• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.91-98
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• 2018

When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases. It covers some of the key technical device issues to be considered, the evidence behind the role of inhalers in disease control, population studies which link behaviors and adherence to inhaler devices as well as practice advice on inhaler technique education and the advantages and disadvantages in selecting different inhaler devices. Finally, a list of key considerations to aid health care providers in successfully managing the use of inhaler devices are summarized.

• 정보관리학회지
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• 제39권1호
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• pp.281-308
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• 2022

본 연구는 중소병원에서 근무하는 보건의료인 중에서도 지금까지 연구 대상으로 채택되지 못한 간호사, 의료기사, 약사의 정보이용행태 및 정보요구를 탐색하여 병원 내 의학도서관의 정보서비스 개선 방향을 제시하는 것을 목적으로 한다. 이론적 배경과 선행연구 분석을 기반으로 하여 연구 설계를 진행하였으며, 전국의 중소병원에서 근무 중인 간호사, 의료기사, 약사를 대상으로 심층면담을 실시하였다. 연구 결과, 중소병원 보건의료인의 정보요구 발생 동기와 정보이용행태, 병원 내 의학도서관에 대한 인식을 파악할 수 있었으며, 이를 종합하여 병원 내 의학도서관 정보서비스 개선 방향을 제시하였다. 본 연구는 중소병원에서 근무하는 다양한 보건의료인의 정보이용행태 및 정보요구를 탐색한 초기 시도라는 점에서 의의를 갖는다.

• The Korean Journal of Pain
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• 제36권2호
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• pp.216-229
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• 2023

Background: The role of the sympathetic nervous system appears to be central in causing pain in complex regional pain syndrome (CRPS). The stellate ganglion block (SGB) using additives with local anesthetics is an established treatment modality. However, literature is sparse in support of selective benefits of different additives for SGB. Hence, the authors aimed to compare the efficacy and safety of clonidine with methylprednisolone as additives to ropivacaine in the SGB for treatment of CRPS. Methods: A prospective randomized single blinded study (the investigator blinded to the study groups) was conducted among patients with CRPS-I of the upper limb, aged 18-70 years with American Society of Anaesthesiologists physical status I-III. Clonidine (15 ㎍) and methylprednisolone (40 mg) were compared as additives to 0.25% ropivacaine (5 mL) for SGB. After medical treatment for two weeks, patients in each of the two groups were given seven ultrasound guided SGBs on alternate days. Results: There was no significant difference between the two groups with respect to visual analogue scale score, edema, or overall patient satisfaction. After 1.5 months follow-up, however, the group that received methylprednisolone had better improvement in range of motion. No significant side effects were seen with either drug. Conclusions: The use of additives, both methylprednisolone and clonidine, is safe and effective for the SGB in CRPS. The significantly better improvement in joint mobility with methylprednisolone suggests that it should be considered promising as an additive to local anaesthetics when joint mobility is the concern.

• 대한한의학회지
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• 제37권1호
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• pp.41-52
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• 2016

Objectives: There are no studies which have investigated the health related quality of life(HRQOL) about stroke patients according to the medical care utilization behavior by longitudinal analysis. The purpose of this study is to analyze the quality of life(QOL) and quality adjusted life years(QALYs) of stroke patients of western and combined treatment group by longitudinal analysis. Methods: A retrospective cohort study was conducted among 37 new patients who initiated diagnosis with stroke in 2009 from Korea Health Panel Data. We analyzed the HRQOL of stroke patients and calculated the QALYs after medical use initiation for up to 3 years according to the medical care utilization behavior. Results: Overall, the quality of life of stroke patients was lowered somewhat from 0.8431 to 0.7864 in 2009~2012. Western treatment group was appeared slightly declined in from 0.8527 to 0.8231 and combined treatment group was shown to be falling from 0.8173 to 0.6875. The QALYs of total patients were calculated 2.3654 and western treatment group were 2.4436, combined treatment group were 2.1542 during the 4 year period. The difference of QALYs between two groups was 0.2894 QALYs. Conclusions: Although there was a small difference in QALYs of the two groups, it is not certain that the difference is come from medical care utilization behavior. Further studies should be needed to confirm the relation of the medical care utilization behavior and quality of life by considering severity of the stroke.

