• Title/Summary/Keyword: decision of treatment

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Patients' and parents' concerns and decisions about orthodontic treatment

  • Kazanci, Fatih;Aydogan, Cihan;Alkan, Ozer
    • The korean journal of orthodontics
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    • v.46 no.1
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    • pp.20-26
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    • 2016
  • Objective: Patients' and parents' expectations are important in orthodontic treatment decision making. The literature generally demonstrates the perceived benefits of orthodontic treatment, but patients' and their parents' concerns about orthodontic treatment have not been investigated comprehensively. The aim of this study was to identify patients' and parents' concerns about orthodontic treatment and compare them according to sex, age, and treatment demand level. Methods: One hundred and eighty-nine children and their parents were interviewed about concerns related to orthodontic treatment. Patients and parents were asked about orthodontic treatment decisions. Answers were recorded as "yes," "no," or "don't know." Chi-squared and Fisher's exact tests were used to compare concerns between age groups, sexes, and treatment demand levels. Kappa statistics were used to assess agreement between patients and their parents. Results: Concerns about orthodontic treatment were gathered under 10 items as follows: "feeling pain," "the appearance of braces," "being teased," "avoiding smiling," "speech problems," "dietary changes," "problems with transportation," "economic problems," "long treatment duration," and "missing school." There was no statistically significant difference in concerns between the sexes or age groups. Some concern items and treatment demand were inversely related in patients. Conclusions: The results of this study demonstrate patients' and parents' concerns about orthodontic treatment. Differences between the concerns of patients with different treatment demands imply that children might reject orthodontic treatment because of their concerns. Appropriate consultation of patients addressing their concerns may help reduce anxiety and improve the acceptance of treatment.

Proposal of East-West Integrative Medicine Manual for Mild Cognitive Impairment in a Korean Medicine Hospital (일개 한의의료기관 내 경도인지장애의 의한협진 매뉴얼 제안)

  • Kim, Bomin;Jo, Hee-Guen;Kang, Hyung-Won;Choi, Sung-Youl;Song, Min-Yeong;Sul, Jae-Uk;Leem, Jungtae;Lee, Ga-Won;Son, Sung-Eun
    • Journal of Oriental Neuropsychiatry
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    • v.29 no.4
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    • pp.239-253
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    • 2018
  • Objectives: This is one of the manuals of East-West integrative medicine, which was created by the Committee on integrative medicine of Chung-Yeon Korean Medicine Hospital. To support clinical decision making and communication in the East-West cooperative treatment of mild cognitive impairment. Methods: Drafting was based on literature review from the MEDLINE, EMBASE, OASIS, and CNKI databases using search terms such as 'mild cognitive impairment', 'mild neurocognitive disorder', 'acupuncture', 'herbal medicine' and 'traditional Chinese medicine'. An amendment reflecting the goal of consultation and detailed treatment contents was made by reviewing the draft and holding discussion with the rehabilitation specialist of western medicine. The committee then agreed to adopt the manual through the process of review and feedback in addition to face-to-face discussions. Results: This manual contains the diagnosis of mild cognitive impairment, the goal of consultation, and the cooperative treatment contents of the East-West medicine for mild cognitive impairment. Conclusions: This manual provides significant information about the decision making process and contents of treatment in one medical institution for East-West cooperative treatment of mild cognitive impairment.

Treatment decision for cancer patients with fever during the coronavirus disease 2019 (COVID-19) pandemic

