Purpose : This systematic review was conducted to identify which dyadic intervention could be implemented for heart failure patient-family caregiver dyads to improve patient and/or their family caregivers outcomes. Method : Eleven databases were searched from their inception to July, 2021. This review considered any randomized controlled trials that evaluated the effectiveness of intervention including heart failure patient-family caregiver dyads. Two reviewers independently evaluated the methodological quality using the Cochrane Collaboration's tool for assessing risk of bias and extracted details of the included studies. The studies included in this review were not suitable for meta-analysis and therefore the results were presented as a narrative summary. Results : Six studies including 900 dyads were included and mainly primary family caregiver of patients was spouse. Majority of dyadic intervention were focused on psychoeducational intervention excepting one study on mobile health intervention. All studies included in this review focused on patients' outcomes compared to family caregivers' outcomes and dyadic outcomes. Individual interventions improved quality of life among heart failure patients and their family caregivers in two articles. The overall quality of selected articles was low. Conclusions : This study provides moderate support for the use of a dyadic intervention to improve quality of life among heart failure patients and their family caregivers. More rigorous high-quality studies investigating interventions to meet the needs of patient and family caregivers in heart failure care are needed.
International Journal of Advanced Culture Technology
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제6권4호
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pp.20-28
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2018
Background: As a result of the South Korean government's medical tourism strategies, the number of UAE inbound medical tourists have the highest annual increase rate among the Middle Eastern countries. The need for medical interpreters in such cases is inevitable, especially considering the languages spoken in both countries differs. The work of a medical interpreter affects patient satisfaction, quality of care, and the UAE patients' revisit intention. However, there is a lack of literature that focuses on the role of medical interpreters for the Arabic-speaking medical tourists in South Korea. The purpose of this study is to assess the satisfaction and the experience of UAE medical tourists in South Korea who have used medical interpretation services. Method: A descriptive exploratory design, including semi-structured interviews, was used in this study to examine factors influencing the satisfaction of UAE patients seeking medical attention in South Korea, who considered travelling exclusively for medical purposes. Eleven UAE medical tourists were selected for the interview using convenience sampling. Results: Two types of interpreters were revealed by the analysis: interpreters with Arabic as their mother tongue and interpreters with Korean as their mother tongue. Patients emphasized the origin of the interpreters and differentiated between the two types of interpreters' professionalism, abilities, and personal skills. However, due to the huge gap between the two cultures, languages, and religions, the UAE patients mainly preferred the Arabic medical interpreters. Further, each type had certain traits that impacted the medical care process and patients' satisfaction. Conclusion: This study shows that the South Korean government needs to focus on the training and assessment system for Arabic language interpreters. Additionally, cultural differences training for the interpreters may help to increase UEA patients' satisfaction.
The purpose of this study was to evaluate the changes of liver function test before and after treatment in patients admitted to Korean medicine hospital. We checked liver function test level (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, direct bilirubin) of 147 patient who admitted in Korean medicine hospital from July 1, 2015 to June 30, 2018. The subjects were selected those who took herbal medicine continuously during the admission period and who performed liver function test on admission and before discharge. And the subjects were excluded those who had a history of liver and biliary disease at the time of admission or who took hepatoprotectants. Aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase significantly decreased compared with the values of admission(p<0.05), but total bilirubin and direct bilirubin were not significantly changed(p>0.05). On admission 31 patients(21.1%) had abnormal liver function and 6 patients(4.1%) had liver injury while 19 patients(12.9%) had abnormal liver function and 6 patients(4.1%) showed liver injury before discharge. This study suggests that herbal medicine may not injure liver function.
Purpose: Patients with brain damage suffer from limitations in performing the activities of daily living (ADL) because of their motor function and visual perception impairment. The aim of this study was to help improve the motor function and visual perception ability of patients with brain damage by providing them with virtual reality-based contents. The usability results of the patients and specialists group were also evaluated. Methods: The ADL contents consisted of living room, kitchen, veranda, and convenience store, similar to a real home environment, and these were organized by a rehabilitation specialist (e.g., neurologist, physiotherapist, and occupational therapist). The contents consisted of tasks, such as turning on the living room lights, organizing the drawers, organizing the kitchen, watering the plants on the veranda, and buying products at convenience stores. To evaluate the usability of the virtual reality-based visual cognitive rehabilitation service, general elderly subjects (n=11), stroke patients (n=7), stroke patients with visual impairment (n=4), and rehabilitation specialists (n=11) were selected. The questionnaires were distributed to the subjects who were using the service, and the subjective satisfaction of individual users was obtained as data. The data were analyzed using SPSS 21.0 software. The general characteristics of the users and the evaluation scores of the experts were analyzed using descriptive statistics. Results: The usability test result of this study showed that the mean value of the questionnaire related to content understanding and difficulty was high, between 4-5 points. Conclusion: The virtual reality rehabilitation service of this study is an efficient service that can improve the function, interest, and motivation of stroke patients.
