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The Pilot Survey of the Perception on the Practice Pattern, Diagnosis, and Treatment on Korean Medicine Insomnia: Focusing on the Difference between Korean Medical Neuropsychiatry Specialists and Korean Medical General Practitioners.

ABSTRACT: Introduction:This study aims to investigate the clinical practice states on the diagnosis and treatment for insomnia between Korean medical general practitioners (KMGPs) and Korean medical neuropsychiatry specialists (KMNPSs). Methods:We distributed questionnaires via email or in person to 1,017 KMGPs and via email to 165 KMNPSs. We collected and analyzed responses from 305 (30.00%) KMGPs and 53 (32.12%) KMNPSs. Results:Most KMGPs and KMNPSs responded that the number of new patients visiting the clinic for treatment of insomnia was less than 10 per month (78.2%). Frequently utilized therapies for insomnia are acupuncture and herbal decoctions. Particularly acupoint GV20 and Guipi decoction were chosen with the highest response rate. There was no difference between KMNPSs and KMGPs in the traditional Korean medical diagnosis methods. However, KMNPSs utilized more various methods to diagnose, treat, and evaluate insomnia and educated more actively sleep hygiene compared to KMGPs. Conclusions:This survey showed how insomnia is currently diagnosed and treated in Korean medical care settings. Moreover, we identified some differences between KMNPSs and KMGPs. Further research is required to explore the underlying reasons for these discrepancies among KMDs and to improve the quality of Korean medical clinical practice in treating insomnia.

SUBMITTER: Lim JH

PROVIDER: S-EPMC5828562 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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The Pilot Survey of the Perception on the Practice Pattern, Diagnosis, and Treatment on Korean Medicine Insomnia: Focusing on the Difference between Korean Medical Neuropsychiatry Specialists and Korean Medical General Practitioners.

Lim Jung-Hwa JH Jeong Jin-Hyung JH Kim Sang-Ho SH Kim Kyeong-Ok KO Lee Seung-Yeon SY Lee Sang-Hyup SH Kim Bo-Kyung BK

Evidence-based complementary and alternative medicine : eCAM 20180211

<h4>Introduction</h4>This study aims to investigate the clinical practice states on the diagnosis and treatment for insomnia between Korean medical general practitioners (KMGPs) and Korean medical neuropsychiatry specialists (KMNPSs).<h4>Methods</h4>We distributed questionnaires via email or in person to 1,017 KMGPs and via email to 165 KMNPSs. We collected and analyzed responses from 305 (30.00%) KMGPs and 53 (32.12%) KMNPSs.<h4>Results</h4>Most KMGPs and KMNPSs responded that the number of new ...[more]

PMID: 29599811

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Project description:BackgroundThere is a large and unexplained variation in referral rates to specialists by general practitioners, which calls for investigations regarding general practitioners' perceptions and expectations during the referral process. Our objective was to describe the decision-making process underlying referral of patients to specialists by general practitioners working in a university outpatient primary care center.MethodsTwo focus groups were conducted among general practitioners (10 residents and 8 chief residents) working in the Center for Primary Care and Public Health (Unisanté) of the University of Lausanne, in Switzerland. Focus group data were analyzed with thematic content analysis. A feedback group of general practitioners validated the results.ResultsParticipating general practitioners distinguished two kinds of situations regarding referral: a) "clear-cut situations", in which the decision to refer or not seems obvious and b) "complex cases", in which they hesitate to refer or not. Regarding the "complex cases", they reported various types of concerns: a) about the treatment, b) about the patient and the doctor-patient relationship and c) about themselves. General practitioners evoked numerous reasons for referring, including non-medical factors such as influencing patients' emotions, earning specialists' esteem or sharing responsibility. They also explained that they seek validation by colleagues and postpone referral so as to relieve some of the decision-related distress.ConclusionsGeneral practitioners' referral of patients to specialists cannot be explained in biomedical terms only. It seems necessary to take into account the fact that referral is a sensitive topic for general practitioners, involving emotionally charged interactions and relationships with patients, colleagues, specialists and supervisors. The decision to refer or not is influenced by multiple contextual, personal and clinical factors that dynamically interact and shape the decision-making process.

Project description:The menopausal transition is marked by increased prevalence in disturbed sleep and insomnia, present in 40-60% of women, but evidence for a physiological basis for their sleep complaints is lacking. We aimed to quantify sleep disturbance and the underlying contribution of objective hot flashes in 72 women (age range: 43-57 years) who had (38 women), compared to those who had not (34 women), developed clinical insomnia in association with the menopausal transition. Sleep quality was assessed with two weeks of sleep diaries and one laboratory polysomnographic (PSG) recording. In multiple regression models controlling for menopausal transition stage, menstrual cycle phase, depression symptoms, and presence of objective hot flashes, a diagnosis of insomnia predicted PSG-measured total sleep time (p < 0.01), sleep efficiency (p = 0.01) and wakefulness after sleep onset (WASO) (p = 0.01). Women with insomnia had, on average, 43.5 min less PSG-measured sleep time (p < 0.001). There was little evidence of cortical EEG hyperarousal in insomniacs apart from elevated beta EEG power during REM sleep. Estradiol and follicle stimulating hormone levels were unrelated to beta EEG power but were associated with the frequency of hot flashes. Insomniacs were more likely to have physiological hot flashes, and the presence of hot flashes predicted the number of PSG-awakenings per hour of sleep (p = 0.03). From diaries, women with insomnia reported more WASO (p = 0.002), more night-to-night variability in WASO (p < 0.002) and more hot flashes (p = 0.012) compared with controls. Women who develop insomnia in the approach to menopause have a measurable sleep deficit, with almost 50% of the sample having less than 6h of sleep. Compromised sleep that develops in the context of the menopausal transition should be addressed, taking into account unique aspects of menopause like hot flashes, to avoid the known negative health consequences associated with insufficient sleep and insomnia in midlife women.

Dataset Information

The Pilot Survey of the Perception on the Practice Pattern, Diagnosis, and Treatment on Korean Medicine Insomnia: Focusing on the Difference between Korean Medical Neuropsychiatry Specialists and Korean Medical General Practitioners.

Publications

The Pilot Survey of the Perception on the Practice Pattern, Diagnosis, and Treatment on Korean Medicine Insomnia: Focusing on the Difference between Korean Medical Neuropsychiatry Specialists and Korean Medical General Practitioners.

Similar Datasets

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