Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease by John Cunningham virus (JC virus) infection in oligodendrocytes. The radiographic and clinical features, along with the identification JC in cerebrospinal fluid polymerase chain reaction, are sufficient for the diagnosis of PML in immunodeficiency. However, it is difficult to suspect PML without the patient history of immunodeficiency. A 32-year-old man presented with headache for a month without any medical history. Based on clinical and image features, the differential diagnoses included demyelinating lesion and neoplasms. Microscopically, biopsy specimen showed multifocal demyelinating and degenerative white matter, consistent with PML. Oligodendrocytes cells with increased nuclei and plum-colored inclusions were admixed with perivascular lymphocytic and histiocytic infiltration, and loss of myelin. Atypical astrocytes had large or multiple nuclei. After brain biopsy, human immunodeficiency virus infection was confirmed by serum chemiluminescent immunoassay. It is unlikely that PML would be considered without the information of immunosuppression. Therefore, it is very important to be aware of the histological features of PML.

본 연구에서는 자기공명영상검사실 방사선사의 환자안전 문화 인식을 분석하고자 하였다. 수도권 자기공명영상검사 실에서 근무하는 방사선사 109명을 대상으로 일반적인 특성, 실태조사, 환자안전 문화 인식에 대해 설문 조사하였 다. 의료종사자들을 대상으로 개발된 한국형 환자안전문화 측정 도구에서 최상위 리더십을 경영진으로, 부서장이라 는 단어를 파트장으로 수정하였고 전문가 5인에게 내용 타당도를 검증받았다. 결과적으로 자기공명영상검사실에서 근무하는 방사선사의 환자안전 문화 인식 점수는 평균 3.97로 높았지만, 안전사고경험 비율이 65.1%로 높게 나타났 다. 따라서 정기적으로 이루어지고 있는 자기공명영상검사 안전교육의 효율성 제고를 위한 연구가 필요하며 본 연구 가 기초자료를 제공할 것이라 사료된다.

Background: Stroke patients experience a variety of physical problems due to neurological problems, including difficulties with trunk control. Trunk taping is used to improve gait in stroke patients. Objectives: To investigated the immediate effect of thoracic and abdominal elastic taping on gait parameters (the dynamic balance and gait speed) in stroke patients. Design: Quasi experimental study. Methods: A total of 24 study subjects were randomly assigned to the experimental group (thoracic and abdominal taping, 12 people), and the control group (sham taping, 12 people). All subjects had timed up and go (TUG) test and 10 meter walk test (10MWT) measured before and after taping. Results: After taping, the TUG test and 10MWT results were significantly reduced only in the study group (P<.05). The TUG test and 10MWT results of the study group were significantly decreased compared to the control group. Conclusion: The thoracic and abdominal taping was found to improve trunk control in stroke patients, thereby improving dynamic balance and walking speed.

본 연구는 간호학생을 대상으로 뇌졸중 표준화 환자를 활용한 시뮬레이션기반 교육 경험을 심 층적으로 이해하고 이를 통해 경험의 본질을 파악하고자 함이다. 자료수집은 2023년 6월 25일부터 자료가 포화상태에 이르게 된 2023년 8월 25일까지 간호학생 10명을 대상으로 심층 개별 인터뷰를 통해 수집되었 고, Colaizzi가 제시한 현상학적 연구 분석 방법으로 분석되었다. 주요 인터뷰 질문은 “뇌졸중 표준화 환자 를 활용한 교육 경험은 당신에게 어떤 의미가 있었나요?”이었고, 수집된 데이터는 내용분석을 이용하여 분 석하였다. 연구결과, 총 7개의 의미있는 진술이 추출되었고, 도출된 주제모음은 ‘간호 교육적 차원’, ‘개인 적 차원’, ‘간호 직무적 차원’으로 나타났다. 이로써 뇌졸중 표준화 환자 활용은 간호학생들의 실무역량 습 득과 뇌졸중 환자간호에 대한 이해를 높였고, 표준화 환자 활용에 있어 긍정적인 요인강화와 제한된 요인 들을 파악하여 실무역량을 증진하기 위한 시뮬레이션기반 교육전략이 필요함을 알 수 있다.

