• 제목/요약/키워드: Academic Medical Center

검색결과 447건 처리시간 0.026초

Lethality-Associated Factors in Deliberate Self-Poisoning

  • Choi, In Young;Kim, Sun-Young;Chang, Jhin Goo;Song, Hoo Rim;Kim, Woo Jung;Lee, Su Young;Kim, Hyun-Soo;Hong, Minha
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제32권1호
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    • pp.17-27
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    • 2021
  • Objectives: Deliberate self-poisoning (DSP) is the most common suicide method and can be life-threatening. The purpose of this study was to investigate the factors related to the lethality of DSP and the characteristics of the adolescent group. Methods: A retrospective study was conducted on patients who had visited an academic hospital's regional emergency medical center between 2015 and 2018. The data reviewed through their medical records included sociodemographic factors, clinical variables, and psychiatric treatment. Four groups (Q1-Q4) were categorized by descriptive analysis using the risk-rescue rating scale. Results: A total of 491 patients were enrolled in this study. This study showed that high lethality had statistically significant associations with male sex, older age, admitting suicidal intentions, and the use of herbicides for suicide. Logistic regression analyses showed a significant association between high-lethality and female [odds ratio (OR)=0.50, 95% confidence interval (CI)=0.30-0.81, p=0.01], non-psychiatric drugs (over-the-counter drug: OR=2.49, 95% CI=1.08-5.74, p=0.03; herbicide: OR=8.65, 95% CI=3.91-19.13, p<0.01), and denial of suicide intent (OR=0.28, 95% CI=0.15-0.55, p<0.01). Conclusion: This study showed the clinical factors associated with the high lethality of DSP and suggested that efforts were needed to care for and thoroughly examine patients with DSP.

당뇨병 환자의 당뇨지식, 자가간호활동과 자기효능감의 관계 - 일 종합병원 환자를 대상으로 - (Relationship between Knowledge on Diabetes, Self-care Activities, and Self Effectiveness of Diabetics Patients)

  • 이미화;김은영
    • 가정∙방문간호학회지
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    • 제10권1호
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    • pp.15-24
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    • 2003
  • This study provides some basic information on the improvement of diabetics' self-care activities through examining the patients' knowledge on diabetes, self-care activities, and how much they feel those activities are effective and through studying the correlation among the three factors. One hundred and fifty four patients were subjected to this study, who were treated or hospitalized in a hospital in Pusan. Researches were conducted from October 21 to November 9, 2002, and information were gathered by questionnaire and direct conversation with the patients. The data was processed through SPSS WIN 10.0 program. The Date were analyzed by descriptive statistics, ANOVA, t-test, Pearson correlation coefficient and Spearman rank correlation coefficient. The results of this study was the followings; 1) The subjects' knowledge on diabetes ranged from 6 to 23 points with a mean of 17.01 points. 2) The subjects' self-care activities ranged from 21 to 103 points with a mean of 67.72 points. That of the patients with regular treatments appeared to have the highest points (3.51) and the lowest points appeared in the measurement of sugar level in blood (2.60) 3) The subjects' feelings of effectiveness ranged from 21 to 103 points with a mean of 70.01 points. Drug therapy had the highest point (3.94) and diet showed the lowest (3.37) 4) In the general characteristics of the subjects, the more education a subject had, the more knowledge on diabetes he or she appeared to have (F=3.36, p=0.012). The self-care activities were significantly high among non-alcoholic subjects (F=4.301. p=.016). The subjects' feelings of effectiveness were higher in female patients than in male patients(t=2.132 , p=.035), and those in the ages between 51 and 60 felt more effectiveness (F=4.198. p=.003). In addition, married subjects felt more effectiveness than the unmarried (t=2.856, p=0.005), and the more education a patient had. the more effectivess he or she felt (F=2.879, p=.025). 5) In the subjects' pathological characteristic, the subjects who experienced diabetes education showed more knowledge on diabetes, more self-care activity, and more effectiveness than those without the education (t=3.193, p=.002; t=2.299, p=.023; t=2.128, p=.035). 6) As the results of the analyses of correlations among knowledge on diabetes, self-care activity, and effectiveness, the more knowledge on diabetes a patient had, the more self-care activity and the more effectiveness he or she showed (p=0.283. p=0.002; p=0.182, p=0.036). Self-care activity became higher as the feeling of effectiveness appeared higher (r=.550, p=.000). Based on the results above, several suggestions were made; 1) This study was conducted in one hospital, so it is difficult to generalize the results. It is necessary to gather more information from more patients through repeated researches. 2) The study on the other factors which can affect a patient's self-care activity is required. 3) The development of a program which improves a patient's self-care activity, knowledge on diabetes. and effectiveness is needed.

