• Title, Summary, Keyword: precipitating factors

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Prevalence and Precipitating Factors for Delirium in Elderly Patients Admitted to Long-Term Care Hospitals or to General Hospital (요양병원과 종합병원 노인 입원환자의 섬망 유병율과 유발요인)

  • Yang, Young-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.1
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    • pp.26-34
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    • 2010
  • Purpose: The purpose of this study was to compare long-term hospital and general hospital for delirium prevalence and precipitating factors in elderly patients. Method: The participants were 184 patients aged 65 or older from one general hospital and 4 long-term facilities. Delirium was assessed using the Confusion Assessment Method and precipitating factors for delirium were classified as demographic, physical condition, disease and drug factors associated with delirium found in a literature analysis. Results: Delirium prevalence was 5.4% and there was no significant difference according to hospital type. Most of the patients with delirium were male, dependent and dehydrated and had sleep disturbances, diseases and drugs associated with delirium and, had multi-drugs prescriptions. Non-delirious patients also had two or more delirious symptoms and several precipitating factors. Delirious patients were more dependent, urinary incontinent and had sleep-disturbances compared to the non-delirious group. The participants in the long-term hospitals were found to have frequently previous delirium history. Conclusion: Even though the prevalence rate of delirium was not high, most elderly patients, regardless of delirium, are a very high risk group and dependent ADL, sleep disturbances, and/or urinary incontinence could be used predictive factors for delirium.

The Precipitating Factors of Amputation as Initial Treatment in Diabetic Foot (당뇨발 환자의 치료시 초기 절단 결정의 예상인자)

  • Ko, Sang-Bong;Lee, Sang-Wook;Jeung, Dae-Ui
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.26-30
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    • 2005
  • Purpose: To evaluate the precipitating factors of amputation as initial treatment in diabetic foot patients. Materials and Methods: Between March, 1994 and February 2003, 41 cases (37 patients) diabetic foot patients who had diabetic ulcer, pyogenic inflammation and gangrene and followed up over 1 year were collected. Among them, We evaluate the precipitating factors of amputation for average 39.6months (12-118months). Results: Among many factors, Wagner classification, pulse volume recording of toes, Ankle-Brachial Index and Albumin level are statistically significant in amputation patients. Conclusion: In determining the amputation of diabetic foot as initial treatment, the trauma history, circulation of foot and serum albumin level are important precipitating factors. So the education about preventing even minor trauma and maintaining good nutrition state decrease the amputation rate in diabetic foot patients.

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Theoretical Models of Causative Factors in Depression : A Review of the Literature for Nursing (우울 발생요인에 관한 이론적 고찰)

  • 김수지;고성희
    • Journal of Korean Academy of Nursing
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    • v.19 no.2
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    • pp.173-190
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    • 1989
  • This literature review was undertaken to explore theoretical models of depression for their potential usefulness in nursing research and practice. Depression has bean accounted for by numerous theories or models of causation ; 11 theories selected from psychology, medicine and psychoanalysis and supported by empirical or experimental research were reviewed. These theories identify a variety of precipitating and predisposing factors that may affect the individual's depression. Aggression - turned - inward theory, object loss theory, ego functioning theory, personality organization theory, behavioral theory, learned helplessness theory, cognitive theory, genetic factors, and biological theories conceptualize predisposing factors. Only life stressors theory identifies precipitating facotrs. Each of these theories contributes to an understanding of depression, but many of them use overlapping and interrelated factors. It is also evident from recent. research that there are multiple causes for depression involving an interactive effect among predisposing and precipitating factors that are both biological and psychological in origin. That is, a single theory is not useful, but perhaps a unified theory could be developed that would be helpful to nursing. This review points to the need for continuing development and testing of theories that would integrate the multiple conceptualizations of depression.

