• 제목/요약/키워드: medical interview

검색결과 726건 처리시간 0.028초

한의 개인건강기록 플랫폼 구축에 관한 연구 (Study on Korean Medicine Personal Health Record Platform)

  • 서진순;김안나;김상현;이승호;남보령;이명구;장현철
    • 동의생리병리학회지
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    • 제30권6호
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    • pp.458-465
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    • 2016
  • The information relating to the health of person has been increasing. The information is such as medical information and personal health record and the information collected by utilization and dissemination of mobile devices. Therefore, the interest and demand for systems that can integrate and manage the Personal Health Record(PHR) is increasing. Quantity and quality of information that is collected from the patient can have a major impact on the diagnosis and treatment of Korean Medicine(KM) in clinical practice. Because closely observe the usual clinical symptoms of patients to utilize the treatment. But if the interview when memories are not sure of the correct answer does not get much easier to find exactly the symptoms. So when recording original symptom(素證) and daily subjective symptom can be helpful for care. Therefore, the personal health care services that can record and manage and own is necessary based on KM. In this paper, we propose Korean Medicine Personal Health Record Platform(KM PHR Platform). We have selected the significant symptoms that mean to the personal records from symptom information required for diagnosis in KM. And classifying and scoring as the symptoms were used as personal health care indicators. And significant symptoms were easily configure a screen that can be recorded. simple operation is recorded as a symptom. It was designed to reflect these functions. So KM PHR Platform helps to Personal health care. Doctor may be able to help in the diagnosis and prognosis observation by reference to shared symptom. We look forward to a variety of health services based on KM using a symptom, a medical record, personal health device information.

뇌졸중에 영향을 미치는 생활습관 요인 -흡연, 음주, 비만, 식습관을 중심으로- (The Lifestyle Factors in Stroke Etiology: Smoking, Alcohol Consumption, Obesity, Perception of Saltness)

  • 원종임;오희철
    • 한국전문물리치료학회지
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    • 제6권3호
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    • pp.82-93
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    • 1999
  • Stroke is a serious disease despite recent improvement in medical and surgical treatment. Hence, identification of modifiable risk factors for stroke is important. This case-control study was done to demonstrate that relationship between smoking, alcohol consumption, obesity, perception of saltness and the incidence of stroke and to identify that smoking, alcohol consumption, obesity and perception of saltness, after adjusting for age, hypertension. A structured interview was carried out from April 15, 1996 to May 3, 1996 in Yonsei Medical Center. The study group consisted of 59 neurologically confirmed stroke patients as the study group and 59 non-stroke patients as controls. Analysis of the data was done by means of ${\chi}^2$-test and logistic regression analysis. The results were as follows. In the study group: 1) Hypertension in males had a 10.2 odds ratio (p<0.05), cardiovascular disease in females had a 11.3 odds ratio (p<0.05) and a farnily history of stroke in males had a 3.1 odds ratio (p<0.05). 2) Females smoking one or more cigarettes had a 8.3 odds ratio (p<0.1), but males had no direct relationship with odds ratio of 1.5 (non-significant). 3) Alcohol consumption in males had a 0.4 odds ratio, and in females had a 0.8 odds ratio. The odds ratio was decreased in alcohol consumption group (non-significant). 4) Males with more than 20 cigarettes pack-years history had a 2.5 odds ratio (p<0.05), more than 25 Body Mass Index had a 3.1 odds ratio (p<0.05) and more than 220 ml ethanol weekly consumption had a 1.5 odds ratio (non-significant). 5) Female smokers had a 8.3 odds ratio (p<0.1), drinkers a 0.8 odds ratio and more than 25 Body Mass Iidex, a 43.1 odds ratio (p<0.05). 6) Females without saltness perception from a 0.5% salt solution had a 6.8 odds ratio (non-significant). 7) By logistic regression analysis independent risk factors for stroke in males were found to be hypertention, age, and obesity. The study was limited because number of subjects was too small for practical implications. However, like as other results, this study suggest that people should be advised to control hypertension, and obesity since these carry a risk of stroke.