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임상 간호사의 당뇨병에 대한 지식, 중요도 및 인지도 조사 (Research into Clinical Nurses' Knowledge, Importance and Perception of Diabetes Mellitus)

  • 신정섭;박춘자
    • 한국간호교육학회지
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    • 제8권1호
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    • pp.95-107
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    • 2002
  • The purpose of this study is to determine the clinical nurses' knowledge of DM and diabetes patient education aptitude so as to provide a basis for clinical nurse training with respect to diabetes patient education program. The data has been collected through the questionnaires of 42 items from the Knowledge on DM and each 16 item from the Importance on the elements of diabetes patient and the Recognition for clinical nurses, respectfully. 166 nurses from a general hospital who had participated in clinical nurse training in Sep. 28 and Oct. 4, 2001 were subject to respond the questionnaires. Analysis has been done by using statistical method such as percentage, average, standard deviation, t-test, ANOVA, Duncan test and Pearson correlation coefficients. The findings are as follows: 1. Clinical nurses' knowledge levels of diabetes 1) The average level of nurses' knowledge about diabetes is 29.37 (right answer- finding rate: 70%), which is intermediate. 2) Amongst the nurses classified by their knowledge levels about diabetes, the group with less than one year career and that with more than 5 year careers are found to have higher knowledge levels. The item with the highest right answer-finding rate was 'Please find the wrong out of the following examples about foot care'. Meanwhile, the item with highest incorrect answer-finding rate was 'what does blood sugar control aims for amongst gestational diabetes?'. 2. Clinical nurses' importance and perception levels of educational training about diabetes 1) There were no differences amongst nurses' importance level about diabetes. 2) Nurses usually had high scores(4.30) in terms of the items related to the importances about educational training. 3) There were quite high recognitions of general characteristics and symptoms about diabetes, amongst the nurse cohorts working more than one year and less than 5 years, and over 5 years, the group belonging to the internal department, that having the previous experiences of dealing with diabetes, and that having their diabetic relatives and other close people. Meanwhile, strangely, the group who identified themselves as 'not good at treating diabetes' had a high recognition level of educational training about diabetes. 3. Relationship between knowledge levels and importance & perception levels of diabetes 1) The higher knowledge about diabetes nurses had, the more importance they recognized. 2) It is found that there was no relationship between knowledge and perception of diabetes. 3) The more importance about diabetes nurses had, the higher perception they obtained. In conclusion, there is an urgent need for systematic educational programs about diabetes including technical aspects, in order to upgrade and improve nurses knowledge levels. In addition, re-educational training should be provided at regular intervals. Further, we believe the nurses with high knowledge about diabetes and interests in the provision of educations for patients can be far more confident, and in return, patients can have better self-management about diabetes obtained through educations. Based on the above-mentioned findings, we would like to make the suggestion: re-evaluation about nurses' knowledge and cognition levels should be carried out after job training programs about diabetes.

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피지국에서의 의료폐기물 처리현황과 문제점 (Challenges of Medical Waste Treatment in Fiji)

  • 김대선;;;이철우
    • 적정기술학회지
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    • 제6권1호
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    • pp.37-44
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    • 2020
  • 의료폐기물은 감염성물질을 함유하고 있는 모든 종류의 폐기물을 가리키며 전염을 예방하기 위해 운송에 신중을 기해야 한다. 처리 수단으로의 소각은 부피 감소, 악취 제거, 위해성 측면에서 매립이나 투기보다 장점을 갖고 있다. 야외 소각이나 바람직하지 않은 환경에서의 소각은 환경오염 물질의 대기 중 배출을, 생물학적 폐기물의 매립은 토양과 수질오염을 야기시킨다. 피지의 대부분의 2차 병원은 의료 폐기물을 세 군데에 있는 3차 병원으로 차량 또는 배로 이송하여 소각 처리한다. 어떤 의료폐기물은 일반폐기물로 간주되어 현장에서 야외 소각되거나 출산 시 발생한 생물학적 의료폐기물은 매립되기도 하였다. 이런 측면에서 의료폐기물 처리 관련 인력들에 대한 인식 증진을 위한 교육이 시급하다. 피지에서의 의료폐기물 처리는 단일 도로를 따르는 차량운송, 배를 이용한 도서간 운송보다 소형 소각로를 이용한 현장소각이 권장되며, 가이드라인 제정, 관련 인력 훈련, 정부의 법률적 제정 등 의료 폐기물 처리를 위한 기반 조성이 필요하다.

간호학생의 임상실습 간호활동시간 분석 (Analysis of Nursing Care Activities of Nursing Students in Clinical Experience)

  • 이정희;성영희;정연이;김정숙
    • 한국간호교육학회지
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    • 제4권2호
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    • pp.249-263
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    • 1998
  • The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

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일개 대학생의 스트레스 요인 및 우울 수준의 융복합적 관련성 분석 (Analysis of the Convergent Relationship between Stress Factors and Depression Levels in a College Students)