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Psychological Problems and Psychosocial Predictors of Cigarette Smoking Behavior among Undergraduate Students in Malaysia

  • Saravanan, Coumaravelou;Heidhy, Imran
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7629-7634
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    • 2014
  • Background: Cigarette smokers have their own motivation and justification to smoke. For example, smoking reduces their stress or enhances their pleasure. This study aimed to identify the (a) prevalence of cigarette smokers among undergraduates in Malaysia, (b) gender differences in nicotine dependence among current smokers, (c) differences in psychological problems (depression, anxiety and stress) based on the status of smoking cigarettes (current, former and non-smokers) and (d) extent to which precipitating factors (tension reduction, addiction, automatism, handling, social interaction, pleasure, and stimulation) predict the smoking behavior among current smokers. Materials and Methods: In this study 780 undergraduate students participated from a private university in Kuala Lumpur and Selangor state in Malaysia. The Depression, Stress and Anxiety Scale, Modified Reason for Smoking Scale and Fagerstrom Nicotine Dependence Test were used to measure psychological problems, predictors of smoking behavior and nicotine dependency among current smokers. Results: The results showed that 14.7%(n=106) of the students were smokers. Current smokers exhibited more psychological problems (depression, anxiety and stress) compared to former and non-smokers. Addiction, tension reduction, pleasure and automatism were predictors of smoking behavior among the current smoking students. Step wise regression analysis showed that smoking behavior was highly predicted by nicotine dependency or addiction. Smoking students were motivated to smoke cigarettes as they believed that it reduced their tension and enhance pleasure. Conclusions: Hence, there is a need for health promotion and anti-tobacco prevention as cigarette smokers experience more psychological problems. Nicotine dependency or addition was one of the major causes for smoking behavior among the student population in Malaysia.

Role for Epigenetic Mechanisms in Major Depression (우울증의 후생유전적 기전의 역할)

  • Kim, Jae-Won;Yoon, Bong-June
    • Korean Journal of Biological Psychiatry
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    • v.18 no.4
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    • pp.181-188
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    • 2011
  • Major depression is a devastating disorder of which lifetime prevalence rate is as high as up to 25% in general population. Although the etiology of the disorder is still poorly understood, it is generally accepted that both genetic and environmental factors are involved in the precipitation of depression. Stressful lifetime events are potent precipitating environmental factors for major depression and early-life stress is in particular an important element that predisposes individuals to major depression later in life. How environmental factors such as stress can make our neural networks susceptible to depression and how those factors leave long-lasting influences have been among the major questions in the field of depression research. Epigenetic regulations can provide a bridging mechanism between environmental factors and genetic factors so that these two factors can additively determine individual predispositions to major depression. Here we introduce epigenetic regulations as candidate mechanisms that mediate the integration of environmental adversaries with genetic predispositions, which may lead to the development of major depression, and summarize basic molecular events that underlie epigenetic regulations as well as experimental evidences that support the active role of epigenetic regulation in major depression.

Risk Factors Associated with Germinal Matrix-Intraventricular Hemorrhage in Preterm Neonates

  • Kim, Kwang-Ryeol;Jung, Sang-Won;Kim, Dong-Won
    • Journal of Korean Neurosurgical Society
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    • v.56 no.4
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    • pp.334-337
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    • 2014
  • Objective : The purpose of this study is to identify the risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) and the relationship of the severity of disease and prematurity. Methods : A total of 168 premature neonates whose birth weight ${\leq}1500g$ or gestational age ${\leq}34$ weeks were examined by cranial ultrasound (CUS) for detection of GM-IVH among the babies admitted between January 2011 and December 2012 in our medical center neonatal intensive care unit. The babies were divided into two groups : GM-IVH and non-IVH. Clinical presentations, precipitating factors of the patients and maternal factors were analyzed. Results : In univariate analysis, gestational age, birth weight, delivery method, presence of premature rupture of membrane (PROM) and level of sodium and glucose were statistically meaningful factors (p<0.05). But only two factors, gestational age and presence of patent ductus arteriosus (PDA) were statistically meaningful in multivariate logistic regression (p<0.05). Delivery method [normal vaginal delivery (NVD) to Caeserean section] was borderline significant (p<0.10). Conclusion : Presence of PDA and gestational age were the important risk factors associated with development of GM-IVH.

