• Title/Summary/Keyword: 낮 병동

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The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

Effect of Raw-Si Particle Size on the Mechanical Properties of Sintered RBSN (출발 Si 분말의 입자크기에 따른 Sintered RBSN의 기계적특성 변화)

  • 이주신;문지훈;한병동;박동수;김해두
    • Journal of the Korean Ceramic Society
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    • v.38 no.8
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    • pp.740-748
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    • 2001
  • 출발원료 Si 분말의 입자크기를 다양하게 하여 질화반응 및 가스압 소결시 입자크기에 따른 산소함량의 차이에서 나타나는 상변화와 그로 인한 치밀화 거동, 미세구조 발달 및 기계적 특성에 대하여 고찰하였다. 145$0^{\circ}C$의 질화반응에서는 조대분말을 사용한 경우가 미세분말을 사용한 경우보다 높은 질화율을 나타냈으며, 각 분말크기에 따른 native oxide의 함량차에 따라 각기 다른 2차 결정상들이 검출되었다. 조대분말을 사용한 경우에는 제 2상의 석출로 인한 액상량의 부족으로 고온의 소결온도에서도 치밀화를 이루지 못해 낮은 강도값을 나타내었다. 한편, 미세분말을 사용한 경우에는 질화반응 후 석출된 제 2상이 소결온도가 증가함에 따라 용융되면서 치밀화를 이루어 높은 강도값을 나타내었다. 높은 강도값은 미세분말을 사용한 시편들에서 얻어졌으나 높은 파괴인성값은 상대적으로 큰 분말을 사용한 시편들에서 얻어졌는데, 이는 미세한 입자들로 구성된 기지상 내에 잘 발달된 주상정 입자들을 갖는 미세구조에 기인된 것으로 사료된다.

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The effect of Jeon-buk area daytime ward occupational therapy convergent activity on hand function, cognitive function and IADL in people with dementia (전북지역 낮 병동 작업치료 융복합활동프로그램이 치매환자의 손기능, 인지기능 및 수단적 일상생활활동에 미치는 영향)

  • Kim, Hyun-Gi;Lee, Min-Young;Kim, Ko-Un;Oh, Hye-Won
    • Journal of Digital Convergence
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    • v.15 no.4
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    • pp.511-519
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    • 2017
  • This study developed a occupational therapy convergent activity program to provide dementia patients admitted to the daytime ward, and investigated the program's effect on the hand and cognitive functions and instrumental activities of daily living. A total of 34 dementia patients were divided into two groups: a convergent occupational therapy program and medication were provided for 17 patients, and medication alone was provided for a control group of 17. The intervention was performed for 24 weeks, 8 times per week, 192 times in total. A handgrip strength test was performed to examine hand function before and after the intervention, and the MMSE-K and GDS were performed to evaluate cognitive function. In addition, the K-IADL was used to assess instrumental activities of daily living. With intervention, the experimental group showed significant improvements in hand and cognitive function and instrumental activities of daily living. In contrast, the control group did not show improvements in hand and cognitive function or instrumental activities of daily living. In conclusion, the study showed that a convergent/integrated activity program for occupational therapy has a positive effect on hand and cognitive function as well as instrumental activities of daily living.

Distribution of Hospital Airborne Microorganisms in Seoul, Korea (서울시내 종합 병원 공기중의 미생물 분포)

  • Hong, Jun-Bai;Chung, Yun-Hee;Yun hee Chang
    • Journal of Environmental Health Sciences
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    • v.29 no.1
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    • pp.1-7
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    • 2003
  • This study was carried out to investigate the airborne microbial pollution in hospital environment. Using a mechanical air sampler, microbiological samples were taken from intensive care unit, general ward room, patients wailing room and outdoor of 20 hospitals in Seoul, Korea. The concentration of airborne bacteria and fungi ranged 97-410 cfu/㎥ and 37-77 cfu/㎥, respectively and patients waiting room had highest bacterial count. 10 genera of molds were identified and the most frequently recovered molds were Aspergillus, followed by Penicillium, Alternaria and Cladosporium. Among Staphylococcus species, S. haemolyticus and S. epidermidis were predominant and 47% of Staphylococcus species were isolated from intensive rare unit.