Kim, Jeong-Yeon;Cha, Jae-Kwan;Kim, Dae-Hyun;Nah, Hyun-Wook;Jeong, Jin-Heon
대한신경집중치료학회지
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제11권2호
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pp.86-92
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2018
Background: A delay of transfer for patients with acute stroke needing emergent revascularization is a huge hurdle for efficacy of revascularization. The objective of this study was to investigate changes of transportation time calculated by image to door (ITD) time (from checking brain images at first contact hospital to arriving at our emergency center) before and after 2015. Methods: This study was performed in a retrospective manner from 2013 into 2017. Acute ischemic stroke (AIS) patients having intravenous thrombolysis and/or mechanical thrombectomy during the observation period were enrolled. Among them, those who had revascularization under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm were selected. Results: During the observation period, 225 patients were treated under 'Drip-and-Ship' or 'Ship-and-Drip' paradigm. Twenty-three were excluded due the lack of detailed data. Among 202 patients, 73 and 129 were treated under Drip-and-Ship and Ship-and-Drip paradigms, respectively. In 2013, 35 patients from 18 hospitals (median distance, 25 km) were transferred to our regional stroke center and their median ITD time was 116 minutes. It was gradually decreased after 2015. In 2017, ITD time was significantly (P<0.01) shortened to 85 minutes without significant changes in transfer distance. The median onset to puncture time was also significantly (P=0.03) decreased from 365 minutes in 2013 to 270 minutes in 2017. Conclusion: Our results implicate that many hospitals in our stroke region might have recognized the importance of rapid transportation for AIS after 2015.
Purpose: Minor foot amputations are performed for recurrent or infected ulcers or osteomyelitis of the diabetic feet. Patients may require a large amount of bone resection for wound closure. On the other hand, this results in more foot dysfunction and a longer time to heal. The authors describe fillet flap coverage to avoid more massive resection in selected cases. This study shows the results of fillet flap coverage for the closure of diabetic foot minor amputation. Materials and Methods: This was a retrospective case series of patients who underwent forefoot and midfoot amputation and fillet flap for osteomyelitis or nonhealing ulcers between March 2013 to November 2017. In addition, the patient comorbidities, hospital days, complications, and duration to complete healing were evaluated. Results: Fourteen fillet flap procedures were performed on 12 patients. Of those, two had toe necrosis, nine had forefoot necrosis, and three had midfoot necrosis. Eleven forefoot amputations and three midfoot amputations were performed. Among forefoot necrosis after a fillet flap, three patients had revision surgery for partial necrosis of the flap, and two patients had an additional amputation. Two patients had additional amputations among those with midfoot necrosis. By the fillet flap, the amputation size was reduced as much as possible. The mean initial healing days, complete healing days, and hospital stay was 70.6 days, 129.0 days, and 60.0 days, respectively. Conclusion: The fillet flap facilitates restoration of the normal foot contour and allows salvage of the metatarsal or toe.
Purpose: Oral candidiasis is the most common fungal infection in the oral cavity which is usually diagnosed from clinical findings. A retrospective study was conducted to identify risk factors for oral candidiasis and to characterize the demographic and clinical features of affected patients. Methods: From January 1, 2019 to December 31, 2019, it consisted of 90 oral candidiasis patients diagnosed based on clinical finding and treated with antifungal drugs. As a retrospective study of those people, surveys were conducted on sex, age, systemic disease, a use of dentures, complaints of dry mouth, smoking and alcohol consumption, culture on potato dextrose agar (PDA) medium, culture on chromogenic agar (CA) medium and a duration of antifungal treatment. Results: Among 90 selected patients, the male and female ratio was 41:49. Overall, female had a higher infection rate than male in all age groups. In this study, oral candidiasis was not clearly susceptible to dry mouth, smoking or drinking, wearing dentures and association with systemic disease. Among 90 patients with oral candidiasis, 83 had colonies formed on PDA medium and 53 had colonies formed on CA medium. The duration of antifungal treatment was highest between 5 and 8 weeks. In addition, there was statistical significance between the culture results in CA medium and the duration of antifungal treatment. Conclusions: Generally, old age or infants, dry mouth, smoking, a use of dentures and endocrine abnormalities are risk factors to increase oral candidiasis; however, in this study, it was mainly found in the elderly aged 60 or older regardless of sex and the incidence of oral candidiasis was not obviously related with patients with dry mouth, smoking or drinking, denture wearers and endocrine abnormalities. Interestingly, when the fungi were cultured in CA medium, the duration of antifungal treatment was increased.