• Tuberculosis and Respiratory Diseases
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• 제68권4호
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• pp.226-230
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• 2010

Androgen deprivation therapy, which is the standard treatment for metastatic prostate cancer, includes nonsteroidal antiandrogenic drugs, such as flutamide, nilutamide and bicalutamide. Of them, bicalutamide rarely induces interstitial pneumonia. We report a case of bicalutamide-induced interstitial pneumonia. A 68-year old male diagnosed with prostate cancer and multiple bone metastases presented with dry cough and low grade fever for 3 days. He had taken bicalutamide (50 mg/day) for 13 months. High resolution computed tomography revealed ground glass opacity in his right upper lung. The laboratory studies showed no eosinophilia in the serum and bronchoalveolar lavage fluid. Despite the use of antimicrobial agents for 2 weeks, the extent of the lung lesions increased to the left upper and right lower lung. He had no environmental exposure, collagen vascular disease and microbiological causes. Under the suspicion of bicalutamide-induced interstitial pneumonia, bicalutamide was stopped and prednisolone (1 mg/kg/ day) was initiated. The symptoms and radiologic abnormalities were resolved with residual minimal fibrosis.

• 보건의료생명과학 논문지
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• 제11권2호
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• pp.351-360
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• 2023

건강보험심사평가원 2018년 고령환자데이터셋(HIRA-APS)을 이용하여 요양병원 입원환자 33,821명을 주요 질병군별로 구분하여, 의료이용 현황과 특성을 파악하여, 요양병원의 기능정립에 효과적인 정책 기초자료를 제공하고자 하였다. 첫째, 질병군에 따라 의료이용 특성에 차이를 보이고 있어, 환자의 질병군 특성에 맞는 치매 전문, 재활 전문, 호스피스 전문, 회복기 전문 등 특화된 요양병원 설립과 운영이 필요하다. 둘째, 요양병원 입원환자의 연간 입원일수에 영향을 미치는 요인 중 주상병별로는 마비군, 뇌혈관질환군, 치매군이 가장 길었으며, 환자분류군별로는 인지장애군이 가장 길어, 질병군별 장기 환자에 대한 의료 수요 및 질 관리가 필요하다. 셋째, 요양병원 입원환자의 치료결과 중 정상 퇴원에 영향을 미치는 요인 중 질병군별로는 근골격계질환군에서 가장 높았고, 마비군, 뇌혈관질환 순으로 퇴원 후 재가 프로그램 지원이 요구된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1081-1083
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• 2014

Malignancy-associated mortality, decreased productivity, and spiritual, social and physical burden in cancer patients and their families impose heavy costs on communities. Therefore cancer prevention, early detection, rapid diagnosis and timely treatment are very important. Use of modern methods based on information technology in cancer can improve patient survival and increase patient and health care provider satisfaction. Robot technology is used in different areas of health care and applications in surgery have emerged affecting the cancer treatment domain. Computerized and robotic devices can offer enhanced dexterity by tremor abolition, motion scaling, high quality 3D vision for surgeons and decreased blood loss, significant reduction in narcotic use, and reduced hospital stay for patients. However, there are many challenges like lack of surgical community support, large size, high costs and absence of tactile and haptic feedback. A comprehensive view to identify all factors in different aspects such as technical, legal and ethical items that prevent robotic surgery adoption is thus very necessary. Also evidence must be presented to surgeons to achieve appropriate support from physicians. The aim of this review article is to survey applications, opportunities and barriers to this advanced technology in patients and surgeons as an approach to improve cancer care.

