• Title/Summary/Keyword: 수술전 교육

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Decision-making process and satisfaction of pregnant women for delivery method (임산부의 분만방법 결정과정과 만족도)

  • Jun, Hae-Ri;Park, Jung-Han;Park, Soon-Woo;Huh, Chang-Kyu;Hwang, Soon-Gu
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.751-769
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    • 1998
  • This study was conducted to assess the attitude of pregnant women toward delivery method, understanding of the reason for determining her own delivery method, participation in decision-making process and satisfaction with delivery method after labor. Study subjects were 693 pregnant women who had visited obstetric clinic for prenatal care in the last month of pregnancy in one general hospital and one obstetrics-gynecology specialty hospital in Taegu city from February 1 to March 31 in 1998. A questionnaire was administered before and after labor and a telephone interview was done one month after labor. Proportion of women who had health education and/or counselling about delivery method during prenatal care was 24.0% and this proportion was higher for women who had previous c-section(35.5%) than others. Women thought vaginal delivery is better than c-section for both maternal and baby's health regardless of previous delivery method. About 90% of primipara and multiparous women who had previous vaginal delivery wanted vaginal delivery for the index birth, while 85.6% of multiparous women who had previous c-section wanted repeat c-section. Reasons for choosing c-section in pregnant women who preferred vaginal delivery before labor were recommendation of doctors(81.9%), recommendation of husband (0.8%), agreement between doctor and pregnant woman(4.7%), and mother's demand (12.6%). Reasons for choosing vaginal delivery were mother's demand(30.6%) and no indication for c-section(67.2%). Reasons for choosing c-section in pregnant women who preferred c-section before labor were recommendation of doctors(76.2%), mother's demand(20.0%), recommendation of husband(1.3%), and agreement between doctor and pregnant woman(2.5%). Of the pregnant women who had c-section, by doctor's recommendation, the proportion of women who had heard detailed explanation about reason for c-section by doctor was 55.1%. Mother's statement about the reason for c-section was consistent with the medical record in 75.9% . However, over 5% points disparities were shown between mother's statement and medical record in cases of the repeat c-section and mother's demand. In primipara and multiparous women who had previous vaginal delivery, the delivery method for index birth had statistically significant association with the preference of delivery method before labor(p<0.05). All of the women who had previous c-section had delivered the index baby by c-section. Among mothers who had delivered the index baby vaginally, 84.9% of them were satisfied with their delivery method immediately after labor and 85.1% at 1 month after labor. However, mothers who had c-section stated that they are satisfied with c-section in 44.6% immediately after labor and 42.0% at 1 month after labor. Preferred delivery method for the next birth had statistically significant association with delivery method for the index birth both immediately after labor and in 1 month after labor. The proportion of mothers who prefer vaginal delivery for the next birth increased with the degree of satisfaction with the vaginal delivery for the index birth but the proportion of mothers who prefer c-section for the next birth was high and they did not change significantly with the degree of satisfaction with the c-section for the index birth. These results suggest that the current high technology-based, physician-centered prenatal and partritional cares need to be reoriented to the basic preventive and promotive technology-based, and mother-fetus-centered care. It is also suggested that active involvement of pregnant woman in decision-making process for the delivery method will increase the rate of vaginal birth after c-section and decrease c-section rate and improve the degree of maternal satisfaction after delivery.