본 연구는 요양보호사의 환자안전 지식과 환자안전관리 활동의 관계에서 자기효능감의 매개 효 과를 확인하기 위해 수행된 서술적 조사연구이다. 자료수집은 노인요양시설과 재가센터 소속 요양보호사를 대상으로 2022년 7월 1일부터 7월 29일까지 실시되었으며, 197명의 자료가 최종 분석에 사용되었다. 수집 된 자료는 SPSS 28.0 프로그램을 이용하여 t-test, ANOVA, Scheffé test, Person’s correlation coefficients, Hierarchical multiple regression으로 분석하였다. 연구결과, 요양보호사의 환자안전 지식과 자 기효능감(r=.653, p<.001), 환자안전 지식과 환자안전관리 활동(r=.467, p<.001)은 각각 유의한 양의 상관관 계를 보였다. 또한 요양보호사의 환자안전 지식과 환자안전관리 활동의 관계에서 자기효능감의 완전 매개 효과가 확인되었고, 설명력은 46.8%였다. 따라서 요양보호사의 환자안전관리 활동을 강화하기 위해서는 자기효능감 향상을 위한 체계적인 프로그램 개발과 함께 교육의 기회가 제공되어야 할 것이다.

We aimed to develop and analyze the effectiveness of a “Room of Errors” simulation program for educating nursing students in patient safety management. Methods: This study used a quasi-experimental method (two group, before and after evaluation) and enrolled 35 nursing students as the participants. Data were collected using a self-reported questionnaire and analyzed through descriptive statistics and the independent t-test and Mann-Whitney U test using SPSS/WIN Statistics version 25.0. Results: After completing the “Room of Errors” simulation program, the participants’ score of intention and confidence in performance for patient safety management in the experimental group were significantly higher than those in the control group. Conclusion: A “Room of Errors” simulation education program for nursing students effectively increased the intention and confidence in performance of nursing students in patient safety management.

The purpose of this study was to develop a nursing education program using Web-based simulation for the care of patients with intracranial pressure. An additional aim was to verify the effectiveness of nursing knowledge, problem-solving competency, a critical thinking disposition, and the expectation of learning transfer. Methods: This was an experimental study using repeated measures with a nonequivalent control group. The participants were senior nursing students, randomly assigned to experimental (n=30) and control (n=30) groups. The experimental group participated in a nursing education program that included Web-based lectures, pre-briefing, Web-based simulation, and debriefing, whereas the control group’s program included only Web-based lectures. Results: A significant difference was found between the experimental and control groups in problem-solving competency (F=5.84, p=.005), critical thinking disposition (F=4.25, p=.021), and the expectation of learning transfer (t=2.30, p<.025). Also, a significant interaction between time and group was found in problem-solving competency and critical thinking disposition. Conclusion: The results of this study showed that the education program using Web-based simulation positively affected nursing students’ problem-solving competency, critical thinking disposition, and the expectation of learning transfer. Therefore, this program can be considered a valuable aid in educating nursing students.

Degenerative arthritis is a common joint disease that affects many elderly people and is typically diagnosed through radiography. However, the need for remote diagnosis is increasing because knee pain and walking disorders caused by degenerative arthritis make face-to-face treatment difficult. This study collects three-dimensional joint coordinates in real time using Azure Kinect DK and calculates 6 gait features through visualization and one-way ANOVA verification. The random forest classifier, trained with these characteristics, classified degenerative arthritis with an accuracy of 97.52%, and the model's basis for classification was identified through classification algorithm by features. Overall, this study not only compensated for the shortcomings of existing diagnostic methods, but also constructed a high-accuracy prediction model using statistically verified gait features and provided detailed prediction results.

