• Title/Summary/Keyword: 수술불안

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Clinical Analysis of 500 Cases of Coronary Artery Bypass Grafting (관상동맥 우회술 500례의 임상적 고찰)

  • Shin, Yoon-Cheol;Kim, Ki-Bong;Ahn, Hyuk;Chae, Hurn;Rho, Joon-Ryang;Suh, Kyung-Phill
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.525-531
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    • 1999
  • Background: We analyzed five hundred patients who underwent either isolated or concomitant coronary artery bypass grafting(CABG) between November 1981 and June 1997. Material and Method: There were 330 males and 170 females with a mean age of 57.4$\pm$8.9 years. To evaluate the preoperative status, we performed electrocardiograghy, echocardiography, MIBI scan, Duplex sonogram, common blood test including CK and LDH and coronary angiography. Result: Preoperative clinical diagnoses were unstable angina in 282 (56.4%), stable angina in 141 (28.2%), postinfarction angina in 58 (11.6%), acute myocardial infarction in 8 (1.6%), variant angina in 7 (1.4%) and failed percutaneous transluminal coronary angioplasty in 4 (0.8%) patients. Preoperative angiographic diagnoses were three-vessel disease in 263 (52.6%), two-vessel disease in 93 (18.6%), one-vessel disease in 71 (14.2%), left main disease in 68 (13.6%), and others in 5 (1.0%) patients. Patients had various risk factors for coronary disease, and the frequency of the risk factors such as hypertension, diabetes and smoking showed increasing tendency year by year. We used saphenous vein grafts in 1143, internal thoracic artery grafts in 442, radial artery graft in 17, and gastroepiploic artery graft in 1 anastomosis. The mean number of grafts was 3.2$\pm$1.2 per patient. Concomitant operations were prosthetic valve replacement or valvuloplasty in 31, coronary endarterectomy and angioplasty in 27, left main coronary angioplasty in 13, carotid endarterectomy in 5, and neurologic problems, bleeding, and perioperative myocardial infarction. The mean follow-up period was 25$\pm$23 months and there were 5 cases of reoperation. Conclusion: We hope that the surgical results would improve with the accumulation of experience, application of new myocardial protection technique, and timely intervention of mechanical assisted devices.

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지지적 간호중재가 두경부암 수술환자의 불안, 우울에 미치는 효과

  • Seok, Jeong-Hui;Gang, Eun-Sil
    • Korean Journal of Hospice Care
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    • v.3 no.2
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    • pp.19-33
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    • 2003
  • Cancer causes many crises to cancer patients imcluding physical dysfunction and emotional changes such as anxiety, depression as well as a threat of life, fear of death. As it develops, cancer makes people feel powerlessness due to the losses of their own positions, roles and independence. Although occupying a little proportion among all types of cancer, head and neck cancer may cause a wide range of physical transformation by surgical operation, damage to active functions such as eating and speaking, provoke anxiety and depression after its operation, influencing the quality life of head and neck cancer patients. Thus nursing intervention should be developed to provide supportive nursing for head and neck cancer patients and play roles as competent supporters. This study is a nonequivalent, control group, pretest-posttest, non-synchronized quasi-experimental research design to determine, how nursing intervention has effects on anxiety, depressing of head and neck cancer and operated. They were divided into experimental and comparison groups, each consisting of 20 members. The data were collected during the period from December 1, 1999 to April 11, 2000. Tools of the study included the protocol of supportive nursing intervention which was developed by researcher with reference to a literal review and esperts' advice. The measurement tool of anxiety was consisting of totaled 20 question items which was prepared by Spielberger and translated by Kim et al., the device of depression measurement consisting of total 20 question items which was the output of Song's translation the device of depression self-evaluation from Zung. Data were analyzed using the SPSS/PC 9.0 program. The homogeneity of the subjects were tested using x2-test and t-test. 5 hypoteses were tested using t-test. The results of the study can be summarized as follows. 1.The first hypothesis that the experimental group receiving supportive nursing intervention shows a little anxiety than the control group not receiving supportive nursing intervention was supported(t=3.817, P=.000). 2.The second hypothesis that the experimental group receiving supportive nursing intervention shows a little depression than the control group not receiving supportive nursing intervention was supported(t=8.089, P=.000). Consequently, supportive nursing intervention was found an effective nursing intervention strategy to reduce anxiety and depression of head and neck cancer patients. Providing supportive nursing intervention in nursing practice can enhance the quality of life of those cancer patients.

