• Title/Summary/Keyword: 증상사정

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A Clinical Study of Probable Acute Axonal Guillain-Barré Syndrome Occurring at a Mental Hospital (한 정신병원에서 발생한 급성 축삭성 길랑-바레 증후군으로 추정되는 환자들에 대한 임상적 연구)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.81-88
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    • 2000
  • Background : Guillain-$Barr{\acute{e}}$ syndrome(GBS) is characterized clinically by acute flaccid paralysis, areflexia, and albumino-cytologic dissociation. Based on electrophysiology and pathology, GBS can be divided into either predominantly demyelinating or predominantly axonal patterns. Objectives : The clinical and laboratory status of probable acute axonal GBS occurring at a mental hospital was evaluated. Methods : Eight schizophrenia patients with probable acute axonal GBS were analyzed. Results : The mean age of the patients was 38 years old. Most of the patients were men. All patients showed an acute ascending paraparesis and/or quadriparesis with areflexia, and all have a history of schizophrenia for 3~20 years. The diseases occurred predominantly in the summer and electrodiagnostic studies revealed axonal patterns. The patients were treated by supportive care, except one patient with intravenous immunoglobulin. The prognosis was improved in 3 ; no change in 4 and 1 became aggravated. One patient with acute motor-sensory axonal neuropathy had a recurrence after 10 months of the first attack. Conclusions : Axonal GBS has been considered uncommon clinically or electrophysiologically, but 8 probable acute axonal GBSs occurring at a mental hospital have been diagnosed in 3.5 years.

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업종별 산업간호사의 보건관리업무 분석

  • Yun, Sun-Nyeong;Park, Jeong-Hui;Kim, Myeong-Sun;Im, Hye-Gyeong;Lee, Ae-Gyeong;Lee, Nam-Jun;Hyeon, Hye-Jin
    • Korean Journal of Occupational Health Nursing
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    • v.2
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    • pp.13-25
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    • 1992
  • 본 연구는 업종별 산업간호사의 보건관리업무의 내용과 수행정도를 측정하고 업종별 보건관리업무 수행정도를 비교 분석코저 한다. 연구방법은 산업간호사회에 등록된 산업장중 서울, 인천, 마산, 창원, 부산, 울산 지역에 있는 130개 산업장을 임의로 선정하여 산업간호사를 대상으로 설문조사하였다. 자료분석은 반도와 백분율, 업종간의 보건관리업무 내용별 수행정도는 일원분산분석과 다중검증 비교로 유의성을 검증하였다. 연구결과는 다음과 같다. 1) 업종별로 산업간호사의 업무수행에 유의한 차이를 보인 보건관리내용은 서비스업에 있어서 근로자의 건강사정에 대한 수행정도가 제조업과 기타제조업에서 보다 높게 나타났다.(F=4.23, P=.0167) 반면에 근로자의 건강진단과 계속관리, 작업환경 관리업무 수행정도는 제조업과 기타제조업에서 서비스업보다 높게 나타났다.(F=9.78, P=.0001 ; F=5.366. P=.005) 2) 업종간에 유의한 차이가 없는 보건관리내용은 산업장진단 또는 건강문제분석, 보건교육, 통상증상에 대한 투약, 기록과 보고, 건강관리실 운영 등이었으며 업무수행정도는 가끔 또는 필요시하는 정도로 나타났다. 반면에 조사, 연구 참여에 대한 수행정도는 세 업종 모두 가장 낮은 것으로 나타났다. 이러한 연구결과들은 산업장 간호사의 신규교육이나 직무교육과정운영이 업종별로 운영되어야 함을 시사해 준다고 볼 수 있으며 또한 산업간호사의 직무 중 보건 교육, 통상질환에 대한 투약, 기록 및 보고, 건강관리실운영등은 업종간에 유의한 차이가 없으나, 수행정도는 낮은것으로 나타나 이에 대한 실제적인 직무교육이 강화되어야 할 것으로 생각된다. 특히 보건교육도 업종별로 차이가 있으므로 다양한 보건교육교재의 개발이 필요하다고 생각된다.