Mucosa-associated lymphoid tissue (MALT) lymphoma (ML) is a type of non-Hodgkin’s lymphoma involving MALT, commonly the stomach or salivary glands, although virtually any mucosal site can be affected. ML originates from B cells in the marginal zone of MALT, and is also called extranodal marginal zone B cell lymphoma. It is a slow-growing cancer that usually responds well to treatment. A 59-year-old female presented with a 1-day history of quadriparesis and dysarthria. Up arrival at the hospital, motor power in the right upper and lower extremities was grade 3/5 according to the Medical Research Council scale, while that in the left leg was 4/5. The patient had been diagnosed with gastric ML 1 year prior, and had received antibiotics during the previous 2 weeks. The emergency magnetic resonance imaging of the brain performed at the time of presentation showed multifocal embolic infarction in the cerebral hemisphere bilaterally, which did not have a cardiac origin. Magnetic resonance angiography revealed no stenotic or occlusive lesions. Secondary prophylaxis with daily administration of 300 mg aspirin was prescribed. The patient was discharged with residual right hemiparesis 2 weeks after the onset of symptoms. Herein, we present a rare case of multifocal cerebral infarction in a gastric ML patient.

이번에 제시할 화상 사례 보고는 환자와 검사를 시행하는 방사선사의 부주의로 인한 화상 안전사고가 아니라 환자 가운 의 치수 구별을 하기 위하여 사용한 녹색 염료가 착색된 파이핑 라인에서 발생한 복부 부위 화상 안전사고에 대한 MRI 인공물 영상과 사례를 보고하고자 함이다. 화학 착색염료는 다양한 금속을 사용하여 만들어지고 주로 금속 염화물로 이루 어져 있으며 이번에 화상 사례로 발생한 녹색 염료는 열 전도성이 높은 구리와 크롬, 철 성분이 많이 함유된 염화물이 주로 사용되고 있다. 이러한 화상 안전사고를 막기 위해서는 염료의 성분에 대해서 알아보고 열 전도성이 없는 스펀지나 면으로 된 포 등을 피부와 환자 가운 사이에 끼워 간격을 두어야 할 것이다. 이번 화상 사례는 철저한 검사 전 선별 절차에도 불구 하고 화상 안전사고가 발생할 수 있음을 보여 주고 있으며 MRI 인공물 영상을 확인하여 조치하면 화상 안전사고를 미리 예방할 수 있는 정보로 가치가 있을 것으로 생각된다.

본 연구는 노인 요양병원 간호사의 환자안전관리 활동 영향요인을 파악하여 노인 요양병원의 환자안전사고를 예방하기 위한 기초자료로 활용하기 위해 실시한 서술적 조사연구이다. 대상자는 노인 요 양병원 간호사 220명이며, 자료수집은 2023년 2.1~2.28일까지 실시 하였으며, 수집된 자료는 SPSS 29.0 프로그램 이용하여 t-test, ANOVA, Scheffe’s test, Person’s correlation coefficients, Multiple linear regression으로 분석하였다. 환자 안전동기는 환자안전도(r=.41, p<.001), 환자안전도는 환자안전관리 활동 (r=.18, p<.01)과 양의 상관관계를 보였으며, 환자안전관리 활동에 가장 유의한 영향요인은 환자안전도(β =.21, p<.001)와 환자안전지침서(β=.16, p<.001)로 나타났고, 설명력은 7.5%였다(Adj R2=.075, p<.001). 따라서 환자안전관리 활동 역량을 증진시키기 위해 안전사고 발생 이전에 사고를 미연에 방지하도록 위험 예지 훈련과 함께 안전사고 후 효과적인 대처를 위한 실습교육을 강화하는 환자안전 교육 프로그램 개발과 적용을 제안한다.

Background: Pain Neuroscience Education (PNE) is an educational approach that deals with the physiology of the nervous system as well as the pain system and refers to educating patients with chronic musculoskeletal disorders such as chronic back pain. Objectives: This study examined the effects of pain neuroscience education on patients with low back pain. Design: Systematic review. Methods: Electronic bibliographic databases of a regional information sharing system (RISS) and PubMed were searched to identify randomized controlled studies. In the final outcome, 43 publications were identified, and 13 studies met the inclusion criteria. Results: There were a total of 13 pain-related studies, including 11 studies using NPRS (VAS) and 2 studies using other pain measurement instruments. In NPRS, the effect size was 0.683, which had a medium effect size. In Roland morris disability questionnaire (RMDQ), the effect size was 0.544, which had a medium effect size. In Oswestry disability index (ODI), the effect size was 0.951, indicating a large effect size, but the confidence interval could not be obtained because there was only one study. Conclusion: Pain neuroscience education has positive effects on low back pain and disability index in related patients.