  • Lee, In Hee;Koh, Sung Ae;Lee, Soo Jung;Lee, Sun Ah;Cho, Yoon Young;Lee, Ji Yeon;Kim, Jin Young
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.344-349
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    • 2021
  • Background: Cancer patients have been disproportionally affected by the coronavirus disease 2019 (COVID-19) pandemic, with high rates of severe outcomes and mortality. Fever is the most common symptom in COVID-19 patients. During the COVID-19 pandemic, physicians may have difficulty in determining the cause of fever (COVID-19, another infection, or cancer fever) in cancer patients. Furthermore, there are no specific guidelines for managing cancer patients with fever during the COVID-19 pandemic. Thus, this study evaluated the clinical characteristics and outcomes of cancer patients with fever during the COVID-19 pandemic. Methods: This study retrospectively reviewed the medical records of 328 cancer patients with COVID-19 symptoms (fever) admitted to five hospitals in Daegu, Korea from January to October 2020. We obtained data on demographics, clinical manifestations, laboratory test results, chest computed tomography images, cancer history, cancer treatment, and outcomes of all enrolled patients from electronic medical records. Results: The most common COVID-19-like symptoms were fever (n=256, 78%). Among 256 patients with fever, only three (1.2%) were diagnosed with COVID-19. Most patients (253, 98.8%) with fever were not diagnosed with COVID-19. The most common solid malignancies were lung cancer (65, 19.8%) and hepatobiliary cancer (61, 18.6%). Twenty patients with fever experienced a delay in receiving cancer treatment. Eighteen patients discontinued active cancer treatment because of fever. Major events during the treatment delay period included death (2.7%), cancer progression (1.5%), and major organ dysfunction (2.7%). Conclusion: Considering that only 0.9% of patients tested for COVID-19 were positive, screening for COVID-19 in cancer patients with fever should be based on the physician's clinical decision, and patients might not be routinely tested.

An Implementation Analysis of the National Health Insurance Coverage Expansion Policy in Korea: Application of the Winter Implementation Model (건강보험 보장성 확대정책의 집행분석: Winter의 정책집행모형의 적용)

  • You, Sooyeon;Kang, Minah;Kwon, Soonman
    • Health Policy and Management
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    • v.24 no.3
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    • pp.205-218
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    • 2014
  • Background: Most studies on the national health insurance benefit expansion policy have focused on policy tools or decision-making process. Hence there was not enough understanding on how policies are actually implemented within the specific policy context in Korea which has a national mandatory health insurance system with a dominant proportion of private providers. The main objectives of this study is to understand the implementation process of the benefit coverage expansion policy. Unlike other implementation studies, we tried to examine both the process of implementation and decision making and how they interact with each other. Methods: Interviews were conducted with the ex-members of the Health Insurance Policy Review Committee. Medical doctors who implement the policy at the 'street-level' were also interviewed. To figure out major variables and the degree of their influences, the data were analyzed with Winter's Policy Implementation Model which integrates the decision making and implementation phases. Results: As predicted by the Winter model, problems in the decision making phase, such as conflicts among the members of committee, lack of applicable causal theories application of highly symbolic activities, and limited attention of citizen to the issue are key variables that cause the 'implementation failure.' In the implementation phase, hospitals' own financial interests and practitioners' dependence on the hospitals' guidance were barriers to meeting the policy goals of providing a better coverage for patients. Patients, the target group, tend to prefer physicians who prescribe more treatment and medicine. To note, 'fixers' who can link and fill the gap between the decision-makers and implementers were not present. Conclusion: For achieving the policy goal of providing a better and more coverage to patients, the critical roles of medical providers as street-level implementers should be noted. Also decision making process of benefit package expansion policy should incorporate its influence on the implementation phase.

The Development and the Effectiveness of a Career Group Counseling Program for Career Maturity, Career-Identity, and Career-Decision Self-Efficacy in High School Students (청소년의 진로성숙도와 진로정체감 및 진로결정 자기효능감 증진을 위한 진로 집단상담 프로그램의 개발과 효과)

  • Kim, Sarah Hyoung-Sun
    • Korean Journal of Child Studies
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    • v.34 no.5
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    • pp.43-59
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    • 2013
  • The purpose of this study was to develop a Career Group Counseling Program to increase the career maturity, career-identity and career-decision self-efficacy of high school students, and to examine the effectiveness of such a program. In order to evaluate the effectiveness of the program thus developed, an experimental group which was exposed to the program and a control group without exposure to the program were compared. The program was administered over eight weekly sessions, each session lasting ninety minutes. The subjects in this study consisted of twenty four students. The experimental group and a control group were organized with twelve students in each. For the purpose of data processing, SPSS 16.0 was used to analyze the statistical results. The Career Maturity Scale, the Identity Scale, and Career Decision-Making Self-Efficacy Scale were used in a pre-test, post-test, and follow-up test. The findings of this study were as follows : The treatment group exhibited a significant statistically increasing degree of career maturity, career-identity and career-decision self-efficacy levels in comparison to the control group. The results of the study indicated the effectiveness of this newly developed Career Group Counseling Program on increasing career maturity, career-identity and career-decision self-efficacy levels.