The Relation among Experience of Verbal Abuse, Emotional Labor, Emotional Intelligence, Social Support and Turnover Intention of Hospital Nurses. (병원간호사의 언어폭력 경험, 감정노동, 감성지능 및 사회적 지지와 이직의도와의 관계)

  • Park, An-Na
    • Journal of Internet of Things and Convergence
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    • v.4 no.2
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    • pp.29-46
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    • 2018
  • The purpose of this study is to understand the relation among experience of verbal abuse, emotional labor, emotional intelligence, social support and turnover intention of hospital nurses. The survey was conducted with 189 hospital nurses working at general hospital in the city of S. The data was collected by using structured questionnaires as research tools from November 17, 2015 to November 27, 2015. The collected data was analyzed by using SPSS ver. 18.0 program. As a result of the correlation analysis between the nurse 's experience of verbal abuse, emotional labor, emotional intelligence, social support and turnover intention, the turnover intention of the nurse was a significantly positive correlation between the experiences of verbal abuse from the doctor, nurses, patients, and the caregiver and the emotional labor. Also, There is a significantly negative correlation between emotional intelligence and social support. In order to identify the factors influencing the turnover intention of the subjects, multiple regression analysis was performed. The statistically significant variables were emotional labor & the ER in the working department.

Influencing Factors of Near Miss Experience on Medication in Small and Medium-Sized Hospital Nurses (중소병원 간호사의 투약 근접오류경험 영향요인)

  • No, Me-Hee;Chung, Kyung-Hee
    • The Journal of the Korea Contents Association
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    • v.20 no.10
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    • pp.424-435
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    • 2020
  • The study was descriptive survey research for establishment of patient safety culture in small and medium-sized hospitals as providing baseline data of educational program regarding safe medication and prevention of near miss on medication, checking influencing factors of nurses near miss experience on medication in small and medium-sized hospital. The collected data was analyzed by SPSS/WIN 20.0 program to obtain mean, frequency, x2-test, independent t-test, one-way ANOVA, logistic regression. The influencing factors of near miss experience on medication was working department and patient safety culture among general characteristic. The nurses who were working in general ward had lesser chance to experience near miss rather than nurses working in special department (Odds ratio:2.23, 95%, Confidence Interval: 1.07~4.67, p=.032). The 1 point higher in patient safety culture, the lesser chance to experience in near miss (Odds ratio: 2.24, 95% Confidence Interval: 1.02~4.95, p=.045). To sum up the result of this study, nurses working in special department had higher chance to experience near miss rather than nurses working in general wards. The higher patient safety culture awareness was the lower near miss was experienced. Thus, miss surveillance system for improvement of nurses' patient safety culture awareness should be developed. Moreover, educational program for medication considering nurses' career and department' character should be requested with simulation training considering and theory education.

CHARACTERISTICS OF UNRULY & DELINQUENT ADOLESCENTS ADMITTED TO A PSYCHIATRIC INPATIENT UNIT (청소년 병동에 입원한 비행 청소년의 특성에 관한 연구)

  • Lee, Young-Sik;Kim, Wun-Jung;Carey, Michael
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.70-82
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    • 1997
  • Objective:This study was performed to identify and understand the characteristics of adolescents who had a history of police arrest and/or were adjudicated unruly/delinquent by the juvenile court. Method:The study employed a retrospective reivew of coumputer-recorded data set on 210 consecutive admissions to an adolescent psychiatric inpatient unit. Three groups(No Police Contact, N=115;Police Contact Only, N=60;Adjudicated, N=35) were compared on the areas of a) cognitive and educational performance b) emotion:anxiety, depression, suicidality c) personality d) family and life experiences. Standardized assessments were administered to all subjects using WISC-Ⅲ, Kaufman Test of Educational Achievement, Millon Adolescent Personality Inventory, Reynolds Adolescent Depression Scale, Revised-Chilren’s Manifest Anxiety Scale, Suicide Ideation Questionnarie, Suicide Behavior Interive, Life Events Checklist, and Family Environmental Scale. A subgroup of the subjects, 60 cases also received a standardized interview by Child Assessment Schedule. Results:The characteristic findings of the delinquent group(the police contact only and adjudicated subjects combined) included (1) a high rate of adoption, sexual promiscuity, out of home placement, and repeated psychiatric hospitalization, (2) low verbal IQ scores and educational achievements, (3) high impulsivity, low social conformity, and high forcefulness in personality inventory, (4) low activityrecreation orientation and low moral religious emphasis in family environment, (5)a high frequency of adverse life experiences, (6) among 3 groups, the Police Contact Only group showed the lowest depression, anxiety and suicidal ideation scores, (7) a high diagnostic frequency of conduct disorder, ODD, and ADHD. Conclusions:The adolescent psychiatric inpatients with a delinquent history presented with a certain clinical, family, psychometric characteristics that warrant specific clinical intervention strategies for their cognitive deficits, an impulsive personality style, family dysfunction with adverse life experiences and disruptive behavioral disorders, different from the rest of adolescent psychiatric inpatients.