Purpose: Room of Errors is a little-known method in Korea, effective for patient safety education. This study aimed to examine nursing students’ recognition of pre-staged medical errors while working as individuals or in a team. Methods: Thirty-four errors for a pre-op care scenario and thirty errors for a post-op care scenario were pre-set in two simulated patient rooms. Fifty-six nursing students randomly participated as individuals or as a team in one of two “Room of Errors” to find as many errors as possible within a certain time. The evaluation of error detection and debriefing occurred immediately following the simulation. Results: “Wrong patient name on wrist band” (77-100%) and “bedside rails down” (91-100%) were the most frequently identified errors by both individuals and teams. Few students found “injection of a drug to which the patient is allergic” (0-9%) and “administration of a contraindicated drug to the patient” (0-7.7%). The performance of students working in a team was much better than those working alone. Conclusion: This study found that “Room of Errors” provided very experiential and practical learning to nursing students in identifying simulated patient threats. The method is also useful for interprofessional patient safety education to develop teamwork and communication.

This study aimed to investigate the levels of perception of, knowledge of, and attitude toward patient safety and identify factors that affected patients’ attitude towards patient safety. In this descriptive study, participants included 196 patients hospitalized at a tertiary hospital in South Korea. Data were collected using self-reported questionnaires. Perception of and attitude towards patient safety were measure with a tool developed by Ahn Jin-ok, and the questionnaire for knowledge of patient safety was developed by researchers based on a literature review and validated by an expert group. Data were analyzed with Pearson’s correlation coefficients and multiple regression. The average perception of patient safety was 35.48(±6.80) out of 50; the average knowledge of patient safety was 84.33(±8.66) out of 100; and the average attitude towards patient safety was 36.88(±3.74) out of 50. The perception and knowledge of patient safety, level of hospital safety, and age were identified as influential factors explaining 13% of the variation in attitude towards patient safety. The results showed that the direct and indirect educational experience of patients may increase their perception and knowledge of patient safety that can influence their attitude towards patient safety. Therefore, patient education would be an important intervention to improve patients’ attitude towards patient safety. We recommend further studies with educational interventions for improving patient safety activities.

Background: The traditional treatment protocol in adhesive capsulitis cases is physical therapy agents and a home exercise program. The extensive majority of patients respond to conservative treatment, but the painful rehabilitation program makes it inconvenient for individuals to fully comply with the treatment. In order to reduce pain and spasm, intraarticular injections or suprascapular nerve block may be effective before the rehabilitation program. Objectives: To investigated the effect of suprascapular nerve block (SNB), which is added to standard physical therapy on pain, functionality and range of motion in patients with adhesive capsulitis (AC). Design: Retrospective study. Methods: This study included 46 patients who were treated for AC. Patients in both groups were given 15 season physical therapy and home exercise. The treatment group consisted of patients who underwent multiple SNB in addition to physical therapy and home exercise. Datas were analyzed retrospectively. Results: The Visual Analogue Scale (VAS), ROM, Shoulder Pain and Disability Index (SPADI) and Constant scores in both groups after treatment and at the third month follow-up (P<.001). In the comparison between the groups, it was determined that the improvement in VAS, ROM and SPADI scores in the treatment group at the 3-month control was statistically significant (P<.05). Conclusion: Multiple SNB added to physical therapy and home exercise program in cases of AC may be effective in terms of pain control, increasing joint range of motion and improving functionality.

Purpose: Since the COVID-19 pandemic, virtual simulation practice has been increasingly activated as an alternative to clinical practice in nursing colleges. This study aimed to provide basic data by confirming changes in self-efficacy and nursing knowledge in the virtual simulations of nursing students, and identifying virtual presence, virtual patient learning system evaluation (VPLSE), and practical satisfaction. Methods: This was a single-group pre-post quasi-experimental study. The subjects were 28 third-grade nursing students. Results: Self-efficacy and nursing knowledge increased significantly (p<.001). Virtual presence had a significant positive correlation with VPLSE) (p=.002) and practice satisfaction (p=.011). There was also a significant positive correlation between virtual simulation learning evaluation and practice satisfaction (p<.001). Conclusion: Based on these results, virtual simulation practice can be used with clinical practice as an educational method to improve nursing students' self-efficacy and nursing knowledge in nursing education. Virtual presence was confirmed as a significant variable to improve practice satisfaction and VPLSE. It is necessary to develop a virtual simulation program that can improve virtual presence through collaboration with virtual reality technology experts.