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대구ㆍ경북지역 대장직장암환자의 식행동 특성

  • 서수원;구보경;이혜성
    • Proceedings of the KSCN Conference
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    • 2003.11a
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    • pp.1089-1090
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    • 2003
  • 본 연구는 대구ㆍ경북지역 대장직장암 환자의 일반 생활 상황과 식행동 특성을 분석 평가하여 지역민의 대장직장암 예방을 위한 영양교육에 활용할 수 있는 식생활 관련 기초 자료를 얻고자 수행되었다. 최근 경북대학교 병원에서 대장직장암 진단을 받고 입원한 수술 전후 환자 123명 (남 79명, 여 44명)을 환자군 대상으로 하였고 대장질환이 없는 정형외과 환자 등 182명(남 117명, 여 65명)을 비교군 대상으로 하였다. 대상자의 일반 특성, 식습관, 식행동 특성, 식품섭취 빈도 등의 내용을 포함한 설문지를 이용하여 개인 면담을 통하여 조사하였다. 현재 BMI와 과거 가장 높았던 체중의 BMI는 남녀 모두 환자군에서 유의하게 높게 나타났다. 환자군의 교육 수준은 비교군에 비해 낮았고 주 거주지역 분포는 농촌이 가장 많았으며 가계 소득은 환자군에서 비교군에 비하여 높은 것으로 나타났다. 주요 일상활동 강도는 비교군에 비해 환자군에서 유의적으로 가벼운 것으로 나타났다. 발병 전 일상생활에서 느끼는 스트레스의 정도가 환자군에서 비교군에 비해 유의적으로 높았던 것으로 나타났다. 자신의 성격 유형을 비관적인 것으로 생각하는 비율과 가족의 암 병력이 환자군에서 유의적으로 높게 나타났다 식사의 규칙성에서도 환자군에서 끼니를 거르는 비율이 유의적으로 높았다. 환자군은 비교군에 비해 육식을 유의적으로 높게 선호하였으며 외식시 고기류를 선호하는 비율이 높았다. 평소 물 섭취량은 환자군에서 비교군에 비해 적었다. 환자군이 비교군에 비해 짠맛에 대한 선호도가 유의적으로 높았고 단 맛과 매운 맛은 비교군에 비해 싫어하는 경향을 보였으며 기름진 맛을 선호하는 경향이 환자군에서 유의하게 높았다. 환자군에서 굽기, 튀기기를 좋아하는 경향이 유의적으로 높았다. 환자군에서 음주 빈도, 음주량 그리고 커피 섭취량이 높게 나타났으며, 1일 흡연량이 많았고, 흡연 시작 연령은 빨랐으며, 금연 연령은 늦어 흡연 기간이 유의적으로 긴 것으로 나타났다. 환자군의 영양지식 정도와 영양태도는 비교군에 비해 유의적으로 낮았고 환자군의 영양지식 수준이 높을수록 좋은 영양태도를 가지는 것으로 나타났다. 과거 10년간 식품 섭취 빈도 조사 결과 환자군은 등푸른 생선류와 콩류 및 된장, 두부를 비교군에 비해 유의적으로 더 많이 섭취하였고 해조류, 생 녹황색채소류, 익힌 녹황색 및 담색채소류와 녹차를 더 적게 섭취한 것으로 나타났다. 본 연구의 결과는 일상생활의 스트레스와 가족의 암 병력 및 비관적 성격 유형이 대장직장암 발병의 위험인자가 될 수 있음을 제시하며 육식 선호, 적은 양의 물 섭취, 짜고 기름진 맛에 대한 높은 기호도, 음주, 흡연, 커피의 섭취 그리고 나쁜 식습관이 대장직장암 발생과 관련된 식생활 위험인자가 될 수 있음을 제시한다. 해조류, 녹황색채소, 담색채소, 녹차가 대장직장암 발생의 보호인자의 가능성도 제시되었다. 따라서 향후 지역적 식문화 특성을 고려한 보다 광범위하고 체계적인 조사 연구를 통해 이 지역의 대장직장암 발생의 위험인자와 보호인자를 재확인할 필요가 있다고 보며 본 연구의 결과는 지역민의 대장직장암 예방을 위한 영양교육 자료로서 활용될 수 있다고 본다.

