• 제목/요약/키워드: 수술후 간호

검색결과 193건 처리시간 0.028초

뇌사자로부터 공여받은 신장이식자의 근력과 일상생활활동에 프레드니손(Prednisone)이 미치는 영향 (Influences of Prednisone on Muscle Strength and Instrumental Activities of Daily Living in Patients of Kidney Transplantation from Brainstem Dead Heart-beating Donors in Korea)

  • 안경주;최명애
    • Journal of Korean Biological Nursing Science
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    • 제9권1호
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    • pp.59-69
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    • 2007
  • 목적: 본 연구의 목적은 뇌사자로부터 공여받은 신장을 이식한 대상자들이 프레드니손을 생체이식 대상자들보다 더 많이 투여받는 임상상황에서 프레드리손이 근력과 일상생활활동에 영향을 주는지 규명하기 위함이다. 방법: 연구 대상은 뇌사자로터 신장을 응급으로 수여받은 32명이었으며 모두 혈액투석을 하고 있었다. 이식 수술 전날, 환자의 일반적인 정보, 근력, 일상생활활동에 대해 조사하였으며 이식수술 후 12주째 되는 날 외래에서 근력과 일상생활활동을 다시 조사하였다. 프레드니손 용량은 임상기록지를 통해 수집하였다. 연구결과: 신장이식술 후 12주의 근력은 고관절 신전근력을 제외하고는 유의하게 감소되지 않았다. 그러나 신장이식 후 12주의 일상생활활동은 수술 직전보다 유의하게 감소된 것으로 나타났다. 근력은 혈액투석을 시행한 기간에 의한 영향을 더 받았으며 일상생황활동의 저하는 3개월간 활동을 제한하는 퇴원교육의 영향이 큰 것으로 볼 수 있다. 결론: 본 연구에서 대상자의 근력과 일상생활활동은 프레드니손 투약의 영향을 받지 않았으며 오히려 혈액투석을 시행했던 기간에 따라 영향을 받은 것으로 나타났다. 따라서 혈액투석 환자들의 근력 증진을 위한 간호중재 개발이 필요하다.

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Ondansetron과 Dexamethasone의 병합 투여가 복강경하 질식 전자궁 적출술 환자의 수술 후 오심 및 구토, 통증에 미치는 효과 (Effect of Ondansetron combined with Dexamethasone on Postoperative Nausea & Vomiting and Pain of Patients with Laparoscopic Hysterectomy)

  • 남미옥;윤혜상
    • 대한간호학회지
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    • 제39권1호
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    • pp.44-52
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    • 2009
  • Purpose: The purpose of this study was to compare the effects of ondansetron combined with dexamethasone on Post-Operative Nausea and Vomiting (PONV) and pain with ondansetron alone in patients with laparoscopy assisted vaginal hysterectomy under general anesthesia. Methods: Data were collected from April 1 through September 30, 2005 using a double blind method. Ondansetron 4 mg and dexamethasone 10 mg were administered to the experimental group (25 patients), and ondansetron 4 mg only to the control group (25 patients). The medications were administered through an intravenous line at the beginning peritoneum suture. PONV by Index of Nausea Vomiting and Retching (INVR), nausea by Visual Analogue Scale (VAS), and pain (VAS) were assessed at postoperative 1 hr, 3 hr, 6 hr, 24 hr, and 48 hr. Data were analyzed using repeated measures ANOVA, and Bonferroni methods. Results: The experimental group that received ondansetron combined with dexamethasone had less PONV (p=.048), and nausea (p=.012) than control group that received ondansetron alone. However, there was no difference in pain (p=.557) between the patients in the two groups. Conclusion: We conclude that the administration of ondansetron combined with dexamethasone is more effective than the administration of ondansetron alone to reduce PONV in patients with laparoscopic hysterectomy.

갑상선 유두암환자의 수술 후 삶의 질 (Postoperative Quality of Life in Patients with Papillary Thyroid Cancer)

  • 김주성
    • 한국산학기술학회논문지
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    • 제12권3호
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    • pp.1260-1269
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    • 2011
  • 본 연구의 목적은 갑상선 유두암환자의 수술 후 삶의 질, 갑상선 특이적 증상, 자가간호이행도, 불안 및 우울수준을 파악하고 수술 후 삶의 질에 미치는 영향 요인을 분석하는 것이다. 154명의 갑상선 유두암환자가 연구에 참여하였으며 구조화된 질문지를 이용하여 수집된 자료는 SPSS/WIN 18.0을 사용하여 기술통계, t-test, ANOVA, Pearson correlation 및 다중회귀분석법으로 분석하였다. 갑상선 유두암환자의 수술 후 삶의 질 평균점수는 2.72점이었고 사회/가족상태 영역에서 가장 낮았으며 연구대상자들의 대부분은 피로, 추위를 견디지 못함, 변덕스런 기분변화 등의 갑상선 특이적 증상을 호소하였다. 자가간호이행 참여도가 가장 높은 항목은 갑상선호르몬제 복용(100%)이었으며 외래방문을 통한 추후관리는 두 번째로 높았다(99.4%). 불안은 45.3점으로 보통 수준이었으나 대상자의 63%가 우울한 상태로 판정되었다. 갑상선 유두암환자의 수술 후 삶의 질은 갑상선 특이적 증상, 불안, 우울과 부정적 상관관계가 유의하게 나타났으며(r=-.573, p<.001; r=-.739, p<.001; r=-.742, p<.001) 갑상선 특이적 증상, 불안, 우울이 수술후 삶의 질 정도를 64.9% 설명하였다. 이에 갑상선 유두암환자의 수술 후 삶의 질을 증진시키기 위해서 건강관리전문가들은 장기간의 암치료과정에서 느끼는 부정적 정서를 완화시키고 지지체계를 개발하며 신체적, 심리적 증상관리를 돕는 실무정보를 제공해야 할 것이다.