Kim, Ryuck Seong;Yi, Changryul;Kim, Hoon Soo;Jeong, Ho Yoon;Bae, Yong Chan
대한두개안면성형외과학회지
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제23권1호
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pp.17-22
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2022
Background: Reconstruction of large facial defects is challenging as both functional and cosmetic results must be considered. Reconstruction with forehead flaps on the face is advantageous; nonetheless, reconstruction of large defects with forehead flaps alone results in extensive scarring on the donor site. In our study, the results of reconstruction using a combination of forehead flaps and other techniques for large facial defects were evaluated. Methods: A total of 63 patients underwent reconstructive surgery using forehead flaps between February 2005 and June 2020 at our institution. Reconstruction of a large defect with forehead flaps alone has limitations; because of this, 22 patients underwent a combination of procedures and were selected as the subjects of this study. This study was retrospectively conducted by reviewing the patients' medical records. Additional procedures included orbicularis oculi musculocutaneous (OOMC) V-Y advancement flap, cheek advancement flap, nasolabial V-Y advancement flap, grafting, and simultaneous application of two different techniques. Flap survival, complications, and recurrence of skin cancer were analyzed. Patient satisfaction was evaluated using questionnaires. Results: Along with reconstructive surgery using forehead flaps, nasolabial V-Y advancement flap was performed in nine patients, local advancement flap in three, OOMC V-Y advancement flap in two, grafting in five, and two different techniques in three patients. No patient developed flap loss; however, cancer recurred in two patients. The overall patient satisfaction was high. Conclusion: Reconstruction with a combination of forehead flaps and other techniques for large facial defects can be considered as both functionally and cosmetically reliable.
Purpose : This study investigated the effects of wearing a mask and different mask filters on the respiratory function of stroke patients. Methods : A total of 15 stroke patients were selected according to the inclusion and exclusion criteria. The respiratory functions were compared between participants with and without masks and among respiratory functions with three different mask filters. The order of using masks was non-wearing masks, Dental masks, KF80 masks, and KF94 masks; the difference in respiratory volumes among these conditions were measured. For accuracy of the measurement, sufficient education on the respiratory measurement method was provided to the researcher, and the heart rate of the participants was estimated to confirm their stability before the measurements. To ensure accuracy, the subjects were educated on the researchers' respiratory measurement methods. Each measurement was followed by 10 min breathing stability before replacing the next mask. Results : The results of this study showed that the difference in respiratory functions, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and maximal voluntary ventilation (MVV), in stroke patients was statistically significant among different masks (p<.05). Afterwards, the values of FVC, FEV1, and MVV in stroke patients wearing masks were significantly lower than those of the non-masked control group (p<.05). The difference in respiratory functions with different mask filters showed no statistical significance (p<.05). Conclusion : This study showed that participants wearing any of the masks presented a lower respiratory function than that of those without using masks; additionally, no difference in respiratory functions was observed with differences in mask filters. Therefore, wearing a mask for a prolonged period is confirmed to affect breathing in stroke patients with weak respiratory function.
Objective: One of the treatment strategies for controlling chronic pain and preventing disability is patient education. Pain neuroscience education (PNE) has been proven to be effective in explaining the biological and physiological processes associated with pain experiences to patients. The purpose of this review is to investigate the effectiveness of PNE for kinesiophobia such as avoidance response in patients with chronic pain. Design: A systematic review and meta-analysis. Methods: MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of controlled trials databases were searched through November 2020 and included a randomized controlled trials evaluating kinesiophobia in musculoskeletal patients with chronic pain. In 8 randomized controlled trial studies, 'Cochrane's risk of bias (RoB) tool was used for qualitative analysis, and results of post-intervention were analyzed through RevMan 5.4 for quantitative analysis. Results: For this review, 8 randomized controlled trials of 369 patients with chronic pain were selected for PNE. A systematic review and meta-analysis also included 8 randomized controlled trials. The effect on kinesiophobia was more effective than the control group (-0.86; 95% confidence interval [CI], -1.22 to -0.51; heterogeneity [χ2=21.18, df=7, I2=67%]; overall effect [Z=4.80]). In addition, the effect on pain was more effective than the control group (-0.53; 95% CI, -1.05 to -0.01; heterogeneity [χ2=47.42, df=7, I2=85%]; overall effect [Z=2.01]). Conclusions: The results of this review suggest that PNE and combined PNE have a positive effect on the improvement of pain and kinesiophobia in patients with chronic pain.
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