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A Study on the Development of a Program to support VFSS by using Deeplearning (딥러닝을 활용한 VFSS를 도와주는 프로그램 개발 연구)

  • Choi, Dong-gyu;Jang, Jong-Wook
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2018.10a
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    • pp.58-61
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    • 2018
  • In Korea, current medical technology is the highest level in the world. As a result, many doctors have specialized knowledge of various disorders or diseases, and are proceeding in a better way. With such high medical technology, it is possible to increase the probability of success of surgery to provide high reliability to patients. Rehabilitation is also a form of medical treatment that reduces the side effects that occur after surgery that is done for quick cure. However, the situation in this section is slightly different. There are moves to develop rehabilitation devices and operations, but most of them are now dependent on foreign technology. Rehabilitation therapy, which we commonly know, is dominated by behavior. However, it is also a kind of rehabilitation to find out how much the patient's symptoms are improved or recovered. In this paper, we have studied the development of a program by using the Deeplearning method in order to detect the problem of the food swallowing operation by the severity.

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Development of Korean Adult Patients Delirium Screening Tool (한국형 성인 환자 섬망 선별 도구 개발)

  • Jeong, Hye Won;Moon, Sun Hee;Choi, Myoung Lee;Lee, Jung A;Ahn, Shin Hye;Jeon, Ji Hye;You, Ji Na;Kim, Hee Jin;Byeon, Ji Eun;Kim, Sook Young;Sung, In Suk
    • Journal of Korean Clinical Nursing Research
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    • v.29 no.2
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    • pp.198-209
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    • 2023
  • Purpose: The purpose of this study was to develop a Korean Adult Patients Delirium Screening Tool (K-APDS) for those admitted to general wards, and to verify its reliability and validity. Methods: For the development of the tool, 12 items were derived through the results of literature review and focus group interviews with general ward nurses, and the content validity was confirmed by experts. To verify the reliability and validity of the developed tool, 317 adult patients who were admitted to general wards of three tertiary general hospitals from October to November 2022 were evaluated by the attending nurse and data were collected. Results: After factor analysis for construct validity verification, two factors were extracted, which explained 60.1% of the total variance. After the validation of the control group, the difference in the delirium incidence scores calculated using the K-APDS between the delirium group and non-delirium group was very significant (Z=-10.82, p<.001). To verify the criterion validity, K-APDS, Delirium Observation Screening, and Pearson's correlation coefficient were checked and found to be .94 (p<.001). The predictive validity test reported that the sensitivity was 91.1%, specificity was 82.4%, positive predictive value was 52.6%, and negative predictive value was 97.8%. The reliability of K-APDS was found to be high with Cronbach's ⍺=.91. Conclusion: K-APDS can screen for delirium with 2 or more points, excellent validity and reliability have been verified. Therefore, this tool could be applied immediately in the clinical field, and will contribute to the early detection of delirium, enabling rapid interventions.

Curriculum Development for Hospice and Palliative Care Nurses (간호사를 위한 호스피스 완화의료 교육과정 개발)

  • Choi, Eun-Sook;Kim, Hyun-Sook;Lee, So-Woo;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.77-85
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    • 2006
  • Purpose: The purpose of this study is to develop the basic curriculum for the nurses who work at hospice and palliative care settings. Methods: Seven curricula of hospice and palliative care for the nurses in Korea and other countries were reviewed, and Education Need for hospice and palliative care was surveyed from 162 nurses by mailing the questionnaires to hospice palliative care settings. Results: 1. The curricula of hospice and palliative care for the nurses in Korea and other countries in common include 'understanding of hospice and palliative care', 'understanding of lift and death', 'pain and symptom management for person with terminal disease', 'on-the-spot study and practical training', 'management of hospice and palliative ward', 'hospice and palliative care at home', 'physical assessment', 'therapeutic communication skills', 'children's hospice', 'administration and management of hospice and palliative care', 'interdisciplinary team of hospice and palliative care', 'ethics and laws in hospice and palliative care', 'psychological, social and spiritual care', 'care of the dying', 'bereavement care', etc. 2. The scores above 3.3 were marked for 34 items in education Need Survey. The highest scores were given in the order for the items 'understanding of death and dying', 'attitude and response to death and dying', 'understanding and assessment of pain' etc. respondents marked that they have been trained for 'pain and symptom management', 'ethics and laws in hospice and palliative care', 'building the system for cooperation and publicity activities in hospice' etc. 3. The basic curriculum of hospice and palliative care for the nurses requires 78 studying hours for 17 subjects, comprising 48 hours of theory education and 30 hours of practical training. The education methods are lectures, discussions, and case studies. Conclusion: The efforts of developed basic curriculum should be evaluated after educating nurses. It is necessary to develop the standard curriculum and regularly update it based on the result of education Need Survey for actively working nurses in hospice and palliative care settings.