통증자가조절기 융합교육이 척추수술환자의 수술 후 통증관리에 미치는 효과 (Effects of Patient Controlled Analgesia Convergence Education on Postoperative Pain Management in Spinal Surgery Patients)

  • 최가영;김주성
    • 한국융합학회논문지
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    • 제9권2호
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    • pp.371-380
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    • 2018
  • 본 연구목적은 통증자가조절기(patient controlled analgesia:PCA)융합교육이 척추수술 후 통증관리에 미치는 효과를 조사하기 위함이다. 60명의 척추수술환자를 대상으로, 실험군(30명)에게 수술 전 PCA동영상, 소책자, 및 PCA실습으로 구성한 PCA융합교육을 적용하였다. 구조화된 질문지로 자료수집한 후 기술통계, ${\chi}^2-test$, Fisher's exact test, t-test 및 repeated measures ANOVA로 분석하였다. 연구결과 척추수술 후 실험군의 PCA지식태도, PCA만족도, 통증관리만족도는 대조군보다 유의하게 높았다(p<.001; p=.001; p<.001). 실험군의 수술 후 통증과 추가 진통제사용은 대조군보다 유의하게 낮았다((p<.001; p=.001). 따라서 시청각매체와 PCA실습을 접목한 PCA융합교육은 척추수술환자의 통증관리에 효과적인 실무중재임을 확인하였으며 다양한 간호실무에서 융합중재개발에 응용 가능할 것이다.

수용개작방법을 활용한 전신마취 수술 후 폐합병증 예방 간호실무지침 개발 (Development of the Nursing Practice Guidelines for Preventing Postoperative Pulmonary Complications using the Guideline Adaptation Process)

  • 최진주;김현정;강혜민;추희영;김경숙
    • 임상간호연구
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    • 제27권2호
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    • pp.187-198
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    • 2021
  • Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.

노인 환자의 수술 전 영양상태가 수술 후 임상경과에 미치는 영향 (The Effect of Preoperative Nutritional Status on Postoperative Outcome in Elderly Patients)

  • 김민영
    • Journal of Korean Biological Nursing Science
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    • 제21권4호
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    • pp.292-299
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    • 2019
  • Purpose: The purpose of this study was to determine whether poor preoperative nutritional status in elderly patients exhibited a negative influence on postoperative clinical outcomes. Methods: The medical records of 645 elderly patients were examined retrospectively. The patients had undergone major surgery between January 2017 and January 2018. Their nutritional status was measured using the Nutritional Risk Screening 2002. The data were analyzed using the chi-squared test, the Mann-Whitney U test, logistic regression, linear regression, Cox proportional hazards regression, and the Kaplan-Meier analysis. Results: Preoperative malnutrition was found in 73 patients (11.3%). Poor preoperative nutritional status was significantly associated with pressure ulcers, length of hospitalization, discharge to patient care facilities rather than home, and mortality rate at three months. Conclusion: Preoperative malnutrition in elderly patients was associated with negative postoperative clinical outcomes. These results indicate that an effective nutritional program before surgery can lead to a more rapid postoperative recovery.

수술후 병원 감염 발생과 입원일수 및 수술 소요 시간과의 관계 (A Study of Hospital Infection in the Postoperative Patients)

  • 박정호;윤혜상
    • 대한간호학회지
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    • 제16권2호
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    • pp.70-76
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    • 1986
  • This study was aimed to observe the incidences and types of hospital infections and to compare the length of hospitalization and of the operation between the infected Patients and those of non-infected after the operations. The subject of study were 465 patients who had been operated surgically in a University Hospital from March 1 to April 30, 1985. The data were collected by reviewing medical charts of subjects. The criteria to diagnose hospital infection for this study had been revised the one utilized at University of Virginia Hospital in the U.S. Summary of the results were as follows: 1. The incidence rate of hospital infection was 6 %. The type of infection with higher incidence rate in order were wound infection(28.5%)urinary infection(28.5%), fever of unknown origin (25%) and septicemia (18%). 2. There was a statistically significant difference in the duration of hospitalization between the patient group without it (t=265.2, p<0.005). 3. There was a statistically significant difference in the duration of operation between the patient group with it (t=75.0, p<0.005).