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Training of Radiofrequency Ablation for Thyroid Nodules in Korea: Current and Future Perspective (국내의 갑상선 고주파 절제술에 대한 교육: 현황 및 미래 전망)

  • Hye Shin Ahn;So Lyung Jung;Jung Hwan Baek;Jin Yong Sung;Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1009-1016
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    • 2023
  • Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. In Korea, RFA for thyroid nodules was first performed in 2002, and a large population study was published in 2008. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed its first recommendations for RFA in 2009, which were revised in 2012 and 2018. The KSThR guideline was the first guideline for RFA of thyroid nodules worldwide and has become a guideline for physicians to perform thyroid RFA in Korea and other countries around the world. These guidelines have contributed significantly to the establishment and widespread use of RFA worldwide. In addition, since 2015, the KSThR has conducted intensive hands-on courses depending on the level of the participants. In this article, the authors introduce the history of eduction for RFA conducted by the KSThR and describe the learning curve of RFA and current training programs in Korea, along with future directions for training programs.

Mortality rate undergoing anesthesia in Thoroughbred racehorses at Busan Race Park (부산경남경마공원 Thoroughbred 경주마의 마취중 치사율)

  • Yang, Jaehyuk;Park, Yong-Soo
    • Journal of Practical Agriculture & Fisheries Research
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    • v.17 no.1
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    • pp.125-132
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    • 2015
  • The report about equine anesthesias in Korea are very rare. This paper aimed at the mortality rate during anesthesia in Thoroughbred horses at Equine Hospital of Busan Race Park, KRA in South Korea from 2005 to 2010. Drugs used in anesthesia was IV injection of detomidine hydrochloride (0.01 mg/kg) or xylazine(0.5mg/kg) for sedation and premedication, Guaifenesin(50-100 mg/kg) for muscle relaxation, ketamine hydrochloride(2 mg/kg) for induction of anaesthesia and Inhalational isoflurane(1.3-1.5 %) to maintain anesthesia. Total number of anesthetic cases was 190, 150 of inhalational anesthesia and 40 of general anesthesia, repectively. The purpose of anesthesia was highest in the disorder of musculoskeletal system, followed by urogenital system and respiratory system Mortality case due to anesthesia was one during arthroscopic surgery for removal of osteochondral chip fragments. The time of anesthesia was 150 min, fatal sign was hypoxemia and the reason was improper machine operation of the anesthetist. In conclusion, the perianesthetic mortality rate during anesthesia in Thoroughbred horses at Busan Race Park was 0.52%(1 death per 190 anesthetics).

Exercise for reducing and controlling lymphedema in Women with breast cancer: A systematic review and meta-analysis (여성 유방암 환자의 림프부종 감소와 조절을 위한 운동의 효과: 체계적 고찰과 메타분석)

  • Kim, Kyung-Hee;Oh, Ki Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.4
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    • pp.512-520
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    • 2016
  • Breast cancer is the most common malignancy in women, and lymphedema is one of the most common postoperative complications of breast surgery. Exercises are usually prescribed to prevent this occurrence. On the other hand, conflicting results regarding the effects and timing of such exercises have been reported. This study reviewed systematically the contemporary literature, peer-reviewed publications, and web sites of professional organizations that examined exercise for lymphedema prevention or therapy to determine the effects of exercise on lymphedema providing the best evidence for the treatment of patients. Exercise or training groups have strategies that appear to reduce the development of secondary lymphedema and altering its progression compared to the control group. Advances in cancer treatment, cancer and exercise research, and lymphedema management require physicians to have a basic understanding of the current evidence to provide the appropriate patient education and specialist referral.