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The Effects of Inhalation Method Using Essential Oils on the Preoperative Anxiety of Hystrectomy Patients (향기흡입법이 자궁적출술 환자의 수술전 불안에 미치는 효과)

  • Oh, Young-Hi;Jung, Hyang-Mi
    • The Korean Journal of Rehabilitation Nursing
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    • v.5 no.1
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    • pp.18-26
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    • 2002
  • The purpose of this study was to elucidate the effects of inhalation method using essential oils on the preoperative anxiety of hystrectomy patients, and to provide effective and holistic nursing care to them. The research design was a nonequivalent control group non synchronized design. The data were collected from February 1 to March 31, 2002 at D Medical Center in Busan. The subjects were forty one patients that were operated on under general anesthesia for hystrectomy. They were assigned to two groups, twenty one subjects in the experimental group and twenty subjects in the control group. The tool of the Visual Analogue Scale(VAS) was used to anxiety on all patients the day before surgery and the preoperative period. Then systolic and diastolic blood pressure, pulse rate levels were measured the day before surgery and the preoperative period. The experimental group received two treatments of inhalation method using essential oils of with lavender, ylang ylang, and bergamot oil. The data were analyzed by the $X^2$ test and the independent t-test. The results of this study were summarized as follows: 1. Hypothesis 1: It has been supported that the experimental group received inhalation method using essential oils might cause lower level of the preoperative VAS anxiety than that of the control group(t=-2.93, p=.006). 2. Hypothesis 2: It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative systolic blood pressure than the control group(t=-.120, p=.905). It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative diastolic blood pressure than the control group.(t=1.766, p=.085). 3. Hypothesis 3: It has been supported that the experimental group received inhalation method using essential oils might cause lower level in preoperative pulse rate than the control group(t=5.853, p=.000). According to these results, inhalation method using essential oils can be considered an effective nursing intervention that relieves the preoperative anxiety of hysterectomy patients and stabilizes vital sign partially.

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Suture Anchor Capsulorraphy in the Traumatic Anterior Shoulder Instability: Open Versus Arthroscopic Technique (봉합나사를 이용한 Bankart 봉합술의 관절경적 및 개방적 수술의 비교)

  • Kim Seung-Ho;Ha Kwon-Ick;Kim Sang-Hyun
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.157-169
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    • 1999
  • Eighty-nine shoulders in eighty-eight patients with traumatic unilateral anterior shoulder instability were evaluated for Rowe and UCLA scores, recurrence, return to activity, and range of motion by an independent examiner at an average of 39 months after either arthroscopic or open Bankart repair using suture anchors. The arthroscopic technique included a minimum of 3 anchors, and a routine incorporation of capsular plication and proximal shift. Twenty­six shoulders(86.6%) out of thirty in the open Bankart repair group had excellent or good results while fifty­four(91.5%) of the fifty-nine shoulders with arthroscopic Bankart repair had excellent or good results. The arthroscopic group revealed significantly better results in the Rowe(p=.041) and UCLA scores(p=.026). Two shoulders in each group developed redislocation. There were no significant differences in the loss of external rotation and return to prior activity between the two groups(p>.05). The residual instability occurred more frequently in the group of patients with lesser anchors. Arthroscopic suture anchor capsulorraphy has results equal to or better than the open Bankart procedure.

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The Effects of Pre-operative Visual Information and Parental Presence Intervention on Anxiety, Delirium, and Pain of Post-Operative Pediatric Patients in PACU (회복실에 대한 사전 정보제공과 보호자 상주 중재가 수술 직후 각성 시 소아 청소년 환아의 불안, 섬망 및 통증에 미치는 효과)

  • Yoo, Je-Bog;Kim, Min-Jung;Cho, Soo-Hyun;Shin, Yoo-Jung;Kim, Nam-Cho
    • Journal of Korean Academy of Nursing
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    • v.42 no.3
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    • pp.333-341
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    • 2012
  • Purpose: The purpose of this study was to test whether pre-operative visual information and parental presence had positive effects on anxiety, delirium, and pain in pediatric patients who awoke from general anesthesia in a post-surgical stage. Methods: This study used a non equivalent control-group post test design (n=76). Independent variables were provision of pre-operative visual information and parental presence for post-surgical pediatric patients in PACU (post anesthesia care unit). Dependent variables were anxiety, delirium, and pain in the pediatric patients measured three times at 10 minute intervals after extubation in the PACU. Measurements included Numerical Rating Scale for assessing state anxiety, Pediatric Anesthesia Emergence Delirium Scale by Sikich & Lerman (2004) for delirium, and Objective Pain Scale by Broadman, Rice & Hannallah (1988) for pain. Results: Experimental group showed significantly decreased state anxiety at time points-10, 20, and 30 minutes after extubation. Delirium was significantly lower at 10 minutes and 30 minutes after extubation in the experimental group. Pain was significantly lower at 10 minutes after extubation in the experimental group. Conclusion: The results of this study suggest that this intervention can be a safe pre-operative nursing intervention for post-surgical pediatric patients at PACU.

