• 임상간호연구
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• 제26권2호
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• pp.254-264
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• 2020

Purpose: This study was to examine the reliability and validity of the Korean version of the Cornell Assessment of Pediatric Delirium (CAPD). Methods: For testing the reliability of the Korean version of the CAPD, this study calculated the internal consistency (Cronbach's α) and the Interrater Correlation Coefficient (ICC) by comparing the independent assessment results of three nurses in Pediatric Intensive Care Unit (PICU). For testing the validity of the Korean version of the CAPD, the assessment result of the Korean version of the CAPD compared with that of the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V). Receiver Operating Characteristics (ROC) analysis was used for measuring sensitivity and specificity. Results: Overall interrater reliability of the Korean version of the CAPD, ICC was .98 (95% CI .96~.99). Cronbach's α was .91 for eight items. The concordance between the Korean version of the CAPD and psychiatrist's diagnosis was 90.0%. When the Korean version of the CAPD has the cut point of 9, sensitivity was 93.8%, and specificity was 75.0%. The area under the curve indicated by the ROC analysis was .88. Conclusion: The Korean version of the CAPD showed good reliability and validity. This tool will be useful for pediatric delirium screening and management in Korean PICU.

• Journal of Trauma and Injury
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• 제35권2호
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• pp.92-98
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• 2022

Purpose: Critically ill patients are frequently transferred from one point of care to a hospital that can provide a higher level of care. To achieve optimal treatment within the targeted window of time necessary for time-sensitive cases like major trauma, rapid transportation and decision making are essential. Transferred patients have often undergone radiologic imaging at the referring hospital. Examining these outside images is paramount. Therefore, this study was conducted to estimate the upload time of outside images. Methods: This retrospective study was conducted from January to April 2020. Patients transferred from other hospitals with digitally recorded CDs or DVDs of radiologic or diagnostic images were included. When the patients were registered at the emergency department reception desk, the digital images were transmitted to our picture archiving and communication system using transmission software. The time of upload and the numbers of digital images were recorded. The time interval from patient registration to the time of upload was calculated. Results: The median number of images was 688 in the trauma team activation (TTA) group (688 in the TTA group, 281 in the non-TTA trauma group, and 176 in the nontrauma group, respectively; P<0.001). The median upload time was 10 minutes. The longest upload time was 169 minutes. The upload time was more than 20 minutes in 12 cases (19.4%). Conclusions: Patients with major trauma bring more images than patients with other diseases. Unexpected delays (>20 minutes) were noted in approximately 20% of cases. It is necessary to minimize this time.

• 한국치위생학회지
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• 제10권6호
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• pp.1037-1048
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• 2010

Objectives : The awareness of health care need increasing attention from the public along with changing professional human-resources activity. As there are increasing social demand for the roles and professionalism of dental hygienists, the purpose of this study was to examine the job performance, creativity and organizational climate of dental hygienists by their own self-diagnostic evaluation in an attempt to help enhance their work ability. Methods : According to the data released as August 2008 by the Dental Association and public health centers in Gwangju, 735 dental hygienists worked at 425 dental clinics. The subjects in this study were 156 dental hygienists at 85 dental clinics who were selected by proportionate sampling method from among the dental hygienists. After an interview survey was conducted in person, the answer sheets from 132 respondents were analyzed except 24 incomplete ones. The questionnaire used in this study consisted of 49 items. A five-point Likert scale was used and SPSS 12.0 program was analyzed the data. Results : 1. As a result of checking the types of works, treatment cooperation(54%), and oral health education often(45%), They weren't responsible for preventive treatment(42%). 2. When they made a self-diagnostic evaluation of creativity and organizational climate, they put the highest value on their autonomy(2.21), followed by positive attitude(2.10). Out of seven organizational climate, challenging spirits(2.81) ranked highest, followed by reliability(2.66). 3. Major management eopmubyeol individual creativity compared with three business relationships and a positive attitude in the case of the high group received oral health education and care management services in a group doing the most was General office work and office assistance work in the medical assistance group that was doing business primarily. 4. In the relationship between self-assesment score and three performance duties, Positive difference was noted in the group with positive attitude and elevated autonomy in terms of performing oral health education. Conclusions : As a result, individual creativity and organization of the atmosphere, each detail, through analysis of the self-assessment model, developed guide on the investigation by doing a dental hygienist, a unique business promotion and Enlargement of the study suggested the need to be considered is.