The Knowledge and Confidence in Performance on Patient Safety among Health-Related Majors : Convergent Approach (보건계열 학생의 환자안전 지식 및 수행 자신감 : 융복합적 접근)

  • Lee, Mi Hyang;Park, Jung Hee;Bae, Seok Hwan
    • Journal of Digital Convergence
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    • v.17 no.1
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    • pp.219-227
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    • 2019
  • The purpose of this study was to investigate the knowledge on patient safety and performance confidence for the subject of health-related major students. Participants were 349 Health-related majors. Data were analyzed using SPSS 21.0. According to the study results, correct answer rate for patients' knowledge on safety was 65.7% in average. Average point of performance confidence was $7.11{\pm}1.74$. Considering in terms of question, patient identification was high, while effective communication was shown to be low. Patient identification, communication, surgery procedure, fall, patient's safety accident report as the lower domain for patients' knowledge on safety and performance confidence had a positive correlation, while knowledge and infection management, facility environment had a negative correlation for health-related major students, development of patients' safety education program is needed to enhance importance of patients' safety before clinical practice and to allow implementation of safe clinical practice.

The Change of perception according to the fidelity of simulation in Objective Structured Clinical Examination for Procedural Skill of 4th Medical Students (의전원 4학년 학생의 과정기술 객관구조화진료시험에 도입된 시뮬레이션의 충실도에 따른 인식 변화)

  • Son, Hee-Jeong;Kim, Jin-Uk;Yi, Yu-Ri;Hwang, Byeong-Moon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.3
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    • pp.1178-1185
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    • 2012
  • The 4th year medical students were randomly divided and designated as group HF and LF, representing high and low fidelity simulations respectfully. Both groups performed OSCE on 2 topics(adult intubation and IV cannulation) with each composed of the same scenario. Each scenario was developed by a faculty in charge of clinical skill education with supervision from 2 other faculty members. High fidelity simulations were designed as in-situ simulations in real OR. Low fidelity simulations had the same scenarios but the environment was simulated only with a simple task trainer in the classroom. All students participated in series of survey using a Likert scale before and after the simulations. The provided data was anlayzed with paired T-test and Mann-Whiteney test(p<0.05). The post simulations self evaluation score for group HF was lower than pre-simulation self confidence score for both topics of adult intubation and IV cannulation where as for group LF, it was lower only for adult intubation(p<0.05). In group HF, the needs for clinical training on both topics increased after the simulation. In group LF, there was no significant change of needs for clinical training between pre and post simulation survey. This suggest that fidelity may be a helpful factor to improve the motivation of the students and further study on economical aspect should be addressed.

Initial changes of dental plaque, gingivitis and decalcification in Korean orthodontic patients with fixed appliance (한국인 고정식 교정 환자의 치태, 치은염 및 탈회의 초기 변화에 관한 연구)

  • Kang, Kook-Jin;Shon, Byung-Hwa
    • The korean journal of orthodontics
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    • v.29 no.3 s.74
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    • pp.361-374
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    • 1999
  • Intraoral filled type of orthodontic appliance can cause reversible or irreversible damages such as gingivitis, periodontitis, enamel decalcification, dental caries, root resorption, and pulpal changes. Such adverse effects are brought by increase in dental plaque as well as oral flora. Such an increase causes gingival inflammation and enamel decalcification. The purpose of this study is to get klowledge on initial changes in dental plaque, gingivitis, and enamel decalcification after bonding fixed orthodontic appliances according to time flow, gender, and sides(right/left) of premolar region. For control group, 48 students of dental college, Yonsei university(26 males, 22 females) were chosen; for experimental group, 73 orthodontic patients(36 males, 37 females) who will be treated with fixed appliances were chosen. All the subjects had no systemic disease, juvenile periodontitis and all the females had passed their ,menarche. Tooth brushing instruction was given to all the subjects prior to the experiment. For control group, plaque index, gingival index, and decalcification index were measured twice at 3 weeks interval ; for experimental group, the same was done prior to, 3, 6, 9 weeks after bonding fixed appliances. The following results were obtained: 1. In plaque index 3 weeks after placement of appliances, and it showed gradual increase afterwards. 2. In gingival index3 weeks after placement of appliances, and afterwards it showed increase at a faster rate than plaque index. 3. Enamel decalcification began to show between 3 and 6 weeks after bonding fixed appliances. Decalcification index began to increase 6 weeks after appliance placement, but there was no statistical significance. 4. When the comparison was made between two sides of premolar region, the right side showed greater index in plaque and gingival index of experimental group.