본 연구는 의료분야에서 정확한 환자 확인(patient identification)을 위한 의료생체인식기술(medical biometrics)을 소개하고 자 한다. 첫째, 생체인식기술(biometrics)에 대한 정의, 분류 및 종류와 같은 기본 정보다. 둘째, 생체신호 (biological signal)와 의료영상(medical imaging)을 활용한 의료생체인식기술의 종류와 최근 연구에 관한 정보를 기술했 다. 마지막으로 의료 환경에서 적용되는 생체인식기술의 종류와 사례와 함께 의료 환경의 현주소를 언급했다. 환자확인이 라는 궁극적인 목적을 가진 의료생체인식기술은 의료 현장에 점진적으로 도입되리라 생각한다. 본 연구는 본 연구가 정확 한 환자확인을 위한 의료생체인식기술을 이해하고 연구방향에 도움이 되는 기초 자료로 활용될 것으로 사료된다.

Purpose: This study aims to investigate the effect of a simulation-based patient safety performance improvement education program on caregivers’ knowledge, attitude, and performance toward safety. Methods: This study adopted a quasi-experimental design that applied before-and-after designs for the test and control groups. It was configured focusing on “infectious disease,” “fires,” “falls,” and “drug abuse.” Results: There was a significant difference in knowledge and patient safety performance between the experimental group and the control group. However, there was no significant difference in attitudes toward safety. Conclusion: The results of this study showed that the simulation-based patient safety performance improvement education program is effective in improving patient safety performance. Therefore, it is necessary to continuously apply and evaluate the simulation-based patient safety performance training program to enable caregivers to develop professional prevention and management capabilities within elderly care facilities

Patient-controlled sedation systems, in which the patient has control of sedative administration, have been shown to be effective and safe for patients undergoing minor procedures. Safety depends on the adequacy of the step-wise increase in dose of the sedative, the lockout time and patient’s ability to adjust the effective activation of the handset. While there is no patient-controlled sedation (PCS) system available domestically, we have developed a new purpose-built PCS pump, and determined its degree of precision using a microweight measuring scale. The PCS system was designed to be applied to most intravenous sedatives and work through a newly developed operating software algorithm that titrates the doses and lockout times. Our system titrates the doses through software modification, and for experimental purposes, the number of steps for handset activation by the patient was set to four, and the lockout time was set to 30 s. The degree of precision of the PCS system was tested using an electronic weighing scale. The comparison of the amount infused via the PCS system with weight on the scale showed nearly same patterns at the four infusion stages, and the difference was minimal (3% on average at each infusion step). We designed and manufactured a pilot button-type PCS pump capable of use by the patient for optimal sedation, and confirmed the precise working mechanism of the pump, thereby reducing the margin of error for infusion accuracy to 3% or less on average

본 연구는 신규간호사를 대상으로 환자안전동기, 환자안전관리태도, 환자안전관리행위 정도와 상관관계를 확인하고 환자안전관리행위에 영향을 주는 요인을 알아보고자 실시하였다. 신규간호사 127명 을 대상으로 2020년 9월 11일부터 9월 30일까지 설문조사 하였으며, 수집된 자료는 SPSS 22.0 프로그램을 이용하여 t-test, ANOVA, Scheffe’s test, Person’s correlation coefficients, 다중회귀분석을 하였다. 환자 안전동기는 환자안전관리태도, 환자안전관리행위와 양의 상관관계를 보였으며, 환자안전관리태도는 환자안 전관리행위와 양의 상관관계를 보였다. 환자안전관리행위에 가장 유의한 영향을 준 요인은 환자안전동기, 환자안전관리태도, 환자안전관리 교육경험 이었다. 따라서 신규간호사의 환자안전관리행위 능력을 증진시 키기 위해 환자안전동기, 환자안전관리태도를 포함한 환자안전교육 프로그램의 개발과 적용을 제안한다.