale, Numerical Rating Scale, Pain Faces Scale, and Poker Chip Tool and the latter include McGill Pain Questionnaire, MMPI, Pain Behavior Scale, Pain disability index, and Pain Rating Scale. Unidimensional pain scales mainly measure the intensity of pain on the basis of the patient's self report and their simple construction and ease of use enable the invesgator to assess acute pain. Multidimensional pain scales are used to evaluate subjective, psychological and behavioral aspects of pain and because of its comprehensive and confidential properties they are applied to chronic pain. Patient's linguistic and cognitive abilities are major factors to restrain accurate assessment of pain. Although behavioral patterns and vital sign are inferior to self-report in the measurement of pain, they can be useful indexes in those situations. When deciding on a pain-assessment tool, the investigator must determine which aspect of pain he or she wishes to evaluate on the characteristics of the group of patients, their backgrounds, and their communication skills. Making the proper choice will facilitate the acquisition of meaningful data and the formulation of valid conclusions.

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A study of facial nerve grading system (구안와사(口眼喎斜)의 평가방법(評價方法)에 대한 고찰(考察))

  • Kim, Jong-In;Koh, Hyung-Kyun;Kim, Chang-Hwan
    • Journal of Acupuncture Research
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    • v.18 no.2
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    • pp.1-17
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    • 2001
  • Background and Objetive : Lack of uniformity in reporting facial nerve recovery in patients with facial nerve paralysis has been a major disadvantage in comparing treatment modalities. The objective evaluation of facial nerve function is a complex procedure. The House and Brackmann grading system, the Yanagihara grading system has been recommend as a universal standard for assessing the degree of facial nerve palsy. However, clinical studies for treatment of facial palsy have rarely used this universal standard in oriental medicine. That is the reason for analysing this facial nerve grading system. Material and Method : We choose 10 scales reported from 1955 till 1995. These facial nerve grading systems may be classified as Gross system, Regional system and Specific system. Result and Conculsion : The scales of Botmann and Jonkees, May, Peitersen, and House and Brackmann are the gross facial nerve grading systems with which we grossly assess the facial motor dysfunction and the secondary defect. Among these scales, H-B scale is the most widespred The scales of Yanagihara(若杉文吉), Smith, Adour and Swanson, Jassen, FEMA are the regional facial nerve grading system in which we weight, or unweight the facial motor dysfunction and the secondary defect. For example, the scales of Yanagihara(若杉文吉) and Smith are the unweighted regional scale, the scale of Adour and Swanson, Jassen, FEMA are the weighted regional grading system. The scale of Stennert is the Specific facial nerve grading system in which we respectively assess the grade of facial dysfunction at rest, in motion and the secondary defect. For the objective evaluation of the oriental medicine treatment for facial palsy, we must use the universal standard scale, i.e. the H-B scale, the Yanagihara scale.

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The effect of plaque control (tooth brushing instruction) for oral health improvement on periodontitis patients (치주질환자 구강관리능력 향상을 위한 치면세균막관리(잇솔질교육)에 관한 연구)

  • Kim, Seol-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.2
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    • pp.293-301
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    • 2011
  • Objectives : The aim of the trial was to study the effect of plaque control(tooth brushing instruction) for oral health improvement on periodontitis patients. Methods : 30 patients(35~65 years) with advanced periodontal disease were subjected to a baseline examination including assessment of oral hygiene status(O'leary index), gingival condition(bleeding). the assessment were repeated after 2, 4, 6 weeks. cognitive, behavioral and clinical outcomes were assessed in the primary care setting by questionnaire and clinical oral examination. Results : The oral hygiene status expressed as the individual mean percentage of tooth surfaces with plaque 59.3% at baseline and 21.2% after 6 weeks(p<0.001). The gingival bleeding status expressed as the individual mean point of interdental papilla 3.8 at baseline and 1.9 after 6 weeks(p<0.001). Also, the patients self-assessment about correct tooth brushing behavior was 3.9(5-point likert scales), satisfaction of plan practices 4.1(5-point likert scales), efficacy of tooth brushing instruction 8.7(10-point likert scales). Patients wanted to continuous participation. Conclusions : A verification of effect after individualized oral health instruction and repeated dental plaque control represented to significance on plaque control score, oral care practice and oral health recognition. The important oral care step against periodontal disease is to establish good oral health habits. Also, oral health behavior recognition is more important for the practice of oral health. Therefore professional plaque control and tooth brushing instruction absolutely need in improving oral health.