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Differences in Patients' and Family Caregivers' Ratings of Cancer Pain (암환자와 그 가족간호자가 지각하는 환자의 통증강도 차이)

  • Kim, Hyun-Sook;Yu, Su-Jeong;Kwon, Shin-Young;Park, Yeon-Hee
    • Journal of Hospice and Palliative Care
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    • v.11 no.1
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    • pp.42-50
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    • 2008
  • Purpose: Undertreatment of canter pain, especially due to the differences in the perception of pain between the patients and caregivers, is a well recognized problem. The purpose of this study were to determine if there exist differences in communication about pain intensity scores between patients and their family caregivers in Korea. Methods: A total of 127 patient-family caregiver dyads who have experienced canter pain participated in this study at a hospital in Seoul for six months. The data were obtained by fare to face interview with a structured questionnaire based on Brief Pain Inventory-Korean version and other previous researches. The clinical information for all patients was compiled by reviewing their medical records. Results: Patients' 'worst-pain for 24-hour' and 'right-now-pain' scores estimated by family caregivers were significantly higher than those by patient themselves. The degree of agreement between patients and family caregivers in the estimate of patients' 'worst-pain for 24-hour' intensity categories was 78.7% for 'severe pain', 40% for 'no pain', 27.5% for 'mild pain' and 22.9% for 'moderate pain'. In case of 'right-now-pain' intensity categories, the agreement was 50% for 'severe pain', 47.2% for mild pain, 46.3% for 'no pain', and 26.3% for 'moderate pain'. Conclusion: This study demonstrates that the degree of agreement between patients and family caregivers in the estimate of patients 'pain intensity categories was less than 50% except for 'severe pain'. The results indicate that Korean family caregivers tend to overestimate the canter pain intensity of their caring patients, especially, when a lancer patient has 'moderate' or 'mild pain'. Health Providers are advised to educate patient-family caregiver dyads to use a pain measurement scale to promote their agreement in pain Intensity stores. Further analyses and studies are needed to identify the factors and differences that influence their communication about pain intensity scores between patients and their family caregivers.

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Medication Non-adherence and Related Factors of Older Adults Who Use Polypharmacy Based on Medication Adherence Model (약물 이행 모델 기반 다제약제 복용 노인의 약물 불이행과 관련 요인)

  • Jung, SuJung;Tak, Sunghee H.
    • The Journal of the Korea Contents Association
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    • v.19 no.12
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    • pp.398-406
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    • 2019
  • This study was conducted to examine the medication non-adherence and related factors based on medication adherence model of older adults that use polypharmacy. A survey was used to collect data from 190 study participants. Among the 190 subjects, 43.2% did not adhere to their polypharmacy intentionally. The reason for medication non-adherence was listed in order of 'when they felt well on symptoms', 'when it was annoying and uncomfortable', and 'when they felt worse due to medication'. Moreover, the older adults often do not seek for medication information actively. Between adherence and non-adherence groups, while there were differences in gender, type of medication, and experience in drug-related side effects, there were no statistically significant differences in medication information contents and route. This study demonstrates that gender, type of medication, and experience in drug-related side effects should be considered to promote medication adherence. In addition, since the elderly with polypharmacy are rarely actively searching for the contents and route of drug information, the contents of drug information need to be provided by the route preferred by the elderly in order to assist in their decision-making process for polypharmacy.

Simulation training applying SBAR for the improvement of nursing undergraduate students' interdisciplinary communication skills (SBAR 적용 시뮬레이션 교육이 간호학생의 의료팀간 의사소통능력 향상에 미치는 효과)

  • Ha, Yikyung;Lee, Yoonju;Lee, Yeon Hee
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.2
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    • pp.407-419
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    • 2017
  • In this paper, we aim to evaluate the effect of simulation training with a focus on the application of SBAR for the improvement of communication skills of nursing students with physician. The results of the analysis of 25 videos recorded pre/post-simulation were as follows: In terms of the SBAR score, "the most recently measured vital signs" in stage B increased significantly (Z = -2.448, p =.014); the frequency of step-by-step progress in SBAR did not advance to the SBA or SBAR stage in the pre-simulation stage, but increased to 48% post-simulation. The frequencies of SBAR evaluation items mentioned in the post-simulation were the following order: the name of the patient (96%), nurse's name (80%), most recently measured oxygen saturation (76%), and main symptoms (60%). The results of the nurse's judgment (A), request for additional prescription or request for the doctor's direct patient visit (R) were not mentioned. Therefore, it is necessary to consider the application of SBAR in simulation training, which requires problem solving through cooperation with physicians, because it has a positive effect on education in nurse-physician communication.