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Effectiveness of Hand Massage Combined with Analgesics on Pain Control in Patients with Terminal Cancer (진통제와 병용한 손 마사지가 말기 암환자의 암성통증 조절에 미치는 효과)

  • Lee, Yunmi;Yoon, Hosoon;Lee, Sungwoon;Kim, Young Mi
    • Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.296-302
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    • 2016
  • Purpose: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. Methods: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient's pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. Results: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). Conclusion: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.

Quality Indicators of End-of-Life Cancer Care from the Family Members' Perspective in Korea (호스피스 임상 질 지표에 대한 보호자의 동의정도와 이와 관련된 인자)

  • Kim, Hyo-Min;Youn, Chang-Ho;Ko, Hae-Jin
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.101-109
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    • 2011
  • Purpose: The Assessing Care Of Vulnerable Elders project has developed indicators for the quality of the end-of-life (EOL) care. However, family members of cancer patients may have a different view on the quality indicators (QIs) established by health care experts. We evaluated the QIs from the family members' perspective. Methods: The information used in this study was gathered by surveying family members of cancer patients who were admitted to the inpatient hospice ward in Korea. A cross-sectional anonymous questionnaire was distributed to 120 potential respondents from July to October 2009. We included 69 responses in this study (effective response rate, 57.5%). Statistical analysis was performed by using SPSS for Win ver. 14.0, with independent t-test and Pearson's chi-square test. Results: Among QIs for good hospice care, families agreed the most on "Medical examination by the palliative care team or specialist" (88.4%) and "Dying in the family's presence" (88.4%). They agreed the least on "Discussing cardiopulmonary resuscitation with patients" (15.9%). Among QIs for bad hospice care, "Occurrence of fall or pressure ulcer are undesirable" showed the highest agreement rate (94.2%). The lowest agreement rate was 11.6% on "Dying in the hospital is undesirable." In addition, women, patients who were aware of their prognoses, and people with a high socioeconomic status tended to agree more on the QIs. Conclusion: Patients' families did not agree on some of the QIs recommended by previous studies. Family members' characteristics were related to their opinions on QIs.

Hospice and Palliative Care for the Terminal Patients with Colorectal Cancer (말기 대장직장암 환자의 호스피스 완화의료)

  • Hong, Young-Hwa;Lee, Choon-Sub;Lee, Ju-Ri;Lee, Jung-Ho;Kim, You-Jin;Lee, Tae-Kgyu;Moon, Do-Ho
    • Journal of Hospice and Palliative Care
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    • v.10 no.1
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    • pp.35-42
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    • 2007
  • Purpose: Colorectal ranter is the 4th leading cause of cancer death in Korea and the prevalence is increasing continuously. This study was aimed to figure out the problems through the clinical consideration about terminal colorectal ranter patients who had died in hospice unit. Methods: We retrospectively reviewed the medical records in 78 patients with colorectal ranter who had admitted, received palliative care, and died in a hospice unit between April 2003 and November 2006. Results: The median age of patients was 59.6 years with 45 men (58%) and 24 women (42%). The median survival in hospice and palliative care was 36 days. The median hospitalization was 22 days. The most prevalent reason for admission was pain (38 patients, 49%), and the most common symptom was also pain (70 patients, 90%). Forty eight patients (62%) took analgesics before hospice referral. Twenty seven patients (65%) of 45 patients with intestinal obstruction have been performed palliative procedures. Median survival of patients with palliative procedure was higher than that of no palliative procedure group (47 days vs 19 days, P-value=0.005). Conclusion: The duration of hospice and palliative care was not enough to care the terminal colorectal cancer. Therefore, we suggest that proper education and information should be provided to physician, patients and their family members for effective hospice and palliative care.

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