• 제목/요약/키워드: rating criteria

검색결과 392건 처리시간 0.021초

재가노인 기능상태 평가도구를 이용한 재가노인 사례관리 프로그램의 효과 평가 (Effects of Case Management using Resident Assessment Instrument-Home Care(RAI-HC) in Home Health Services for Older People)

  • 전경자;이지윤;윤종률
    • 대한간호학회지
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    • 제39권3호
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    • pp.366-375
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    • 2009
  • Purpose: To evaluate the effects of case management using Resident Assessment Instrument-Home Care(RAI-HC) in home health service for older people. Methods: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living(ADL), Instrumental Activities of Daily Living(IADL), Cognitive Performance Scale(CPS), Depression Rating Scale(DRS), Pain and the number of Clinical Assessment Protocols(CAP). Results: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression(odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL(OR: 4.423, CI: 1.151-16.999) and the number of CAP(OR: 11.443, CI: 3.805-34.410). Conclusion: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

Early complications and performance of 327 heat-pressed lithium disilicate crowns up to five years

  • Huettig, Fabian;Gehrke, Ulf Peter
    • The Journal of Advanced Prosthodontics
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    • 제8권3호
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    • pp.194-200
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    • 2016
  • PURPOSE. The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS. 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS. Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17-73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, P<.01) at 24 months. At the last observation, over 90% of all crowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION. Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns.

Literature Review of Postoperative Delirium in Geriatric Patients After Elective Gastrointestinal Cancer Surgery

  • Park, Da-In;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • 제20권3호
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    • pp.177-186
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    • 2018
  • Purpose: Increasing number of older adults are receiving cancer surgeries especially for gastrointestinal cancers, which brings forth attention to age-related postoperative complication prevention. Postoperative delirium (POD) is a common complication that rises after surgical procedures involving general anesthesia, largely in the elderly population. Due to its sudden onset and fluctuating symptoms, POD often goes underdiagnosed and undertreated even though it may lead to various adverse outcomes. POD in GI cancer surgical elderly patients is poorly understood in terms of prevalence, pathophysiology, assessment, treatment and nursing management. We aimed to identify available literature and investigate study results to broaden our understanding of geriatric GI cancer POD. Methods: The search process involved six databases to identify relevant studies abided by inclusion criteria. Results: Eleven studies were selected for this review. Geriatric POD is closely related to frailty and surgical complications. Frailty increases vulnerability to surgical stress and causes cerebral changes that affect stress-regulating neurotransmitter proportions, brain blood flow, vascular density, neuron cell life and intracellular signal transductions. These conditions of frailty result in increased risks of surgical complications such as blood loss, cardiovascular events and inflammation, which all may lead to the POD. Mini Metal State Examination (MMSE), Confusion Assessment Method (CAM) and Delirium Rating Scale-revised-98 (DRS-R-98) are recommended for POD assessment to identify high-risk patients. Conclusion: The POD prevalence ranged from 8.2% to 51.0%. The multifactorial causative mechanism suggests nurses to identify highrisk elderly GI-cancer surgical patients by reviewing patient-specific factors and surgery-specific factors.

소아 진정 시 구강 협점막하로 투여한 Midazolam의 효과에 관한 연구 (The Sedative Effects of Submucosal Midazolam in Children)

  • 이영은;박미경;김윤희;정상혁;백광우
    • 대한치과마취과학회지
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    • 제5권2호
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    • pp.101-106
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    • 2005
  • Purpose: This retrospective study assessed the effectiveness of submucosal (SM) midazolam (M), oral chloral hydrate (CH), hydroxyzine (H), and nitrous oxide (N) 99 uncooperative pediatric dental patients over 182 sedation sessions. Methods: Selection criteria included good medical health (ASA I), from 2 to 6 years of age, uncooperative behavior, and the need for restorations and dental surgery. The children who was administerated with CH H, N was Group 1 (48 case). The children who was administerated with CH, H, N, M was Group 2 (51 case). All the patients received oral CH (50-70 mg/Kg), H (1 mg/Kg) and N (less than 50%). Additionally the Group 2 received SM midazolam (0.1-0.2 mg/kg). Behavior response was rated as quiet (Q), crying (C), movement (M), or struggling (S) every 5 minutes through operative procedures. Behavior response rating was assigned to Houpt scale of Overall behavior. Data was analyzed using Chi-Square Test. Results: The Group 2 had more effective (88.2%) than the Group 1 (68.8%)(P = 0.05). Also, vomiting response decreased in the Group 2 (94.4%) than those with oral administration of chloral hydrate alone without SM midazolam (77.1%)(P = 0.05). Conclusions: SM midazolam improved the quality of sedation and vomiting response.