A Study on the Mediating Effect of Patient Activation between Trust in Healthcare Professionals and Shared Decision Making in Diabetic Patients (당뇨병 환자의 의료진 신뢰와 공유의사결정의 관계에서 환자활성화의 조절효과)

  • Jeong, Miri
    • Journal of the Korea Convergence Society
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    • v.12 no.9
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    • pp.361-371
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    • 2021
  • This study aims to identify the moderating effect of patient activation in relation between trust in healthcare professionals and shared decision making in patients with diabetes mellitus. The participants were 186 patients who received treatment for diabetes at the department of endocrinology in the tertiary hospital located in Daejeon and consented to participate in our survey. The results of this study were a significant interaction between trust in healthcare professionals(β=0.32, p=.045) and patient activation(β=0.32, p=.024) was associated with shared decision making. The patient activation had a moderating effect between trust in healthcare professionals and shared decision making in patients with diabetes mellitus(β=0.25, p=.019). Therefore, it is necessary to assess trust in healthcare professionals to improve negative awareness of healthcare professionals and strengthen trust in them. In addition, to promote participation in shared decision making, it is necessary to develop a convergent program to focus patient activation.

Development a Multi-Criteria Spatial Decision Support System(MC-SDSS) for Analyzing the Suitability of Waste Landfill Sites (다기준-공간의사결정 지원시스템(MC-SDSS)의 구축과 활용 -폐기물 매립시설 입지분석을 중심으로-)

  • 오규식;권오경
    • Spatial Information Research
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    • v.9 no.2
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    • pp.227-238
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    • 2001
  • As society progresses and becomes more complicated, improvements and demanded in the quality of life according to various interest groups. In relation to environment concerns, waste landfill sites in particular have been of concern. Conflicts involving treatment of such sites and decision making policies have been a point of contention between local governments, residents, and concerned organizations. To resolve these conflicts, this study developed the Multi-Criteria Spatial Decision Support System (MC-SDSS). The results of the case study revealed several conclusions; first, the approach used in this study can help to yield a better consensus for deciding upon waste landfill sites; next, by conducing sensitivity analysis, technical errors which can occur during the decision making process can be minimized; and finally, resistance from specific opposition groups can be effectively dealt with by using MC-SDSS.

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상악 측절치가 유실된 증례의 임상적 고찰과 치험일례

  • Lee, Gi-Soo;Yong, Yeol-Il
    • The Journal of the Korean dental association
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    • v.18 no.8 s.137
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    • pp.639-644
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    • 1980
  • In cases with maxillary lateral incisor missing, the problems were usually treated by the choice between space opening for prosthetic lateral incisor replacement and space closure with cuspid sub stitution for the alteral insicors. The decision of the choice could be perplexing in evaluation of the individual case. Therefore, various diagnostic criteria, such as occlusion, dental esthetics, canine position and inclination, tooth size relationship, maxillary lip length, and skeletal relation had to be evaluated. On the basis of this diagnostic information, the treatment planning could be established. A case was shown to illustrate the treatment of patient with congenitally maxillary lateral incisor missing.

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Quality Assurance for Radiation Oncology (치료방사선과 영역의 적정관리)

  • Kim, Gwi-Eon
    • Quality Improvement in Health Care
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    • v.2 no.1
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    • pp.110-117
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    • 1995
  • The Comprehensive quality assurance for radiation oncology provides an overall organizational structures, responsibilities, procedures, processes and resources for assuring the quality of patient management by radiation treatment. Superior performance of modern radiotherapy equipment will be essential part of quality assurance in radiation oncology, which high degree of accuracy and consistency should be maintained under the optimal quality assurance program. Besides quality control of all radiation equipment, this review also emphasizes quality assurance of clinical aspect such as adequacy of the medical decision-making which eventually leads to the treatment prescription, accuracy of treatment procedure from treatment preparation to radiation delivery, and the significance of assessment of treatment outcomes with structure and process.

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