• 중환자간호학회지
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• 제16권2호
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• pp.28-41
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• 2023

Purpose : This study aimed to investigate the characteristics and risk factors associated with pressure injuries related to medical devices among patients admitted to the intensive care unit (ICU). Method : A retrospective study analyzed data from 462 ICU patients. Statistical analyses, including independent t-tests, Fisher's exact tests, and logistic regression were performed to analyze the data. Results : Among the 154 subjects, there were a total of 198 medical device-related pressure injuries (MDRPI). Stage 2 and deep tissue pressure injuries were the most frequent. MDRPI occurred most frequently on the face, with nasogastric tubes being its leading cause, followed by endotracheal tubes. The risk factors for MDRPI included male sex (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.12-2.83), department at the time of ICU admission (OR=4.29, 95% CI=2.01-9.15), post-surgery ICU admission (OR=0.43, 95% CI=0.25-0.73), application of extracorporeal membrane oxygenation machines (OR=2.72, 95% CI=1.06-6.95), number of medical devices (OR=1.16, 95% CI=1.05-1.30), inotropic drug administration (OR=2.33, 95% CI=1.19-4.60), and sedative use (OR=2.53, 95% CI=1.17-5.45). Conclusion : These results enable the determination of the characteristics and risk factors associated with MDRPI. It is crucial to acknowledge the risk factors for MDRPI in ICU patients and establish a prevention strategy.

• 한국임상보건과학회지
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• 제4권3호
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• pp.603-614
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• 2016

Purpose. The purpose of this study was to provide basic data regarding the intention to use community care service based on special grading for dementia in the South Korean Society. Methods. A survey was conducted using a questionnaire adapted on the basis of literature review regarding the first to fourth grade under the long-term care insurance system for the aged from May 1 to 30, 2015 and a total of 272 questionnaires were statistically processed using SPSS 21.0. Frequency analysis, descriptive statistics, and cross-tabulation analysis were performed. The non-parametric type of test, ${\chi}^2$ test, was used for statistical testing. Results. This study obtained the following results: First, caregivers had greater intention to ask recipients to use daytime and nighttime care service. Second, there were statistically significant differences in caregivers' education, occupation, monthly average income, co-residence status, intimacy, and care-giving burden (emotional, financial, and social) and recipients' activities of daily living, instrumental activities of daily living, mental health status, dementia status, and intention to use community care service based on special grading for dementia. Conclusions. There are very few statistical data and academic materials regarding special grading for dementia, which has recently been established. The results of this study are therefore expected to help make a systematic analysis of the intention to use community care service by caregivers based on special grading for dementia.

• 비교문화연구
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• 제25권
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• pp.627-648
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• 2011

The study analyzed a diachronic distribution, social meanings and social evaluations of ROOJIN. 'Headline Database of Newspaper Articles' and 'Balanced Corpus of Contemporary Written Japanese' by KOKKEN were used as research data. There were 305 newspaper articles (About 0.2%) which contained the word ROOJIN at 'Headline Database of Newspaper Articles'. The number of newspaper articles related to ROOJIN started to increase in a rapid rate in 1972 and 1973. They were also increased in 1976, from 1981 to 1987, 1992 and 1993. The reasons of increasing of newspaper articles related to ROOJIN on those 4 periods of time could be summarized as follows. Firstly, there was a increasement of ROOJIN who are lonely, are not able to move about freely or live alone. Secondly, the understanding of a symptom of aging called BOKE was necessary. Thirdly, there were negative evaluations in a society towards ROOJIN. There were 453 cases which contained the word ROOJIN at 'Balanced Corpus of Contemporary Written Japanese' on the data since 2000. The most frequently used words were ones that are related to senior care facilities. There were 109 cases (24%) which contain those words. '~SISETSU', '~SENTA-', '~HO-MU' were presented as words related to senior care facilities. Among them, 78 cases contained the word '~HO-MU' which was similar to a home with family members. The second most frequently used words were ones that are related to 'welfare for the aged' and they are led by 'medical care for the aged'. They occupied about 8%. Institutionalization of medical care for the aged, medical expenses, nursing were presented as words related to 'medical care for the aged'. Words that were related to 'welfare for the aged' led by 'senior care facilities' and 'medical care for the aged' occupied about 32% of research data. As mentioned above, problems of the aged in Modern Japan such as negative evaluations in a society towards ROOJIN, ROOJIN who are lonely, are not able to move about freely or live alone, BOKE could be identified by analyzing the data. Also, The frequent usage of words such as 'Home for the aged', 'medical care for the aged' and 'nursing' could be identified. The outcome of analysis suggested that a family traditionally had a function of solving problems of the aged but that function was reduced in modern Japan. It also suggested that there was a tendency to outsource problems of the aged as much as possible.