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청소년 품행장애의 6개월 단기 예후에 영향을 미치는 변인 II - 우울 및 불안척도와 주의력결핍 과잉활동 척도를 중심으로 - (FACTORS AFFECTING 6 MONTHS' SHORT-TERM PROGNOSIS OF CONDUCT DISORDER IN THE ADOLESCENTS II -RELATION TO DEPRESSION/ANXIETY AND ADHD INVENTORY-)

  • 방양원;채정호;진태원;이정균
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제7권2호
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    • pp.161-166
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    • 1996
  • 본 연구의 목적은 청소년 품행장애의 예후에 영향을 미치는 요인들을 찾는 것이었다. 이를 위해 저자들은 품행장애의 진단하에 6개월 이상 입원치료를 받은 후 퇴원한 환자들을 대상으로 퇴원 후 6개월 동안에 품행장애의 진단기준에 다시 부합되는지 여부에 따라 예후가 양호한 군 37명과 예후가 불량한 군 36명을 선발하였으며 입원기간동안 완료된 우울 및 불안 척도 및 주의력결핍 과잉활동의 척도를 통해 두 군의 비교를 시행하였다. 본 연구에서 얻어진 결과들은 다음과 같다. 1) 퇴원 후 6개월간 추적한 품행장애 환자중에서 예후가 좋지 않은 군이 좋은 군보다 우울정도가 유의하게 높았다. 2) 특성불안의 정도, 주의력결핍 과잉운동장애의 정도는 예후가 좋지 않는 군에서 높았으나 유의하지는 않았다. 3) 6개월 단기예후만을 추적하였으므로 향후 장기적인 추적 조사가 필요하다.

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침구 임상연구 논문동향 분석 (Analysis of Recent Trends in Clinical Research Publications on Acupuncture and Moxibustion Studies)

  • 박지은;오달석;신선화;최준용;구창모;김애란;정소영;한경주;최선미
    • 한국한의학연구원논문집
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    • 제13권2호통권20호
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    • pp.101-112
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    • 2007
  • Objective : This study was aimed to review the trend of clinical research articles of acupuncture and moxibustion from the year of 1995 to 2006. Methods : The retrieving and analyzing period were from January 1995 to July 2006. Articles were collected by retrieving Pubmed database. Search terms were as follows; 'Acupuncture', 'Acupuncture & Meridian', 'Moxibustion'. After reviewing articles by our pre-defined criteria, Correlation was assessed qualitatively between contents of the final selected articles and those of Korea Institute of Oriental Medicine. Results : The number of acupuncture research articles have increased with higher rate since the year of 2000. In the field of medical devices, the articles were sparsely existed. The percentage of clinical acupuncture research articles was 75%. However, in the category of Korean investigators' researches, it was 46%. Publications by Korean investigators were concentrated to several specific journals of which their impact factor were below 1 point. Conclusion : There needs more qualifying studies in acupuncture studies which are represented by impact factor in Journal Citation Reports. It is necessary to research and develop the medical devices quantatively rating the outcome of acupuncture trials. The secondary research, such as, systematic reviews, meta-analysis, would be a key approach to evaluate the effectiveness and safety of acupuncture treatments. Moxibustion research would be noticeable in regard to its historical effectiveness and its variable indications.

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AHP기법을 활용한 임도의 재해위험 등급 구분에 관한 연구 (A Study on Classification of Disaster Risk Rating for Forest Road Using AHP Methodology)

  • 방홍석;권형근;이준우;김명준
    • 한국산림과학회지
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    • 제103권2호
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    • pp.258-263
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    • 2014
  • 본 연구는 임도의 재해위험 등급을 구분하기 위한 평가표를 제시하고자 수행되었으며, 이를 위해 임도의 재해에 영향을 미치는 인자들을 선정하고 산림공학 전문가들을 대상으로 AHP 설문조사를 실시하였다. 평가항목은 전문가집단의 자문을 통해 크게 자연환경, 인문 사회환경, 임도의 구성요소로 구분하였으며, 총 21개의 평가인자로 구성하였다. 설문조사결과를 바탕으로 각 평가항목에 대한 가중치 분석을 실시하였으며, 분석결과 임도의 구성요소 항목 중 배수시설이 가장 높은 가중치를 점하고 있는 것으로 나타났다. 한편, AHP 분석결과를 바탕으로 각각의 평가항목에 대한 평가기준과 평가점수를 부여하여 평가표를 작성하였다. 도출된 평가표를 현장조사에 적용시킨 결과 최고점은 78.8점, 최저점은 42.7점, 평균점수는 61.8점으로 나타났다. 산정된 점수를 바탕으로 전문가 집단의 회의를 통해 임도의 재해위험 등급을 4등급으로 구분하여 제시하였다.