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모비키즈: 통신전자파 노출과 어린이청소년의 뇌종양에 관한 환자 -대조군 연구 프로토콜 (Mobi-kids: A Case-control Study Protocol on Electromagnetic Field Radiation Exposure from Telecommunication and Brain Tumors in Children and Adolescents)

  • 최경화;김동석;이정일;나영신;피지훈;안영환;권종화;이애경;최형도;하미나
    • 한국환경보건학회지
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    • 제41권3호
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    • pp.182-190
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    • 2015
  • Objectives: To introduce a protocol of Mobi-kids study which was aimed to examine an association between radiofrequency (RF) radiation exposure by mobile phone use and brain tumor risk in children and adolescents. Methods: The Mobi-kids study was a multinational matched case control study using a standardized protocol with the number of subjects targeted about 1,000 cases and 2,000 controls aged 10 to 24. In Mobi-Kids Korea, the source population was restricted to Seoul, Incheon, and Gyeonggi-do province. Eligible cases of primary brain tumor (glioma, meningioma, and others) were diagnosed from January 2012 to June 2015. Eligible controls were appendicitis patients operated during the study period. Two controls were matched on age, gender, and study region for 1 case. Information about pattern and history of mobile phone use and other covariates were obtained by face to face interview by trained interviewer. The Mobi-kids study has been involved in Mobi-expo as a validation study about mobile phone use, XGridmaster to localize tumor in the brain for RF energy calculation, and histological review for validation of diagnosis. Results: The Mobi-kids was the first and largest study in children and adolescents to estimate risk of brain tumor in association with the RF energy absorption in the brain estimated by mobile phone use. Forty-six-cases and 54 controls were collected as of September 2014 in Korea. Conclusions: The meaningful results of the study were expected because of the largest sample size, high validity of EMF exposure assessment as well as the susceptible study populationof children and adolescents.

경련과 자연발생 엽상뇌출혈의 임상적연구 (A Clinical Study on the Seizure and Spontaneous Lobar Intracerebral Hemorrhage)

  • 유성동;손은희;권도형;김태우;정기영;김재문
    • Annals of Clinical Neurophysiology
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    • 제4권1호
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    • pp.16-20
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    • 2002
  • Background and Objective : Epileptic seizures are frequent complication of lobar hemorrhage. We investigated the factors affecting development of epilepsy following spontaneous lobar ICH. Methods : From January 1986 to July 1999, 114 patients were admitted to Chungnam National University Hospital with spontaneous lobar ICH. We analyzed 75 patients. Excluded were no follow-up(8 patients) and patients died within few days(31 patients). All the patient was followed up at least two years aside from two patients who underwent epileptic seizure and died five and eight months later each. Medical history was obtained through medical record and by telephone interview. Statistical analyses were performed using Chi-square test, Student's t - test, Fisher's exact test. Results : Seizure occurred in 19 patients. As three patients had previous history of seizures, 16 patients(22.2%) showed first onset early- and late-seizures. Early seizure occurred in 14 patients(19.4%). Three out of 14 were heavy alcoholics. Five patients developed late recurrent seizure 61 days to 800 days after the early seizure. Late seizure with no acute seizure occurred in two patients. The types of seizure were diverse as generalized tonic clonic seizure(10), partial seizure with secondary generalization(5), and complex partial seizure(1). The common risk factors for lobar ICH were hypertension(HT), arteriovenous malformation(AVM), and excessive use of alcohol. We could not find any causes in 23 patients. Although size of hematoma, age of onset, sex, incidence of HT or AVM were not different between patients with seizure and without seizure, the history of excessive alcohol drinking was more frequent in patients with seizure. Five patients with late recurrent seizure had ICH involving temporal area. Conclusions : This study suggests that the risk of seizure in patients with lobar ICH was increase in chronic alcoholics and patient with late recurrent seizure had ICH frequently involving temporal area.