Results of Anterior Cruciate Ligament Reconstruction with Unicondylar Arthroplasty for Medial Compartment Knee Osteoarthritis combined with Anterior Instability (전방 불안정성과 동반된 슬관절 내측 구획 진행성 관절염환자에서 전방십자인대 재건술 및 인공 관절 부분 치환술의 결과 - 3예 보고 -)

  • Lee, Chul Hyung;Song, In Soo;Ji, Jong Hun;Kim, Tae In
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.88-94
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    • 2013
  • Three cases who had medial compartment osteoarthritis of the knee (Kellgrene-Laurence grade 3 and Outerbridge grade 4) and anterior instability of the knee due to rupture of the anterior cruciate ligament in relative young ages underwent staged anterior cruciate ligament reconstruction followed by medial unicondylar arthroplasty in 2 cases and simultaneous anterior cruciate ligament reconstruction and unicondylar arthroplasty. We evaluated clinical results some kinds of preoperative and postoperative International Knee Documentation Committee (IKDC), Lysholm score and last follow-up hospital for special surgery (HSS), knee society score (KSS). We consider that medial unicondylar arthroplasty with staged or simultaneous anterior cruciate ligament reconstruction is very good option of the treatment for the anterior instability and pain from advanced arthritis.

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The Effect of Hand Massage on the Anxiety of the Hysterectomy Patients in Immediately prior to Surgery (손마사지가 자궁절제술 환자의 수술직전 불안에 미치는 효과)

  • 김정미
    • Journal of Korean Academy of Nursing
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    • v.30 no.2
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    • pp.476-487
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    • 2000
  • The purpose of this study was to examine the effects of hand massage as a nursing intervention on the anxiety of the hysterectomy patients in immediately prior to surgery. The method of this study was Nonequivalent Control Group Non-Synchronized Design. The data were selected from at K university hospital in Pusan, and they consisted of Experimental group-25 patients, Control group -24 patients. The data were collected from Jan. 4 to Jan. 30 in 1999. The subjects′ self-reports of anxiety (measured by the Spielberger Trait-State anxiety Inventory and Visual Analogue Scale developed by Cline et al.) were recorded before and immediately after the intervention. The objective physiologic measures of blood pressure and pulse rate. The collected data were analysed by means of frequency, percentage, standard deviation, chi- square test, t-test, ANCOVA with SPSS program. The results of this study were as following; 1. Hypothesis 1: The 1st hypothesis that "There will be significant difference of the state anxiety level just before surgery in the experimental group and control group" was supported(P= .000). 2. Hypothesis 2: The 2nd hypothesis that "There will be significant difference of the visual analogue scale score just before surgery in the experimental group and control group"was supported(P= .000). 3. Hypothesis 3: The 3rd hypothesis that "There will be significant difference of the systolic and diastolic blood pressure level just before surgery in the experimental group and control group"was supported (P= .003, P= .041). 4. Hypothesis 4: The 4th hypothesis that "There will be significant difference of the pulse rate just before surgery in the experimental group and control group"was supported(P= .004). In conclusion, hand massage is a benefical nursing intervention that alleviates the psychological, physiological anxiety of the hysterectomy patients in immediately prior to surgery. therefore it is recomended to use the hand massage as a nursing intervention for patients undergoing anxiety. The results of this study appear promising, additional research is recomended to further the appropriate uses of hand massage in nursing practice for this and other patient population.

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The Effect of a Hand Massage Program on Anxiety and Immune Function in Clients with Cataract Surgery under Local Anesthesia (손마사지 프로그램이 백내장 수술환자의 불안과 면역기능에 미치는 영향)