A Study on the Characteristics of MMPI Profile and Personality in Patients with Hwa-byung (화병환자의 MMPI 프로파일과 성격특성 연구)

  • Kim, Ji-Hwon;Park, Bo-Ra;Jang, Hyun-Ho;Kim, Tae-Heon;Lyu, Yeoung-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.3
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    • pp.189-203
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    • 2009
  • Objectives : This study was to analyze characteristics of MMPI profile, personality and defensive mechanism on 32 Hwa-byeng patients. Methods : 32 Hwa-byeng patients and 28 normal control group were administered the MMPI. The characteristics of MMPI profile and the clinical scales of personality and defensive mechanism were analyzed statistically. Results : 1. Half of female Hwa-byeng patients are in their forties, twelve patients are high school graduates, housewives seem to have Hwa-byeng more than workers, and married ones have Hwa-byeng more than singles, divorcees or separated one 2. 60.6% patients are getting stressed from their husbands(the specific reasons are infidelity(55%), incapability(25%) and violence(20%)). And the rest are from in-law(28.8%), children(6.4%) and their own parents(3.2%). 3. MMPI profile of Hwa-byeng patients appeared as a type of 3-1 elevated by the scale of 3(Hy) and 1 (Hs). And Hwa-byeng patients appeared significantly high in the rest of scales except L, K, Mf and Ma scales comparing to control group. 4. Hwa-byeng patients were classified into 3 groups. First group is "V" type which is high in K scale and low in 3 (Hy), 4(Pd), 6(Pa). Second group is "V" type which is high in K scale and high in 3(Hy), 4(Pd), 6(Pa). Third group is high in F scale and high in 1(Hs), Z(D), 3(Hy), 4(Pd), 6(Pa), 7(Pt), 8(Sc) and 0(Si). 5. The analysis on MMPI profiles indicates that the thirties are highier in F scale than the fifties, the fifties are highier in Hy scale than the forties, workers are highier in Pd scale than housewives, singles or divorcees are highier in Pa scale than the married. 6. The characteristics of personality in Hwa-byeng patients are as follows. They are significantly lower in HST, NAR and very higher in CPS, PAG, DEP, STY, AVD, SZD comparing to control group. Especially in AVD and SZD scales are appeared the highest.

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Mapping Items of Functioning Questionnaires into the International Classification of Functioning, Disability and Health: Stroke

  • Song, Ju-Min;Lee, Hae-Jung
    • The Journal of Korean Physical Therapy
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    • v.28 no.5
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    • pp.341-347
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    • 2016
  • Purpose: The aim of the study was to investigate items of commonly used questionnaires that measure functioning status of persons with stroke and map to the International Classification of Functioning, Disability and Health (ICF). Methods: Eighty-six patients with stroke were recruited from 12 medical institutes for the study. Each item of the Modified Bathel Index (MBI), Stroke Impact Scale (SIS), Mini Mental Status Evaluation (MMSE) and SF-36 were examined and compared its concept with the ICF. Concept linking was performed by 10 health professionals independently. A field test was performed to assess its correlation between those of scales and their linked ICF category sets. Results: It was found that 11 items in MBI was linked to 14 ICF categories, whereas 27 items of MMSE had 10 categories of ICF linked. 60 items of SIS were to be linked with 35 ICF categories. Agreement between professionals in linking was found to be high: 97.5% for MBI items, 78.0%, 78.0%, and 74.8% for MMSE, SIS, and SF-36 respectively. Strong relationship was observed between measurement scales and linked ICF code sets (r=-0.76 for SIS, r=-0.78 for MBI, r=-0.47 for MMSE) whereas there was no relationship was found between SF-36 and its ICF code set (r=-0.06) from the field test. Conclusion: It was found that items of SIS, MMSE and MBI may be linked to ICF categories. Those of linking concept between clinical tools and the ICF could be helpful for clinical data standardization.

The Refinement Project of Health Insurance Relative Value Scales: Results and Limits (건강보험 상대가치 개정 연구의 성과와 한계)

  • Kang, Gil-Won;Lee, Choong-Sup
    • Health Policy and Management
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    • v.17 no.3
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    • pp.1-25
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    • 2007
  • Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

A Qualitative Meta-analysis on Oriental Medicine Clinical Research for Stroke (뇌졸중에 관한 한의학 임상연구의 질적 메타분석)

