환자선택적 과제지향훈련이 뇌졸중 환자의 일상생활동작 수행, 삶의 질, 우울감에 미치는 영향

최성진 ( Sung Jin Choi ),신원섭 ( Won Seob Shin ) 대한물리의학회 2014 대한물리의학회지 Vol.9 No.2

PURPOSE: This study was conducted to determine the effect of patient-selected, task-oriented training on activities of daily living, quality of life, and depression for stroke patients. METHODS: This study included 40 stroke subjects, randomly assigned to either an experimental group or a control group. Both the experimental group and the control group included 20 stroke patients. Patients from the experimental group selected and performed task-oriented training. In the exercise program, the patient chose two categories from six categories and trained for 30 minutes a day, three times a week, for four weeks. Patients from the control group performed conventional task-oriented training. Outcomes were measured using the Korean version of a modified Barthel Index (K-MBI), the Korean Instrumental Activities of Daily Living (K-IADL), the Stroke-specific Quality of Life (SS-QOL), the Short Form 8 (SF-8), and the Beck Depression Inventory (BDI), both before and after training. RESULTS: There were significant differences between the before- and after-intervention data of the K-MBI and the K-IADL (p<.05) for both groups. Also, there were more significant improvements in the experimental group compared to the control group (p<.05) for the SS-QOL, SF-8 and BDI. CONCLUSION: The results of this study showed that patients-selected, task-oriented training had positive effects on stroke patients` activities of daily living, quality of life, and depression.

A Comparison Between Stroke Patients Admitted to Oriental Hospital in the Years 1987 and 1994

Lee Kyung-sup,Cho, Ki-ho,Kim, Young-suk,Ko, Chang-nam,Moon Sang-kwan,Bae Hyung-sup INSTITUTE OF ORIENTAL MEDICINE KYUNG-HEE UNIVERSIT 1998 JOURNAL OF ORIENTAL MEDICINE Vol.3 No.1

The characteristics of stroke slightly vary as time changes. To compare the characteristics of stroke between the 1980s and 1990s we investigated the clinical records of stroke patients in 1987 and 1994. The subjects of this study consisted of the 1971 patients who were admitted as stroke patients to the Kyunghee University Oriental Medicine Hospital during these two years. There were 1092 stroke patients admitted from May, 1987 to April, 1988 and 879 stroke patients admitted between May, 1994 and April, 1995. The results were as follows. The frequency of cerebral infarction was 77.9% in 1987 and 79.9% in 1994. The male to female ratio of stroke patients was 1.4:1 in 1987 and 1.6:1 in 1994. The occurrence rate of stroke in both 1987 and 1994 were highest in patients in their 60s, followed by those in their 50s, 70s and older, in their 40s, and finally their 30s and below. We especially found that the rate of patients in their 70s and over increased from 17.8% in 1987 to 25.3% in 1994, which was remarkable in cerebral infarction patients. The most common disease preceding a stroke was hypertension, followed by heart disease and diabetes in 1987, and in 1994 hypertension was the most common, followed by diabetes and heart disease. The rate of recurrence among cerebral hemorrhage, that was 12% in 1987 and 24.7% in 1994. The most frequent complications of stroke in 1987 and 1994 were pneumonia and urinary tract infection, respectively. The prescriptions used most frequently during admission were Chungpaesagan-tang followed by Sunghyangjungki-san, Yangyeksanhwa-tang etc. in both 1987 and 1994. When patients were getting better, prescriptions for invigorating Qi and enriching the blood(補氣血) were used more frequently. In conclusion, the most remarkable change of stroke patients from 1987 to 1994 was an increase in occupancy rate of aged patients, especially those in their 70s and older. So we suggest that more research are needed on the stroke of aged man, along with many other subjects on stroke.

일부 한.양방병원 뇌혈관질환 환자의 진료결과 및 만족도의 비교연구 -한양방협진 진료프로토콜의 적용을 중심으로-

박종구,강명근,이성수,김달래,최서영,한창호,유준상,김민기,김춘배,Park, Jong-Ku,Kang, Myung-Guen,Lee, Seong-Soo,Kim, Dal-Rae,Choi, Seo-Young,Han, Chang-Ho,Yoo, Jun-Sang,Kim, Min-Gi,Kim, Chun-Bae 대한한방내과학회 2001 大韓韓方內科學會誌 Vol.22 No.4

Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

최근 한방의료기관의 환자감소요인 고찰

이선동,최찬호 한국의사학회 2011 한국의사학회지 Vol.24 No.1

Recently, the oriental medicine industry in Korea has faced much hardship, due to the decreasing number of patients. Therefore, it is essential to investigate the reasons why patients are avoiding oriental medicine, because the percentage of people consuming medical service is an important marker that assesses the value of medical service, The researcher(s), based on theories on factors that affect health, health behaviors, and diseases, sought to find reasons why oriental medicine clinics saw a decline in the number of patients. Also, by proposing the problems inside the oriental medicine, I came to the following conclusion. -Because Koreans have low expectations for oriental medicine, they do not consider it as full medical service, Also, when they get sick, they are reluctant to seek oriental medicine because of reasons such as the limits of oriental medicine and check-ups, expensive medical cost, negative perception of oriental medicine, not enough support from the media, the old image of the oriental medidne and the little power the industry has on the society. -Among the inner problems of the oriental medicine community was the limitations that the science face on incurable and chronic diseases in terms of treatment and management, little professionalism, lack of scientific evidence, the attitude of the oriental medicine society, lack of sophistication in research methodology, and limitations in responding to changes in public health and the surroundings. The purpose of medicine is to eliminate the possibility of shortened life and dangers by treatment of diseases and health maintenance. For this to happen, structural and developed medical theories and means of treatment are necessary. The researcher hypothesizes that the problems that the oriental medicine society is facing mainly come from the lack of efforts and ability to provide such necessities.

의과대학 정신과 실습 학생의 환자중심적 태도와 관련 요인

문석우,서정석,남범우,손인기,함 웅,조인희,권혁중 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.4

Introduction : The practicing of patient-centered medical services means a change in the pattern of the nature of doctor-patient relationship. The doctor oriented relationship is now moving to the pattern that patients resolve problems autonomously and participate in the decision-making in medical services. Authors performed this study to investigate the patient centeredness and influencing variables in medical students. Methods : Authors recruited 94 medical students before psychiatric clinical clerkship and all subjects were assessed by structured questionales including socio-demographic data, frequency of receiving doctor-patient relationship lectures, Minnesota multiphasic personality inventory (MMPl), Meyers-Briggs type indicator (MBTI), the authoritarian personality scale (AP), job satisfaction scale (JS), Patient practitioner orientation scale (PPOS), problem-solving decision-making scale (PSDM), and Beisecker locus ot authority in decision-making scale (BLAS), and the questionnaire of JS, PPOS, PSDM, and BLAS were rechecked after psychiatric clinical clerkship. Results : After psychiatric clinical clerkship, the score of JS, PPOS were higher than before. The group who had a good memory for taking a doctor-patient relationship lecture showed higher scores of the BLAS and PSDM than unexposed group. The AP was related with MBTI, correlated with the subscale of MMPI, however, inversely correlated with PPOS after psychiatric clinical clerkship. Conclusion : The authoritarian personality trait was related not only with other personality trait including introversion and psychopathic deviation (Pd) but also with patient-centeredness. Taking a lecture in doctor-patient relationship is positively related to the patient-centeredness.

한방병원 응급실에 내원한 소아 환자에 관한 임상적 고찰

김지은,백정한,Kim, Ji Eun,Baek, Jung Han 대한한방소아과학회 2014 대한한방소아과학회지 Vol.28 No.4

Objectives By analyzing data of the pediatric patients who had visited the emergency room of the oriental medical hospital, we can understand their characteristics and diseases. The purpose of this study was to introduce the excellence of the Oriental medicine, to develop various treatments, and to revitalize pediatric emergency care at the oriental medical hospital. Methods The study was composed of 334 pediatric patients who had visited the emergency room of the ${\bigcirc}{\bigcirc}$ university oriental hospital from January 2011 to December 2013. Results 1. It has showed that between 7 to 12 years old patients (27.8%) were the most common age populations. 2. The number of pediatric patients was increased during February. According to the weekly distribution data, the number of pediatric patients who had visited on Sunday was the highest (28.7%). Also, the number of pediatric patients who had visited the ER between 21 to 24 hours (29.0%) was the highest. 3. The two major reasons for inpatient hospitalization were digestive and nerve-related symptoms. Nerve-related symptoms were the most common in infants while digestive symptoms were the most common in other child development stages. 4. The duration of time interval from the onset of symptoms to the ER visit was most commonly within 6 hours (50.3%). An acupuncture and herbal medication treatment (70.1%) were the most common medical treatments. The majority of the pediatric patients (95.5%) were discharged after their medical treatments. Conclusions A serious acute illness was not the most common reason for the ER visit among the pediatric patients. The most common disease states that have preferred to be treated with the oriental medicine were dyspepsia, crying, facial palsy, and ankle sprain. We have to introduce the excellence of the oriental medicine. We also need to try developing other treatments such as magnetic acupuncture, aromatherapy, and revitalizing pediatric emergency care at the oriental medical hospital.

시뮬레이션 과제 수행이 뇌졸중 환자의 균형 능력에 미치는 효과

구봉오 ( Bong Oh Goo ),강승수 ( Seung Soo Kang ) 대한물리의학회 2010 대한물리의학회지 Vol.5 No.4

Purpose:This study was performed to examine the effect of stimulation task-oriented training on the balance ability of the hemiplegic patients caused by stroke. Methods:We made a random sampling of 25 hemiplegic patients caused by stroke. 10 patients (experimental group) were treated by simulation Task-oriented training and Conventional training used by balance pad. The other 10 patients (control group) were only treated by Conventional training used by balance pad. During the training, 3 patients from the experimental group and 2 patients from the control group were excluded by private affairs. The control group has done Conventional training 6 times a week for 6 weeks. And experimental group has done Simulation task-oriented training two times, conventional training four times a week for 6 weeks. Balance ability was assessed by Fuctional Reaching Test (FRT) : unilateral and bilateral reaching. Results:In comparison of FRT before and after training, two groups all was significantly improved(p<05). But bilateral reaching variation was significantly improved in experimental group. Conclusion:we can use simulation Task-oriented training valuably to increase balance ability of hemiplegic patients.