Factors Associated with Ruptured Intracranial Aneurysm in a Hospital (일개 병원의 뇌동맥류 파열의 위험요인)

  • Lee, En-Ha;Yun, So-Young;Choi, Ja-Yun
    • Journal of the Korea Convergence Society
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    • v.10 no.1
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    • pp.339-351
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    • 2019
  • This study was conducted to identify the factors associated with the ruptured intracranial aneurysm (RIA) among demographic, admission to hospital, clinical, aneurysym itself and lifestyle characteristics. Medical records of RIA patients and un-RIA patients which had been admitted to undergo treatment including surgery (From January to December 2016) were included into data analysis. Multiple logistic regression showed that two and more than warning signs (14.14 (CI: 1.25-159.40)) indicated the greatest odds ratio with RIA, was followed by headache more than 3 scores (13.95 (CI: 3.68-52.83)), the admission via emergency room (13.62 (CI: 4.85-38.26)), single marital status (9.72 (CI: 2.22-42.49)), 1 mmHg increased systolic blood pressure (1.04 (CI: 1.01-1.08)), 1 score increased GCS (0.58 (CI: 0.37-0.90)), arrythmia finding in electrocardiogram (3.70 (CI: 1.22-11.22)) and increased age (0.95 (CI: 0.91-0.99)). The risk groups having factors associated with RIA were identified. Preventive activities including routine assessment should be done before developing the rupture and urgent care should be needed after developing the rupture for risk groups.

The Severity and Variables Influencing Depression in Cancer Patients with Pain (통증이 있는 암환자의 우울 정도 및 우울에 영향을 미치는 요인)

  • Kim, Hyun-Sook;Yun, Young-Ho;Lee, So-Woo;Heo, Dae-Seog;Son, Haeng-Mi;Huh, Bong-Yul
    • Journal of Hospice and Palliative Care
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    • v.2 no.2
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    • pp.125-137
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    • 1999
  • Purpose : Surveying the rates, severity, and variables influencing depression and their correlation between pain and depression in Korean cancer patients, we attempted to provide a basic database for the effective depression management program. Methods : The results of survey were colleted from 10 patients who were hospitalized at Seoul National University Hospital for cancer treatment from February to June of 1999. Factors of depression and the level of pain were examined by self-reported survey employing Korean version of Beck Depression Inventory(BDI) and an abridged version of Brief pain Inventory respectively. The purpose of this study and guidelines for the questionnaires were clearly explained to participating patients by Resgitered Nurses before answering the survey. Demographic and clinical characteristics of patients were compiled by reviewing their medical records in corporation with a family physician. The difference in the level of depression among patient groups was analyzed with the t-test and ANOVA, and the correlation between variables with Pearson correlation coefficient. Results : 1) 142 subjects comprised 79 male and 63 female, and their mean age was 51.86. 2) The mean scores of the worst pain for last 24-hours was 6.08(SD 2.23), the average pain for last 24-hours 4.44(SD 1.85), and the mean scores of pain at the time of survey 3.48(SD 2.25), while the mean scores of the least pain for last 24-hours 2.25(SD 1.83). 3) The mean BDI scores were 23.73(SD 0.99), and 55.6% of patients were evaluated to be in depression(cutting point 21). Scores of depression for cancer patients were higher than normal population. 4) The correlation between worst pain for last 24-hours and depression(r=0.252, P=0.002), average pain for last 24-hours and depression(r=0.225, P=0.007), present pain and depression(r=0.291, P=0.000) were significant. 5) Significant differences were found among groups of cancer patients with pain with respect to gender(t=3.59, p=0.000), level of education(F=4.063, P=0.009), ECOG(F=3.352, P=0.021). There was significant positive correlation between depression and pain(r=0.171, P=0.042). Conclusions : More than 50% of cancer patients with pain are suffering from depression. We have shown that the variables like the degree of pain, gender, level of education, ECOG, and age are significantly related to the depression in cancer patients. The findings of this study may be used for assessing high-risk patients in need of intervention and for planning effective therapeutic strategies for them after the routine assessment. Further study is necessary to investigate the cultural differences and the variables influencing on depression in Korean cancer patients.

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