• 대한의용생체공학회:의공학회지
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• 제30권1호
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• pp.23-33
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• 2009

It can be used easily to reduce rehabilitation and treatment time if diagnostic and therapeutic devices are attached to cloth or body. Therefore we developed neuromuscular wearable ultra-miniature lighting modules which can improve the neuromuscular function and verified its clinical effectiveness. The system is based on the ultra-miniature lighting treatment module and there are two types of systems. One of them is designed as an attached type and the other type is combined with clothing. The wearable ultra-miniature lighting module is composed of controller (battery, MCU, bidirectional transmitter and receiver), cable, treatment medium generating device and other peripheral devices. To verify the clinical effectiveness of this device, we observed the difference of the strength of a muscle before and after 650nm and 25mW laser irradiation on the reflex point for 1 to 4 seconds. Among 48 patients having the degenerative osteoarthritis, the muscle strength before and after irradiation of laser was $21.8{\pm}7.99$ and $27.3{\pm}8.43$. According to the result, the muscle strength after treatment was significantly increased (p<0.01). To whom having difficulty in visiting to OPD(Out-Patient Department), doctors medically examine the patients and find the therapeutic point, attachment of this wearable ultra-miniature lighting module can function as self treatment (treating instrument) and treatment assist at home. If doctor can remotely control the patient and take part in treatment, the therapeutic device could contribute to prevention and care device.

• 대한응급의학회지
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• 제29권6호
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• pp.663-670
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• 2018

Objective: Radio-contrast abdomino-pelvic computed tomography (APCT) is considered the gold standard diagnostic tool for an acute abdomen in the emergency department. On the other hand, APCT has a risk of contrast-induced nephropathy. Emergency physicians evaluate the creatinine (Cr) level prior to taking a APCT for the above reason but it takes time to evaluation the serum Cr level. This study hypothesized that Cr measured by a point-of-care test (POCT) can shorten the time to making clinically important decisions for patients with an acute abdomen. Methods: This prospective randomized study was conducted between March 2017 and October 2017. The subjects were divided into two groups (Cr measured by laboratory vs. Cr measured by POCT). To analyze the clinical acceptability for creatinine, agreement was demonstrated graphically by Bland-Altman plots. This study compared the time to make a clinically important decision by physicians and the length of stay at the emergency department in both groups. Results: A total of 76 patients were eligible for the study, 38 patients were assigned to each group. There was no statistically significant difference in the time to the first medical examination (P=0.222) and emergency department stay time (P=0.802). On the other hand, the time to recognition of the Cr level (P<0.001), time to performing APCT (P<0.001), time to decision making (P<0.001), and time to initiation of treatment (P<0.001) were shortened significantly in the point-of-care creatinine group. Conclusion: In this study, the POCT for creatinine can allow rapid decision making by shortening the time to performing the radio-contrast APCT than the laboratory for patients with an acute abdomen.

• 한국의료질향상학회지
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• 제4권1호
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• 보건행정학회지
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• 제33권2호
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• pp.173-184
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• 2023

Background: The coronavirus disease 2019 pandemic has been challenging the healthcare service, i.e., the vitalization of the point of care accompanying self-testing in vitro diagnostic medical devices (IVDs). This study aims to suggest priority criteria to classify self-testing IVDs using the analytic hierarchy process technique. Methods: Two dimensions of the characteristics embedded in the IVDs and the diseases to be diagnosed with self-testing IVDs were parallelly considered and independently investigated. In addition, three expert panels consisting of laboratory medical doctors (n=11), clinicians (n=10), and citizens (n=11) who have an interest in the selection of self-testing IVDs were asked to answer to questionnaires. Priorities were derived and compared among each expert panel. Results: First of all, ease of specimen collection (0.241), urgency of the situation (0.224), and simplicity of device operation (0.214) were found to be the most important criteria in light of the functional characteristics of self-testing IVDs. Medical doctors valued the ease of specimen collection, but the citizen's panel valued self-management of the disease more. Second, considering the characteristics of the diseases, the priority criteria were shown in the order of prevalence of diseases (0.421), fatality of disease (0.378), and disease with stigma (0.201). Third, medical doctors responded that self-testing IVDs were more than twice as suitable for non-communicable diseases as compared to communicable diseases (0.688 vs. 0.312), but the citizen's group responded that self-testing IVDs were slightly more suitable for infectious diseases (0.511 vs. 0.489). Conclusion: Our findings suggested that self-testing IVDs could be primarily classified as the items for diagnosis of non-communicable diseases for the purpose of self-management with easy specimen collection and simple operation of devices, taking into account the urgency of the situation as well as prevalence and fatality of the disease.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6283-6286
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• 2014

