The setup of Biologics Infusion Center in the clinic improves rheumatism patients'satisfaction / 中国实用护理杂志

Objective To observe the effect of biologics intravenous infusion center on patient satisfaction. Methods A total of 120 patients with rheumatism diagnosed and treated with biologics at Renji Hospital South Campus and West Campus from August 2016 to November 2016 were enrolled. Patients in South Campus were offered an optimized clinical practice in the biologics intravenous infusion center as an intervention group, while patients in West Campus received an ordinary clinical practice in the department of rheumatism as the control. Patient satisfaction of appointment, treatment process, specialist physician, clinical nurse specialist, and overall sense was compared. Results Patient satisfaction score of appointment in the intervention group was 4.397 ± 0.112, and 3.451 ± 0.080 in the control, a statistically significant difference (t=5.762, P<0.01). Patient satisfaction score of treatment process in the intervention group was 4.105 ± 0.138, and 2.612 ± 0.109 in the control, a statistically significant difference (t=8.202, P<0.01). Patient satisfaction score of specialist physician in the intervention group was 4.495 ± 0.091, and 3.371 ± 0.061 in the control, a statistically significant difference (t=9.745, P<0.01). Patient satisfaction score of clinical nurse specialist in the intervention group was 4.589 ± 0.101, and 3.147 ± 0.064 in the control, a statistically significant difference (t=9.739, P<0.01). Patient satisfaction score of overall sense in the intervention group was 4.238±0.121, and 3.147±0.086 in the control, a statistically significant difference (t=10.514, P<0.01). Conclusions Biologics intravenous infusion center can significantly improve patient satisfaction, helps to promote the management of patients and working efficiency, ensures the safety of biologics use, makes more efficient utilization of medical care resources.

Clinical Practice Patterns of Radiotherapy in Patients with Hepatocellular Carcinoma: A Korean Radiation Oncology Group Study (KROG 14-07) / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aim of this study was to examine patterns of radiotherapy (RT) in Korean patients with hepatocellular carcinoma (HCC) according to the evolving guideline for HCC established by the Korean Liver Cancer Study Group-National Cancer Center (KLCSG-NCC). MATERIALS AND METHODS: We reviewed 765 patients with HCC who were treated with RT between January 2011 and December 2012 in 12 institutions. RESULTS: The median follow-up period was 13.3 months (range, 0.2 to 51.7 months). Compared with previous data between 2004 and 2005, the use of RT as a first treatment has increased (9.0% vs. 40.8%). Increased application of intensity-modulated RT resulted in an increase in radiation dose (fractional dose, 1.8 Gy vs. 2.5 Gy; biologically effective dose, 53.1 Gy10 vs. 56.3 Gy10). Median overall survival was 16.2 months, which is longer than that reported in previous data (12 months). In subgroup analysis, treatments were significantly different according to stage (p < 0.001). Stereotactic body RT was used in patients with early HCC, and most patients with advanced stage were treated with three-dimensional conformal RT. CONCLUSION: Based on the evolving KLCSG-NCC practice guideline for HCC, clinical practice patterns of RT have changed. Although RT is still used mainly in advanced HCC, the number of patients with good performance status who were treated with RT as a first treatment has increased. This change in practice patterns could result in improvement in overall survival.

Survey of the Patterns of Using Stereotactic Ablative Radiotherapy for Early-Stage Non-small Cell Lung Cancer in Korea / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Stereotactic ablative radiotherapy (SABR) is an effective emerging technique for early-stage non-small cell lung cancer (NSCLC). We investigated the current practice of SABR for early-stage NSCLC in Korea. MATERIALS AND METHODS: We conducted a nationwide survey of SABR for NSCLC by sending e-mails to all board-certified members of the Korean Society for Radiation Oncology. The survey included 23 questions focusing on the technical aspects of SABR and 18 questions seeking the participants' opinions on specific clinical scenarios in the use of SABR for early-stage NSCLC. Overall, 79 radiation oncologists at 61/85 specialist hospitals in Korea (71.8%) responded to the survey. RESULTS: SABR was used at 33 institutions (54%) to treat NSCLC. Regarding technical aspects, the most common planning methods were the rotational intensity-modulated technique (59%) and the static intensity-modulated technique (49%). Respiratory motion was managed by gating (54%) or abdominal compression (51%), and 86% of the planning scans were obtained using 4-dimensional computed tomography. In the clinical scenarios, the most commonly chosen fractionation schedule for peripherally located T1 NSCLC was 60 Gy in four fractions. For centrally located tumors and T2 NSCLC, the oncologists tended to avoid SABR for radiotherapy, and extended the fractionation schedule. CONCLUSION: The results of our survey indicated that SABR is increasingly being used to treat NSCLC in Korea. However, there were wide variations in the technical protocols and fractionation schedules of SABR for early-stage NSCLC among institutions. Standardization of SABR is necessary before implementing nationwide, multicenter, randomized studies.