Clinical Efficacy and Safety of Yukgunja-tang for Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis

  • Park, SongWon;Lim, Seong-Woo
    • 대한한의학회지
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    • 제40권4호
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    • pp.16-28
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    • 2019
  • Objectives: The purpose of this meta-analysis was to evaluate the effects of Yukgunja-tang(YGJT, Rikkunshito, Liujunzi) on Gastroesophageal Reflux Disease(GERD). Methods: Sixteen electronic databases were used to search for studies published through March 2019, and a randomized controlled study was conducted to study the effects of YGJT or modified YGJT on GERD. Study quality was assessed using the risk bias tool provided by Cochran, and data analysis was performed using Review Manager 5.3.0 software Results: Two-hundred and forty articles were initially searched, and 13 studies that satisfied the study criteria were evaluated qualitatively; 11 of the 13 were included in the meta-analysis. In the two studies, the effects of YGJT and a placebo were compared. Meta-analysis showed that YGJT significantly improved FSSG (Frequency Scale for the Symptoms of GERD) scores, but not GSRS (Gastrointestinal Symptom Rating Scale) scores (FSSG: MD -2.40, 95% CI [-5.31, 0.51], p=0.11, GSRS: MD 0.05, 95% CI [-0.12, 0.22], p=0.55). Meta-analysis of nine studies comparing the efficacies of YGJT and conventional medicine showed that YGJT had a significant clinical effect (OR 5.72; 95% CI [3.41, 9.61]; I2 p<0.00001). Conclusion: This study suggests that YGJT effectively relieves the symptoms of GERD. Unfortunately, owing to the small sample sizes, limitations of several methodological qualities, we believe large-scale clinical studies with less bias will provide evidence of qualitative improvement.

주요우울증 환자에서 일주기 형태에 따른 양극성 경향, 자살 사고, 청각유발전위와의 관련성 : 예비 연구 (Chronotype in Relation to Bipolarity, Suicidal Ideation, and Auditory Evoked Potentials in Patients with Major Depressive Disorder : Preliminary Study)

  • 박영민;이승환
    • 생물정신의학
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    • 제21권1호
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    • pp.14-20
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    • 2014
  • Objectives The current study investigated the putative relationship between chronotype and suicidality or bipolarity in patients with major depressive disorder (MDD). Method Nineteen outpatients who met the criteria for MDD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision were recruited for the current study. The subjects were divided into two subgroups based on their Basic Language Morningness (BALM) scores (dichotomized according to the median BALM score). The Loudness Dependence of Auditory Evoked Potentials (LDAEP) was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents. In addition, K-Mood Disorder Questionaire (K-MDQ), Beck Scale for Suicidal Ideation (BSS), Beck Hopelessness Scale (BHS), Barratt Impulsiveness Scale (BIS) were applied. Results The K-MDQ, BSS, BHS, BIS score was higher for the eveningness group than for the morningness group. However, the LDAEP, Hamilton Depression Rating Scale, Hamilton Anxiety Scale scores did not differ significantly between them. There were negative correlations between the total BALM score and the total K-MDQ, BSS, and BHS scores (r=-0.64 and p=0.0033, r=-0.61 and p=0.0055, and r=-0.72 and p=0.00056, respectively). Conclusions Depressed patients with eveningness are more vulnerable to the suicidality than those with morningness. Eveningness is also associated with bipolarity.

재발성 비소세포성 폐암환자의 Afatinib과 삼칠충초정 병용투여 경과관찰 1례 (A Case of Patient with Recurring Non-Small Cell Lung Carcinoma Treated with Samchilchoongcho-Jung in Conjunction with Afatinib)

  • 김지혜;배겨레;박소정;조종관;유화승
    • 대한한방내과학회지
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    • 제38권1호
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    • pp.72-80
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    • 2017
  • Objective: The purpose of this study is to report the case of a patient with recurring non-small cell lung carcinoma (NSCLC) taking Samchilchoongcho-Jung with Afatinib. Methods: An NSCLC patient diagnosed with multiple bone and pulmonary metastasis was taking Afatinib (20 mg/day) and suffering from stomatitis caused by the Afatinib. The patient was treated with Samchilchoongcho-Jung (1,500 mg/ day) for 3 months. The tumor size was measured with computed tomography, and laboratory findings, including tumor markers (CEA, Cyfra 21-1), were also followed up. Stomatitis was measured by a numeric rating scale, and adverse events were evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 4.0. Results: After combined treatment, stable disease was shown on computed tomography. The tumor marker levels of CEA and Cyfra 21-1 were decreased, and the stomatitis significantly improved. NCI-CTCAE 4.0 showed no adverse events. Conclusion: This case study suggests that Samchilchoongcho-Jung may have a synergic effect, in conjunction with Afatinib, on the treatment of patients with recurring NSCLC.