In patients with microscopic hematuria there is a need for better identification of those who are at greater risk of harbouring bladder tumors. The RisikoCheck(C) questionnaire has a strong correlation with the presence of urothelial carcinoma (UC) of the bladder and in combination with other available tests may help identify patients who require detailed clinical investigations due to increased risk of presence of bladder tumors. This study aimed to evaluate the efficacy of RisikoCheck(C) questionnaire together with NMP-22(R) (BladderChek(R)) as a point-of-care urine test in predicting the presence of bladder tumors in patients presenting with microscopic hematuria as the sole finding. In this multi-institutional prospective evaluation of 303 consecutive patients without a history of urothelial carcinoma (UC), RisikoCheck(C) risk group assessment, urinary tract imaging and cystourethroscopy as well as urine cytology and Nuclear Matrix Protein-22 (NMP-22 BladderChek) testing were performed where available. The sensitivity, specificity, negative predictive value (NPV), and positive predictive values (PPV) for the risk adapted approach were calculated. All patients underwent cystoscopy, and tumors were detected in 18 (5.9%). Urine cytology and NMP-22 was positive for malignancy in 9 (3.2%) and 12 (7.5%) of patients, respectively. A total of 43 (14%) patients were in the high risk group according to the RisikoCheck(C) questionnaire. The sensitivity and specificity of the questionnaire in detecting a bladder tumor was 61.5 % and 84.0 % in the high risk group. In patients with either a positive NMP-22 test or high risk category RisikoCheck(C), 23.6% had bladder tumors with a corresponding sensitivity of 54.2% and specificity of 88.6%. If both tests were negative only 3.3% of the patients had bladder tumors. The results of our study suggest that the efficacy of diagnostic evaluation of patients with microscopic hematuria may be further enhanced by combining RisikoCheck(C) questionnaire with NMP-22.

• 대한임상검사과학회지
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• 제51권2호
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• pp.125-133
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• 2019

임상병리 검사분야에 있어서 환자로부터 유래된 조직이나 세포의 형태학적 변화, 세포 생리, 세포 내 분자의 추적 및 신호전달 체계 등의 임상검사 및 관련 연구를 위한 빼놓을 수 없는 주요한 진단과 연구장비로서 현미경이 가지는 의미는 크다고 할 수 있다. 현미경에 대한 포괄적인 지식과 이해를 바탕으로 현미경의 올바른 사용, 관리와 유지보수는 신뢰도 높은 이미지 획득과 그에 따른 정확한 데이터 분석을 통한 질병의 진단을 위해서 반드시 요구되는 부분이라고 할 수 있다. 광학현미경의 표준 운영 절차(standard operating procedure, SOP)는 현미경의 작동 절차와 함께 검사실 규모에 따른 현장 사용자의 체계적인 현미경 장해 해결 방안과 기계적 원리에 대한 핵심 정보가 함께 수록되어야 한다. 현미경 유지관리 업무에는 대물, 접안렌즈와 현미경 내부 광학필터의 청소, 광원의 교체와 교정, XY재물대 유지보수, 공초점 레이저 주사 현미경(confocal laser scanning microscope)에서의 점확산함수(point spread function, PSF) 측정, 형광현미경에서의 검사 품질관리(quality control, QC)와 체계적인 현미경 장해 해결방안 등이 포함되어야 한다. 본 종설에서는 국제적 기준에 따른 레이저의 위험도에 따라 일부 현미경에 장착된 레이저 광원에 대한 안전지침과 보호장구에 대한 내용을 함께 소개하였다. 현미경을 통해 획득된 이미지는 촬영된 시점의 검체에 대한 모든 정보를 제공한다고 할 수 있으며, 적절한 유지보수 프로그램과 그에 따라 적합하게 관리된 현미경만이 이미지 데이터를 통한 정보의 획득, 올바른 해석과 정확한 진단에 반드시 필요한 선제 조건들이라고 하겠다.

• Parasites, Hosts and Diseases
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• 제54권3호
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• pp.329-334
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• 2016

Trichomoniasis caused by Trichomonas vaginalis is a common sexually transmitted disease. Its association with several health problems, including preterm birth, pelvic inflammatory disease, cervical cancer, and transmission of human immunodeficiency virus, emphasizes the importance of improved access to early and accurate detection of T. vaginalis. In this study, a rapid and efficient loop-mediated isothermal amplification-based method for the detection of T. vaginalis was developed and validated, using vaginal swab specimens from subjects suspected to have trichomoniasis. The LAMP assay targeting the actin gene was highly sensitive with detection limits of 1 trichomonad and 1 pg of T. vaginalis DNA per reaction, and specifically amplified the target gene only from T. vaginalis. Validation of this assay showed that it had the highest sensitivity and better agreement with PCR (used as the gold standard) compared to microscopy and multiplex PCR. This study showed that the LAMP assay, targeting the actin gene, could be used to diagnose early infections of T. vaginalis. Thus, we have provided an alternative molecular diagnostic tool and a point-of-care test that may help to prevent trichomoniasis transmission and associated complications.