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모유수유 저해요인에 대한 산모와 신생아실 간호사간의 인식정도 비교 연구 (A Comparative Study on the Perception of the Impediment Factors between Mothers and Nurses in Nursery)

  • 이미자
    • 여성건강간호학회지
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    • 제1권1호
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    • pp.138-152
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    • 1995
  • The condition of nutrition during infancy will greatly affect infants' physical, emotional growth, especially breast feeding is important in their growth and development, and emotional stability, too. Despite such advantages of breast-feeding, its rate has continued to fall year after year in Korea : the 95% rate in 1960's has fallen to 25.4% in 1990. It is known that such a downfall of breast-feeding rate is associated with various factors. The purpose of the study is to examine mother's and nurses' in nursery perception of the impediment factors of breast-feeding : to compare those between of breast-feeding : to compare those between two groups : to provide fundamental data for developing strategies for increasing breast-feeding. The subjects were 45 new mothers from one hospital and the same number of nurses sampled from 3 university hospitals, in Seoul. The data were collected for 11 days from April 12 to April 23, 1994 and a questionnaire was developed based on the interview with 14 nurses and 10 mothers and the literature reviews. Liker's Five-Point Scale was used as measurement. The Data were analyzed using SPSS / PC and descriptive statistics, t-test, ANOVA. The results of study are as follows : 1) Most new mothers get the information about breast-feeding from their mothers, books or newspaper, and relatives in rank than professionals(nurses or doctors). 2) The impediment factors the breast-feeding are categorized as mothers, hospital system, medical personnels and social factors. The most frequently mentioned impediment factors from mothers are 'Difficulty by operational wounds'(3.13), 'Lack of will for breast-feeding'(3.47), 'Insufficient rest and sleep'(3.52) and 'Opposition from husband or his family members'(4.77)in rank. On the other hand those factors from nurses are 'Inadequate nipple condition'(2.37), 'Decreasing milk secretion given medicine after operation'(2.63), 'Mothers knowledge deficit by poorly prepared education'(2.79) and 'Mothers abhorance of breast-feeing'(3.87) in rank. 3) As for the hospital system, the highly perceived impediment factors by mothers are 'Seperation of baby from mother after birth'(2.78), 'Lack of space for breast-feeding in the hospital'(2.93), 'Lack of facility for informing the time for breast-feeding'(3.18) and 'Because of babys' preference artificial nipple by being accustomed to it in hospital(3.97), in rank. Meanwhile, those from nurses are "Seperation of baby from mother after birth",(1.92), "Inconsistency between hospital's nursing time and mother's breast secretion time" scretion time(2.97), "Lack of space for breast-feeding in the hospital"(3.39), and "Lack of facility for informing the time for breast-feeding"(3.74) 4) As for the medical personnels, the highestly perceived Impediment factor from mothers in "Lack of professional nurses for breast-feeding"(2.96), and the lowestly perceived one is "Doctors' reluctance"(4.75). Nurses perceived same as mothers, too. 5) As for the social factors, the highestly perceived impediment factor by mothers and nurses is "Inconvience of social activities"(2.83) and the lowestly ones are "The sense of self-sacrifice"(4.22) by mothers, and "The sense of old fashioned"(4.13) by nurses. 6) The difference of the perception of impediment factors between mothers and nurses is statistically significant only in mother factor.

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Risk Factors for Gallbladder Cancer in Nepal - a Case Control Study