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복부수술 환자의 수술후 통증에 미치는 발마사지의 효과 (The Effect of Foot Massage on Post operative Pain in Patients Following Abdominal Surgery)

  • 김진희;박경숙
    • 성인간호학회지
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    • 제14권1호
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    • pp.34-43
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    • 2002
  • More and more non-injured operations are being implemented these days, thanks to the development of medical technology. Still, however, most operations leave direct scars on patient' bodies, as well as accompanying pain. The massage as an independent nursing intervention can stimulate the circulation of the blood of tissue and muscle and increase the relationship between a patient and a nurse. The purpose of this study is to investigate the effect of foot massage on pain in post abdominal operative patients. The nonequivalent control group, pre-post test design is used for this study. From July 7, 2000 to February 20, 2001, the 40 patients who were operated under general anesthesia in a university hospital in Seoul were studied. They were divided into two groups ; 20 patients were part of the experimental group, and the others, in the control group. In order to evaluate the effect of foot massage, severity of pain was checked with the VAS (Visual Analog Scale) and also each patients' vital signs were measured with pulse rate, systolic blood pressure and diastolic blood pressure. The collected datas were processed by SAS version 6.12 program and analyzed by the Chi-square, Fisher's exact test, t-test and repeated measures ANOVA. The results of this study were as follows. 1. The severity of pain decreased significantly in the experimental group as compared to the control group following foot massage (t=-3.317, p= .002). 2. Measured vital signs in the experimental group had more reduction of that than in the control group following foot massage. - The pulse rate in the experimental group was lower than that in the control group following foot massage (F=7.73, p=.008). - The systolic blood pressure in the experimental group was lower than that in the control group following foot massage (F=25.75, p=.000). - The diastolic blood pressure in the experimental group was lower than that in the control group following foot massage (F=15.27, p=.000). In conclusion, foot massage is an effective dependent nursing intervention for pain control of post abdominal operative patients.

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간호사와 환자에게 제공된 수술통증관리 교육이 수술 후 통증관리에 미치는 효과 (The Effects of Postoperative Pain Management Education Provided for Nurses and Patients on Postoperative Pain Management)

  • 이희선;안지혜
    • 임상간호연구
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    • 제14권2호
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    • pp.5-17
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    • 2008
  • Purpose: The purpose of this study was to examine the effects of education regarding postoperative pain management provided for nurses as well as patients on related factors of pain management, including nurses' knowledge and attitude of postoperative pain, and the level of pain that patients felt after surgery. Method: A quasi-experimental research design was used in this research. Twenty-one nurses currently working in general surgery units and 32 patients who were taking on abdominal surgery in A university hospital were participated in this study. The three week-educational program of postoperative pain management including lecture, quiz, poster and discussion was provided for nurse participants. The postoperative pain management education for each patient was provided one day before his/her own operation for 20 minutes with the pamphlet developed by researchers. For assessing the effects, nurses' knowledge and attitude about pain management, patients' postoperative pain, pain control barriers, and satisfaction of pain management were measured. Results: The nurses' knowledge about pain management and the patients' satisfaction of pain management in the experimental group were higher than in the control group. The patients' postoperative pain in the experimental group was lower than in the control group. Conclusion: With the above results, the postoperative pain management education could be an effective nursing intervention for pain management of patients who were taking surgery.

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안위를 고려한 통증관리중재가 수술 후 아동의 폐합병증 발생, 통증, 안위에 미치는 효과 (The Effects of an Active Pain Management with Structured Physiotherapy on Postoperative Pulmonary Complications and Pain among Children)

  • 김선구;김지수
    • 임상간호연구
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    • 제14권3호
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    • pp.47-59
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    • 2008
  • Purpose: The purpose of the study was to compare the active pain management (APM) with structured physiotherapy (SPT) with the conservative care on postoperative pulmonary complications, pain, and comfort in children under three year. Method: A non-equivalent control group, non-synchronized design study was used. A total of 64 children participated in the study. The children in the experimental group (n=32) received APM with SPT after surgical operation. After transferred to the general unit, the parents were instructed to hold the child for 30 minutes to relieve anxiety and have him/her sleep comfortably for 2 hours. Scheduled 20 minutes chest percussion was performed by the parents for 2 days: twice every 4 hours, one in 6 hours, then one every 8 hours for the rest of two days. Analgesic was administered as needed. Pain and comfort were observed and recorded by nurses using the FLACC and COMFORT Behavior Scale. Results: One child in the control group was diagnosed with postoperative pneumonia. The children in the experimental group who were received the APM with SPT reported higher scores in comfort and lower scores in pain than those in the control group. Conclusion: The findings suggest that APM with SPT can help prevent postoperative pulmonary complications and pain.

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