  • 조경숙
    • Journal of Korean Academy of Nursing
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    • v.29 no.1
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    • pp.97-106
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    • 1999
  • This study was designed to investigate the effect of a hand massage program on anxiety and immune function in patients during cataract surgery. The hand massage program, in this study, consisted of hand massage and hand-holding. The subjects were sixty-three patients, thirty for the experimental and thirty-three for the control group, who were admitted at Kang Nam St. Mary's Hospital for cataract surgery. This study was carried out from December 10, 1997 to February 26, 1998. The level of anxiety as measured by the Visual Analogue Scale, systolic blood pressure, diastolic blood pressure, and pulse rate were measured before, after hand massage, and after hand-holding. Epinephrine, norepinephrine, cortisol, blood sugar levels, neutrophil, lymphocyte, and natural killer cell percentages also were measured before hand massage and five minutes before the end of the operation. Data were analyzed by t-tests, ANCOVA, repeated measures ANOVA, and Bonferroni multiple comparisons. The results were as follows : 1) After hand massage, psychological anxiety levels decreased significantly compared with before hand massage in the experimental group, not in the control group. After hand holding, there were significant decrease in both groups. 2) There were not significant differences on systolic blood pressure, diastolic blood pressure, and pulse rates in both groups. 3) The hand massage program decreased epinephrine, norepinephrine, and cortisol significantly in the experimental group, and increased epinephrine, norepinephrine, and cortisol in the control group. 4) There were no differences in blood sugar levels, neutrophil and lymphocyte percentages in white blood cells after the hand massage program. However, natural killer cells in lymphocytes were significantly increased in the experimental group. These findings indicate that a hand massage program could be a effective nursing intervention in decreasing the psychological and physiological anxiety levels and improving immune function in clients having cataract surgery under local anesthesia.

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Effects of Preferred Music Intervention on Anxiety, Vital Signs and Blood Sugar of Surgical Patients Undergoing Operation Using Spinal Anesthesia (환자 선호도를 고려한 음악중재가 척추 마취 환자의 수술 중 불안, 활력 징후 및 혈당에 미치는 영향)

  • Jung, Hyang-Mi;Park, Mal-Young;Lee, Su-Jin;Kim, Nam-Hee
    • Journal of East-West Nursing Research
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    • v.20 no.1
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    • pp.9-20
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    • 2014
  • Purpose: The purpose of this research was to examine the effects of preferred music intervention on anxiety, vital signs and blood sugar of surgical patients undergoing spinal anesthesia. Methods: A quasi-experimental research with non-equivalent control group non-synchronized design was carried out. Subjects consisted of 40 patients (experimental group 20, control group 20) who were scheduled to undergo surgery with spinal anesthesia. During the operation, music individual patients preferred was provided to the experimental group. The data were collected from July 4 to November 10, 2011 and analyzed with descriptive statistics, t-test, chi-square test, ANCOVA and repeated measured ANCOVA using SAS (ver 9.2). Results: 1) Patient anxiety during the operation of the experimental group was significantly lower than the control group (F=93.77, p<.001). 2) There was no significant difference in diastolic blood pressure (F=.00, p=.979), Systolic blood pressure (F=.19, p=.668), heart rate (F=.00, p=.955), and blood sugar (F=.73, p=.399) between the experimental group and the control group. Conclusion: Letting patients hear their preferred music during surgery is an effective nursing intervention to relieve anxiety of patients undergoing surgery with spinal anesthesia.

Effects of Music Therapy on Pain, Anxiety and Length of Stay of Patients with Laparoscopic Hysterectomy in the Postanesthesia Care Unit (선호 음악요법이 복강경 자궁적출술 환자의 수술 후 통증, 불안 및 회복실 체류시간에 미치는 효과)

  • Son, Youn-Jung;Park, Young-Suk;Kim, Hye-Un;Choi, Ju-Yeon;Lee, Kyung-Mi;Yi, Young-Hee
    • Journal of Korean Biological Nursing Science
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    • v.17 no.1
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    • pp.28-36
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    • 2015
  • Purpose: This study examined the effects of music therapy on pain, anxiety and length of stay of patients undergoing laparoscopic hysterectomy in the postanesthesia care unit (PACU). Methods: Sixty patients who received laparoscopic hysterectomy under general anesthesia from a PACU in a university hospital located in Cheonan city participated in this study. The experimental group (n=30) was offered the option to listen to their preferred music by using MP3 players and headphones for 30 minutes. The control group (n=30) received routine postoperative nursing care. Visual analogue scale was used to measure participants' pain and anxiety, length of stay in the PACU was examined by using their medical records. Data were collected from December 2013 to February 2014 and analyzed by descriptive statistics, ${\chi}^2$-test, Fisher's exact test, and independent t-test using SPSS version 21.0. Results: The result showed that the level of post-operative pain (t=2.44, p=.018), anxiety (t=2.37, p=.021), and the length of stay in PACU (t=3.06, p=.004) significantly decreased in the experimental group as compared to the control group. Conclusion: This study indicated that music therapy with the patients' preferred music showed positive effects. Therefore, it can be used as a therapeutic intervention for postoperative pain management of patients with laparoscopic hysterectomy.