  • Tamrakar, D;Paudel, IS;Adhikary, S;Rauniyar, B;Pokharel, PK
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3447-3453
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    • 2016
  • Background: Gall bladder cancer (GBC) is highly fatal disease with poor prognosis, with a 5 year survival rate of <10%. It is relatively rare cancer worldwide; however it is the sixth cancer and second most common gastrointestinal tract cancer in Nepalese women. The study focused on associations of certain demographic, lifestyle, dietary, and reproductive factors with gall bladder cancer. Materials and Methods: We conducted a hospital-based matched case control study on newly diagnosed cases of primary GBC at BP Koirala Institute of Health Sciences and BP Koirala Memorial Cancer Hospital. Controls were healthy non-GBC relatives of cancer patients, matched for age, sex and marital status (in case of females) with cases at a ratio of 1:2. Data were collected between April 2012-April 2013 by semi structured interview from both cases and controls. Analyses were carried out with SPSS. Conditional logistic regression was used to find odds ratios and 95% confidence intervals for bivariate and multivariate analysis. Results: A total of 50 cases and 100 controls were enrolled in this study. On bivariate analysis, factors found to be significantly associated with gallbladder cancer were illiteracy (OR=3.29, CI=1.06-10.2), history of gallstone disease (OR=27.6, CI=6.57, 115.6), current smoker (OR=2.42, CI=1.005-5.86), early menarche <13 years (OR=2.64, CI=1.09-6.44), high parity more than 3 (OR=3.12, CI=1.25,7.72), and use of mustard oil (OR=3.63, CI=1.40, 9.40). A significant protective effect was seen with high consumption of fruits at least once a week (OR=0.101, CI=0.03-0.35). On multivariate analysis, history of gallstone disease, early menarche, current smoker and high consumption of fruits persisted as significant factors. Conclusions: History of gallstone disease, cigarette smoking and early menarche were associated with increased risk of gallbladder cancer while high consumption of fruits was found to have a protective effect.

제주지역 성인의 사회적 지지와 우울 (Depression and Social Support among Adults in Jeju Province, South Korea)

  • 박은옥
    • 농촌의학ㆍ지역보건
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    • 제36권1호
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    • pp.25-35
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    • 2011
  • 본 연구는 성인의 사회적 지지와 우울 정도를 파악하고, 일반적 특성에 따라 사회적 지지와 우울 정도를 비교하며, 사회적 지지와 우울 간에 관계를 분석하여 우울에 미치는 사회적 지지의 효과를 파악함으로써, 우울 예방 및 관리를 위한 기초 자료를 제공하기 위하여 수행되었다. 본 연구의 자료는 제주특별자치도에서 지원하여 수행한 '제주도민 우울실태조사' 연구과제의 원시 자료를 이용하여 이차분석 하였으며, 연구대상은 제주지역에서 계층적 무작위 집락 표출법을 이용하여 선정한 750가구의 성인이었으며, 24명의 훈련된 조사원이 2007년 11월부터 12월까지 가구면접조사를 통해 수집한 1,155명의 자료를 분석하였다. 우울은 The Center for Epidemiologic Studies Depression (CES-D)를 이용하였고, 사회적 지지는 The Medical Outcomes Study (MOS) Social Support Survey 도구를 이용하였다. 연구결과, 우울은 평균 11.35점이었고. 사회적 지지는 평균 75.53점이었다. 주관적 건강수준이 낮을수록, 스트레스가 높을 수록, 학력이 낮을수록, 결혼상태가 미혼이거나 배우자가 있는 경우보다 이혼 및 사별인 경우, 사회경제적 수준이 낮을수록, 종교가 없는 경우 우울 정도는 더 높은 것으로 나타났다. 이 여섯개의 독립변수가 설명하는 변량은 29.8%였고, 회귀모형은 유의하였다. 사회적 지지가 포함되었을 때, 결혼상태, 사회경제적 수준, 종교는 유의하지 않았고, 사회적 지지와 주관적 건강수준, 스트레스, 교육수준은 우울에 유의한 영향을 주는 것으로 나타났으며, 이 회귀모형을 유의하였고, 설명되는 변량은 36.9%로 사회적 지지가 포함되지 않았을 때보다 7.4%가 증가하였다. 또한 단계적 회귀분석을 하였을 때, 사회적 지지가 설명하는 변량은 22%로 비교적 높았고, 주관적 건강수준으로 설명변량이 11.4% 증가하였고, 스트레스 인지를 추가하여 우울에 대한 설명변량이 2.7%가 증가한 것으로 나타나, 다른 변수들에 비해 사회적 지지의 설명 변량이 높은 편이었고, 회귀계수도 ${\beta}$=-.319로 비교적 큰 편이었다. 사회적 지지는 본 연구에 포함된 다른 여러 변수에 비해 우울을 가장 잘 설명해주는 요인이므로 사회적 지지 강화 프로그램을 마련하여 우울예방과 관리를 위한 하나의 전략으로 활용할 것을 제안한다.