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Determinants of Sex-Selective Induced Abortion Among Married Women : A Comparative Study between Taegu & Bay Area in California, USA (선별적 인공유산의 결정인자에 관한 비교연구 : 대구지역과 미국 캘리포니아 베이지역)

  • 김한곤
    • Korea journal of population studies
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    • v.20 no.1
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    • pp.65-96
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    • 1997
  • The main purpose of this study is to explore the determinants of sex ratio imbalance at birth in Taegu which has experienced the extremely imbalanced sex ratio at birth since mid-1980s. This paper attempts to compare the determinants of sex ratio imbalance at birth, such as sex discrimination against women, son preference, prenatal sex identification followes by sex-selective induced abortions, among married women aged 25 to 44 in Taegu with those in Bay area, California in USA. The research is based on the survey data which were conducted in Taegu, Repulic of Korea and Bay area, California in USA. The findings of this analysis suggest that married women in Taegu are more likely to feel sex discrimination against women than married women in Bay area. Furthermore, the percentage of married women's effort for son bearing before pregnancy is much higher than that of married women in Bay area. We also have found that the percentage of sex-selective induced abortion in Taegu is six times higher than that of married women in Bay area. According to the logistic regression analysis, the determinants of sex-selective induced abortion among married women in Taegu are discrimination against women, son preference, prenatal sex identification. On the other hand, age is the only variable which has an important impact on sex-selective induced abortion among married women in Bay area. From the findings of this study, we can conclude that son preference based on Cofucianism is the most important impact on sex ratio imbalance at birth in Taegu where son preference is much stronger than other regions in Korea. The phenomenon of extremely imbalanced sex ratio at birth in Taegu is the result of combination of these factors, such as strong son preference, seeking to have at least one son within small family size, and prenatal sex identification followed by sex-selective induced abortion.

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Hand Hygiene Compliance of Healthcare Workers in a Children's Hospital (소아병원 종사자의 손 위생 수행)

  • Oh, Hyang Soon
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.186-193
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    • 2015
  • Purpose: The aim of study was to estimate the hand hygiene (HH) compliance of healthcare workers (HCWs) in a children's hospital. Methods: This study was conducted in a hospital which is a tertiary and educational children's hospital with 313 beds and 533 HCWs. Data were collected by direct observation methods from November 1, 2010 to December 31, 2010. Results: A total of 2,999 opportunities for HH were observed, and the overall HH rate was 95.3%. HH rate of the registered nurse, physicians and transferer was 97.7%, 89.2%, and 72.1%, respectively (P<0.001). Among physicians, HH rate of the fellows, professors, residents and interns was 97.5%, 93.9%, 89.7%, and 80.9%, respectively (P<0.001). HH rate in the emergency room, operation room, outpatient department (OPD), and the intensive care unit (ICU) was 97.2%, 97.2%, 95.4%, and 92.5%, respectively (P<0.001). Hand rubbing was the most frequently used (81.1%), and hand washing was frequently used in the case of 'after body fluids exposure risk' (37.7%) and 'after touching patient surroundings' (28.5%). HH methods were not statistically different from each departments (P =0.083), however, they were significantly different according to the World Health Organization (WHO) 5 Moments (P<0.001). Distributions in WHO 5 Moments by the job titles were significantly different (P<0.001). The odds ratio of physicians, ICU and OPD was 0.353 (95% CI, 0.241-0.519), 0.291 (95% CI, 0.174-0.487), and 0.484 (95% CI, 0.281-0.834), respectively. Conclusions: Compliance of HH was different by the job titles and departments. Effective custom-tailored HH programs for each job title and department need to be developed.