Inline Skating and Prevention of The Related Injuries (인라인 스케이트와 부상의 예방)

  • Moon Young Lae;Kim Kug Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.31-35
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    • 2004
  • The incidence of in-line skating injuries has increased with the rapid growth in the sport's popularity. The purpose of this article is to describing the type of the inline skating and document basic skills, protective equipment use, identify contributing or precipitating factors associated with injuries. Loss of control and inexperience were factors contributing to the injuries. Also protective equipment among skaters was underused. In conclusion, the safety education program for inline skating, optimal design and efficacy of protective equipment should identify with further study.

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Clinical Study of Neonatal Gastric Perforation (신생아 위 천공의 임상적 고찰)

  • Rhim, Si-Yeon;Jung, Pung-Man
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.123-130
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    • 2005
  • Gastric perforation of the newborn is a rare and life threatening problem. The pathogenesis of gastric perforation is not clear. Since ischemia is responsible for intestinal perforation, a similar mechanism may result in gastric perforation. Twelve patients with neonatal gastric perforation who were treated at the Department of Pediatric Surgery, Hanyang University Hospital from 1987 to 2002 were reviewed. Eight patients were male and four female. The age of perforation was 1 day to 8 days of life. Ten patients were operated upon and 2 patients were treated nonoperatively. The perforation site was located on the anterior wall along the greater curvature of the stomach in 8 patients and along the lessor curvature of the stomach in 2. The precipitating factors were prematurity, gastroschisis, mechanical ventilation, intestinal obstruction, cyanotic heart disease and indomethacine medication. In 5 cases the cause of perforation was not identified. The mortality rate was 25 % (3 of 12). Earlier recognition and treatment were thought to be crucial prognostic factors.

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Development of an Evidence-Based Protocol for Preventing Delirium in Intensive Care Unit Patients (중환자실 섬망예방을 위한 근거중심 간호중재 프로토콜 개발)

  • Moon, Kyoung Ja;Lee, Sun Mi
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.3
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    • pp.175-186
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    • 2010
  • Purpose: Delirium can be a highly prevalent symptom in intensive care units but it may still be under-recognized despite its relation with inclined morbidity, mortality, cost, and readmission. Therefore, this study aimed to develop a protocol that covers risk factors and non-pharmacological interventions to prevent delirium in ICU patients. Methods: This study was conducted using methodological design, and it followed the Scottish Intercollegiate Guideline Network (SIGN) guideline development steps: 1) the scope of protocol was decided (population, intervention, comparison, and outcomes); 2) guidelines, systematic reviews, and protocols were reviewed and checked using methodology checklist; 3) the level of evidence and recommendation grades was assigned; 4) the appropriateness of recommendations was scored by experts; 5) the final protocol & algorithm was modified and complemented. Results: The evidence-based delirium prevention protocol was completed that includes predisposing factors, precipitating factors and recommendations with evidenced grades. Conclusion: This protocol can be used as a guide nurses in screening patients with high risk factors of delirium as well as in intervening the patients non-pharmacologically to prevent delirium.

Risk Factors Associated with the First Osteoporotic Fracture (첫 번째 골다공성 골절에 영향을 미치는 요인)

  • Kim, Young-Sun;Choi, Ja-Yun
    • Korean Journal of Adult Nursing
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    • v.23 no.6
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    • pp.564-573
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    • 2011
  • Purpose: The purposes of this study were to identify the factors associated with the first reported fracture in osteoporotic patients. Methods: One hundred and sixty-four patients who presented with osteoporosis at K hospital in G city, South Korea between July and September 2010 were participated in study. Modified Korea National Health and Nutrition Examination Survey tool were used to measure participants' living habits. Computer aided nutritional analysis program (CAN-PRO) designed by Nutrition Information Center in the Korean Nutrition Society (2002) was used to analyze foods intake and to calculate the individual nutrients intake. Results: The risk of developing the first osteoporotic fracture was ten times higher in the patients between 65 to 74 years (OR=10.06, p=.010), and 28.41 times greater in those with increasing falls (OR=28.41, p<.001). Patients with higher bone marrow density (BMD) and higher consumption of animal protein diet had lower risks of developing the first osteoporotic fracture (OR=0.37, p=.011; OR=0.88, p=.040, respectively). Conclusion: Risk factors for osteoporotic fracture included the age from 65 to 74 years, an increase in falls, low animal protein consumption, and reduced BMD. Systematic educational program is needed to prevent fracture in osteoporotic patients.