National Practice Pattern and Time Trends in Treatment of Upper Urinary Tract Calculi in Korea: a Nationwide Population-Based Study

Despite high prevalence of upper urinary tract calculi (UUTC), there are few studies regarding patterns of care in Asian populations. We investigated treatment patterns and time trends in patients with newly diagnosed UUTC in Korea using the National Health Insurance database that includes de-identified claims from a random 2% sample of the entire population (> 1 million people). A total of 14,282 patients who received active treatments, including shock wave lithotripsy (SWL), ureteroscopic surgery (URS), percutaneous nephrolithotomy (PNL), and uretero/pyelolithotomy (UPL), for newly diagnosed UUTC between 2003 and 2013 were included. The number of primary and all treated cases of UUTC significantly (43% and 103.3%, respectively) increased over the 10-year period. While patients undergoing SWL, URS, PNL, and UPL as primary treatment increased by 43.7%, 31.9%, 87.5%, and 0%, respectively, the relative proportion undergoing each treatment remained constant over the 10 years (SWL > 90%, URS 4.5% to 7.8%, PNL 0.4% to 1.0%, and UPL 40 years (compared to age < 30 years) was significantly associated with URS, PNL, and UPL, rather than SWL, while patients living in urban or suburban/rural areas (compared to metropolitan) were significantly less likely to undergo URS and PNL. In summary, the majority of Korean patients underwent SWL as primary treatment for UUTC, and the predominant use of SWL remained steady over a 10-year period in Korea. Our results will be valuable in examining treatment patterns and time trends in Korean UUTC patients.

Reliability and Validity of the Korean Version of Belongingness Scale-Clinical Placement Experience

PURPOSE: The purpose of this cross-sectional survey was to determine the reliability and validity of the Korean version of the Belongingness Scale-Clinical Placement Experience (BS-CPE). METHODS: The study conducted a cross-sectional survey which used a self-report questionnaire. A convenient sampling method was utilized, and data on 335 students was gathered. We verified construct validity by performing confirmatory factor analysis. RESULTS: The overall Cronbach's alpha score was .90 (range: .71-.84). BS-CPE was correlated with self-respect (r = .47, p < .001) and self-directed learning (r = .50, p < .001). The original BS-CPE was modified based on the validity test. CONCLUSION: This modified Korean version of the BS-CPE is applicable for use with university undergraduates to measure belongingness in clinical practice.

The clinical practice pattern of postterm pregnancy in Korea / 대한산부인과학회지

OBJECTIVE: The purpose of this study is to survey the clinical practice pattern of postterm pregnancy in Korea. METHODS: A questionnaire was mailed to 1114 physicians who are registered in Korean Society of Obstetrics and Gynecology (KSOG) and work in primary and secondary hospital as well as tertiary care center. The questions included information about the practice pattern implicating definition of postterm pregnancy, the time and the method of routine fetal surveillance and induction of labor as well as demographic information such as age, sex, location, professional part and the number of delivery. We got 23.2% (258/1114) of surveys returned and analyzed the data. RESULTS: Seventy-four percent (73.6%) of the respondents define 42 weeks gestation or greater to be postterm. However, 84.5% consider induction of labor at 41 weeks of gestation. Sixty-eight percent (68.3%) of the respondents start postterm pregnancy fetal testing at 40 weeks and 59.3% of them perform testing every week. For fetal surveillance testing, 85.7% of the respondents use NST and 39.5% of them use modified BPP. As for induction of labor, 65% of practitioners use oxytocin and 45% of them use prostaglandins (misoprostol and dinoprostone) when inducing both nulliparous and multiparous women with unfavorable cervix. CONCLUSION: Most of the respondents (84.5%) routinely induce low-risk singleton pregnancy at 41 weeks gestation, whereas the majority of them (73.6%) define postterm pregnancy beyond 42 weeks gestation.

The Current State and Future Directions of Clinical Practicum for Adult Health Nursing at Four-year Nursing Colleges in Korea / 성인간호학회지

OBJECTIVE: The study was conducted by the Association of Korean College of Nursing in order to survey and analyze the current state of clinical practicum for adult health nursing at four-year nursing college in Korea and to suggest improvements in the contents and methods of clinical practicum and its future direction. METHOD: Data were collected using a survey by mail from July to November 2004 using a structured questionnaire on the general state of clinical practicum for adult health nursing. The questionnaires were sent to 53 nursing colleges throughout the country, and 47 recovered questionnaires were analyzed. RESULTS: The number of credits for adult health nursing practicum was 7~10(average range), and various nursing fields were used in clinical practicum. The number of students per team was 5~6 at general wards and 3~4 at intensive care units. Students also experienced practicum during daytime and in the evening. Clinical practicum for adult health nursing was led by full-time professors and field practicum directors. In clinical practicum for adult health nursing, almost every college evaluated students' attitude, skills, leadership, etc. in various forms. CONCLUSIONS: It is urgent to develope a standardized evaluation tool for clinical practicum.