자동차보험 한방진료비 증가요인 분석

이창수(Lee ChangSoo),이현주(Lee Hyeon Ju ),채정미(Chae JungMi) 한국산학기술학회 2019 한국산학기술학회논문지 Vol.20 No.1

자동차보험 총 진료비는 2014년 대비 2015년 12% 증가하였으나 그 중 한방진료비는 36% 증가하였다. 본 연구 목적은 진료비 항등식을 이용하여 자동차보험 한방진료비의 급격한 증가 원인을 구체적으로 파악하는 것이다. 2014년~2015년 기간 중 진료하여 심사 완료된 34,351,120건의 데이터를 이용하여 분석한 결과 한방 환자수는 해당 기간 중 27%, 환자당 진료비는 7% 증가하였다. 환자당 진료비를 세분화하여 분석한 결과, 환자당 입(내)원 일수는 변하지 않았으며 일당진료비만 7% 증가하였다. 환자수 증가를 보면 한방진료만을 받은 환자는 32%, 의과와 한방을 함께 진료 받은 환자는 24% 증가한 반면 의과진료만을 받은 환자는 오히려 4% 감소하였다. 일당진료비 증가에 영향을 미치는 요인으로는 한방물리요법 등 표준화되지 않은 진료행위의 비용 상승이 있다. 그럼에도 불구하고 한방 진료비 증가에 가장 크게 영향을 미친 요인은 환자수의 증가였다. Automobile insurance medical expenses increased by 12% in year 2015 compared to year 2014. But the oriental medical service expenses in automobile insurance increased by 36% during the same period. In this paper the reason for the rapid increase of expenses for oriental medical service was analyzed using the method of decomposing medical expenses. As a result of analyzing 34,351,120 cases that were examined and completed during the period of 2014∼2015, the number of oriental medicine patients increased by 27% and the medical expense per patient increased by 7%. The result of analysis showed that there was no significant change in service period per patient but medical expense per day increased by 7%. The increase in the number of patients receiving only oriental medical services was 32%. Increase in the number of patients receiving medical treatment and oriental medical services was 24% and the number of patients receiving medical treatment only decreased by 4%. There was significant increase in non standardized cost of oriental physical therapy which was one reason of the increase of the expenses. However, the most influential factor of the increase in the expenses of oriental medical services was the increase of the number of patients.

사용자 중심적 병실계획을 위한 사용자 반응조사

오찬옥 대한건축학회 2003 대한건축학회논문집 Vol.19 No.5

This study was based on the idea that the patient-oriented concept in healthcare design would be extended to the user-oriented one which considered all users' views including patients, families, and nurses. The purpose of this study was to investigate what elements the users would consider to be important in patient room design. The subjects of this study were 96 inpatients, 89 families, and 98 nurses in two general hospitals in Busan. Interview and self-administered questionnaire were used for collecting data. The subjects answered about what degree of importance each element had and what element they think to be the most important in patient room design. The results of this study were as follows; The users thought that the location of nursing station, outdoor view from patient room, persons per room, noise, ventilation, square meter per person, home-likeness, and consideration for families and visitors were important design elements which should be considered primarily in patient room design. Also the nurses considered most of the design elements presented as more important than the patients and families. However, in the case of the psychological elements, there were no differences in degrees of importance among the users.

요통환자의 한방재활의학과와 한방신경정신과와의 협진관계 모색 방법론

이명종 ( Myeong Jong Lee ) 한방재활의학과학회 2002 한방재활의학과학회지 Vol.12 No.3

Objectives:Psychologic & Societal studies are in progress for low back pain in these days.But there is no enough interchanges between painful diseases and psychotherapies within oriental treatment system.So the author try to study the methods to increase the treatmental effects and the desirable medical examination & treatment profile between oriental rehabilitation medicine and oriental neuropsychiatry for the low back pain patients.Methods:We can diagnose general body conditions and the disorders of the autonomic nervous system through the medical examination and diagnostic equipments.It is essential to be treated oriental rehabilitation treatments for all the low back pain patients.If the patients have psychogenic low back pain, we must try to treat various of oriental psychotherapies, too.Conclusions:1.There is various oriental psychotherapies as basic treatments for the low back pain patients in the oriental neuropsychiatry.2.We can manage aroma therapy clinic, Qigong therapy clinic and music therapy clinic for the psychogenic low back pain patients.And we can use various treatment methods such as aroma therapy, music therapy, relaxation therapy, Qigong therapy, meditation & yoga therapy, hypnotherapy and color therapy in that clinics.3.It is demanded that multidisciplinary and multidimensional approach as the principle of the treatments for low back pain.In this points, Oriental medicine will be more effective in the basis of body and spirit monism.