약학교과과정의 개국약국실습 방향에 관한 연구 (The Study on Identifying the Components of Community Pharmacy Externship Based on Korean Community Pharmacists' Consensus)

  • 김성현;오정미
    • 한국임상약학회지
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    • 제9권2호
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    • pp.109-118
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    • 1999
  • The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.

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주기성 사지운동증의 운동간격이 수면구조에 미치는 영향 (Effects of Movement Intervals on Sleep Architecture in Subjects with Periodic Limb Movements during Sleep)

  • 손창호;이명희;박두흠;정도언
    • 수면정신생리
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    • 제4권2호
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    • pp.191-200
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    • 1997
  • Objectives : Periodic limb movements during sleep (PLMS) may cause arousals that may lead to non-restorative sleep. PLMS is characterized by long sleep latency, sleep fragmentation, frequent stage shifts, and rarity of stages 3/4 NREM sleep on polysomnography. However, controversies have existed and it still remains to be elaborated whether PLMS actually causes insomnia, since normal persons happen to have PLMS. Clinically, it would be crucial to know factors which might disturb sleep in PLMS. We became interested in Coleman's theory(1980) that invariant periodic movements disturb patients' sleep less. Though, Coleman's study seems to have been confounded by including PLMS patients with various co-morbid sleep disorders. Therefore, we attempted to study in patients only with PLMS the effects of movement patterns on sleep architecture. Methods : In 27 patients diagnosed as having PLMS only with clinical interview and nocturnal polysomnography, we studied the relationship between the movement patterns such as mean duration and variability of periodic limb movement's interval and the sleep architecture variables. Results : The shorter and the more regular the limb movement intervals were, the fewer arousals followed. The movement intervals of the older patients were shorter and more regular than the younger patients. The probability of the accompanying arousal with each limb movement increased as the duration and variance of the movement intervals increased. It decreased as the age and the frequency of limb movements increased. Among these factors the most significant one was the mean duration of the movement intervals. In other words, the shorter the movement intervals were, the less disturbed sleep was. Conclusion : PLMS frequency increases with aging but the probability of the accompanying arousal with each movement decreases with aging. Sleep-disturbing effects of PLMS depends more on the duration and variability of movement intervals than the PLMS frequency.

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일부 노인의 보완대체요법 이용행태와 영향요인 (Utilization Behaviour and Influencing Factors of Complementary and Alternative Medicine Therapies Among the Elderly)

  • 문기원;김준호;김춘배
    • 농촌의학ㆍ지역보건
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    • 제38권1호
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    • pp.25-38
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    • 2013
  • 이 연구목적은 일부 지역 재가 노인을 대상으로 보완대체요법 이용행태와 그 영향요인을 구명하는데 있다. 2단계 집락추출로 선정된 대구광역시와 경상남도의 2개 시 군의 노인복지시설(9개)을 이용한 60세 이상 노인 233명을 대상으로 보완대체요법 이용현황, 보완대체요법 인지 여부, 만성질환유형에 따른 이용실태 등을 파악하기 위해 교차분석 및 로지스틱 회귀분석을 실시하였다. 그 결과 조사대상 노인의 70.4%(164명)가 지난 1년간 보완대체요법 이용 경험이 있었다. CAM 종류별로 48.8%(64명)~60.7%(88명)의 노인들이 보건의료 전문가와의 상담 없이 이용하고 있었다. 보완대체요법을 인지하고 있는 경우의 이용 경험은 2 이상 높았으며, 이환된 만성질환 수가 많은 경우의 이용경험은 수기요법 5.85(95% CI 1.97-17.34), 영양요법 2.92(95% CI 1.07-7.97), 약물요법 2.92(95% CI 1.04-8.17)로 높았으며, 만성질환 중 당뇨병을 진단받은 경우의 영양요법 이용 경험은 3.76(95% CI 1.49-9.47) 높았다. 노인 만성질환관리를 위해서는 보완대체요법에 대한 명확하고 체계적인 분류, 효과 및 안전성에 대한 객관적 검증과 함께 노인들의 건강상태를 고려한 전문가 및 의료인의 보완대체요법 이용 중재가 필요하다.