  • 진수희;임사비나;박히준;이성국
    • The Journal of Korean Medicine
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    • v.24 no.2
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    • pp.47-58
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    • 2003
  • The purpose of this study was to integrate the therapeutic effects of Oriental medicine for stroke in clinical research published in Korea from 1991 to 2000. In the preliminary study, clinical studies on Oriental medical therapy for stroke in Korea were collected. Since it was inadequate to integrate the results of the papers, qualitative meta-analysis was conducted on them. In age distribution of occurrence, the most frequent age was sixties followed by seventies, fifties, forties, and thirties. Sample size was minimum 42 persons, maximum 473 persons. Papers including single therapy were noted in 50.1 %. Among those, herbal medicine was noted in 30%, while acupuncture, physical treatment, and moxibustion was noted in 6.7%. Including more than two therapies were noted in 49.1 %, Among those, herbal medicine was noted in 80%, acupuncture in 20%, physical treatment in 13%, western and oriental medicine in 30%. Papers including control group were noted in 13% and description of scale for the evaluation of treatment effect was 80%. Papers including objectification of scales for the evaluation of therapeutic effects were noted in 26.7% and described follow-up period were noted in 13%. Papers including statistical analysis were noted in 26.7% and calculated p-value was noted in. 13.3%. Papers including design of longitudinal study were noted in 86.7%. Case-control studies were noted in 13.3%. Randomization and blinding were noted in each 0%. These results suggest that followings are required for the improvement of quality of clinical research in Oriental medicine; obvious description of treatment method, objectification of scales for the evaluation of therapeutic effects, adequate research design, randomization and blinding.

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Clinical Characteristics of Formal Thought Disorder in Schizophrenia (조현병에서 형식적 사고장애의 임상적 특성)

  • Yang, Chaeyoung;Kim, Han-sung;Kim, Eunkyung;Kim, Il Bin;Park, Seon-Cheol;Choi, Joonho
    • Korean Journal of Biological Psychiatry
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    • v.28 no.2
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    • pp.70-77
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    • 2021
  • Objectives Our study aimed to present the distinctive correlates of formal thought disorder in patients with schizophrenia, using the Clinical Language Disorder Rating Scale (CLANG). Methods We compared clinical characteristics between schizophrenia patients with (n = 84) and without (n = 82) formal thought disorder. Psychometric scales including the CLANG, the Brief Psychiatric Rating Scale (BPRS), the Young Mania Rating Scale (YMRS), the Calgery Depression Scale for Schizophrenia (CDSS) and the Word Fluency Test (WFT) were used. Results After adjusting the effects of age, sex and total scores on the BPRS, YMRS and WFT, the subjects with disorganized speech presented significantly higher score on the abnormal syntax (p = 0.009), lack of semantic association (p = 0.005), discourse failure (p < 0.0001), pragmatics disorder (p = 0.001), dysarthria (p < 0.0001), and paraphasic error (p = 0.005) items than those without formal thought disorder. With defining the mentioned item scores as covariates, binary logistic regression model predicted that discourse failure (adjusted odds ratio [aOR] = 5.88, p < 0.0001) and pragmatics disorder (aOR = 2.17, p = 0.04) were distinctive correlates of formal thought disorder in patients with schizophrenia. Conclusions This study conducted Clinician Rated Dimensions of Psychosis Symptom Severity (CRDPSS) and CLANG scales on 166 hospitalized schizophrenia patients to explore the sub-items of the CLANG scale independently related to formal thought disorders in schizophrenia patients. Discourse failure and pragmatics disorder might be used as the distinctive indexes for formal thought disorder in patients with schizophrenia.

Study on the Validity of Surface Electromyography as Assessment Tools for Facial Nerve Palsy

  • Ryu, Hye-Min;Lee, Seung-Jeong;Park, Eun-Jin;Kim, Su-Gyeong;Kim, Kyeong Han;Choi, Yoo Min;Kim, Jong Uk;Song, Beom Yong;Kim, Cheol Hong;Yoon, Hyun-Min;Yook, Tae-Han
    • Journal of Pharmacopuncture
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    • v.21 no.4
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    • pp.258-267
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    • 2018
  • Objectives: The purpose of this study was to find out validity of Surface Electromyography(sEMG) compared with Nerve Conduction Study and clinical assessment scale as assessment factors for facial palsy. Methods: We investigated 50 cases of patients with peripheral facial palsy who had records of sEMG and NCS to check. Then we analyzed the correlation between sEMG and NCS that carried out around 1 week after onset. And we analyzed the correlation between sEMG and clinical assessment scales that were measured three times around 1 week, 3-4 weeks and 5-6 weeks after onset. Clinical assessment scales used in this study were House-brackmann grade, Yanagihara unweighted grading scale and Sunnybrook facial grading system. We used Pearson's correlation for statistical analysis. Results: sEMG and NCS, measured at similar times, were statistically correlated. Especially, the correlation with the forehead region was high. And sEMG and clinical assessment scale, measured at same time, were statistically correlated, especially after 5 weeks from onset. Conclusion: According to this study, sEMG is expected to be useful to assessment facial palsy.