  • 이현숙;배상윤
    • 디지털융복합연구
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    • 제17권4호
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    • pp.219-227
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    • 2019
  • 본 연구는 일개 대학생의 우울수준(CES-D: Center for Epidemiologic Studies Depression scale)과 관련된 스트레스 요인들의 융복합적 관련성을 조사하였다. 설문조사는 2018년 11월 12일부터 2018년 12월 14일까지 임의로 선정된 J지역 대학의 재학생 304명에 대하여 무기명 자기기입식 설문지를 사용하였다. 위계적 다중회귀분석 결과, 취업스트레스(CMI: Conell Medical Index)가 높은 군에서, 학업소진(MBI-SS: Maslach Burnout Inventory-Student Survey)이 높은 군에서, 불안(BAI: Beck Anxiety Inventory)이 높은 군에서 우울수준이 높았으며 이들의 설명력은 60.7%이었다. 이상의 연구결과를 볼 때, 대학생의 우울수준을 낮추기 위해서는 취업스트레스를 낮추고, 학업소진을 낮추고, 불안을 낮추는 노력이 필요하다. 이러한 결과는 대학생의 우울수준을 낮추는 학업 상담 및 지도, 취업상담, 및 심리 및 정서적 안정을 위한 다양한 중재 노력에 활용될 수 있다. 추후연구에서는 대학생의 우울수준에 영향을 미치는 융복합적 요인들에 대한 구조모형의 제시 및 분석이 필요하다.

Cytomorphologic Patterns of Breast Lesions in Sudanese Patients: Lessons Learned from Fine Needle Aspiration Cytology

  • Almobarak, Ahmed Omer;Elhassan, Taiseer Mohamed;Elhoweris, Mohamed Hassan;Awadalla, Heitham Mohammed;Elmadhoun, Wadie Mohamed Yasin;Ahmed, Mohamed Hassan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3411-3413
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    • 2014
  • Background: Cytology for breast lesions is a safe, rapid and cost-effective with a high specificity and sensitivity. Objective: To determine the cytomorphologic patterns of breast lesions identified among a group of Sudanese patients. Materials and Methods: This study included 759 patients undergoing either a fine needle aspiration FNA, nipple discharge (ND) smears or breast skin scraping (SS) at a cytology clinic in Khartoum. Clinical and demographic data were reviewed. Stained smears were categorized into: inadequate sample, normal breast, benign lesion, suspicious, or malignant neoplasm. Results: Of the 759 cases, 734 (96.71%) were FNA, 18 (2.37%) ND and 7 cases (0.92%) SS. For 28 cases, FNA was done under ultrasound guidance. Females were 720 (94.86%). Benign lesions were 423 (55.75%) and 248 (32.67%) were malignant and 77 (10.14%) of smears were normal without any detected abnormality. Ten (1.31%) cases were suspicious for malignancy, and only one case (0.13%) was reported as inadequate. Most lesions were observed among the age group 30 years and above. Conclusions: Most patients investigated have benign lesions, one third of cytological smears were malignant. FNAC is a useful tool for investigating breast lesions in limited-resource settings.

혈액투석환자의 자가간호 역량 및 자기효능감에 대한 연구 (A Study on Self-Care Agency & Self Efficacy of Hemodialisis Patients)

  • 박형숙;조징림
    • 가정∙방문간호학회지
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    • 제9권2호
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    • pp.78-89
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    • 2002
  • The purpose of this study was to identity degree on self-care agency & self efficacy of hemodialisis patients. The subjects for the study consisted of 260 hemodialisis patients and the data were collected from April 1st. 2002 to April 30. 2002. The instruments used for this study were the Self-carer As Inventory Scale(Genden & Taylor. 1998) and Concrete Self Efficacy Scale(Joo-Hyen Kim. 1995). The Self-carer As Inventory translated by So Hyang-Sook and was modified by auther of this study. The data were analysed by using SPSS/WIN program and included number. percentange. t-test, ANOV A and Pearson Correlation Coefficient. The results of the study are summarized as follows. 1. As the average score Self-care agency indicated $132.21\pm19.11$ points and Self efficacy showed $597.33\pm130.95$points. it can be said that Self-care agency and Self efficacy were high. 2. In the relationship between general and hemodialisis cure characteristics and Self care agency were significant difference in age(F=3.065. p=0.018). married(F=3.160. p= 0.029). religion(F=4.128. p=0.003). hemodialisis cure duration(F=2.615. p=0.049). 3. In the relationship between general and hemodialisis cure characteristics and Self efficacy were significant difference in age (F=2.992. p=0.019). married(F=4.427. p=0.013), job(before attack-F=1.926. p=0.044. after attack-F=1.784. p=0.048). incomes (F=2.235. p=0.041), hemodialisis cure frequency (F=1.718. p=0.042). diet practice (F=2.248. p=0.025). 4. Self efficacy was significantly related to Self-care agency(r=0.474. p<(0.001). That is the higher the self efficacy. the higher the level of Self-care agency. The result in the above showed that more concern and endeavors need to improve hope. medical support. self efficacy, self-care agency of hemodialisis patients.

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항암화학요법 환자의 가정간호 이용 양상과 간호 만족도 (Home Care Services Utilization and Satisfaction for Clients with Cancer)

  • 김윤옥;백희정
    • 가정∙방문간호학회지
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    • 제10권2호
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    • pp.132-140
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    • 2003
  • This study was to identify the utilization of home care service and home care nursing satisfaction for clients with cancer who had completed secondary and tertiary chemotherapy session. Raw data was collected by reviewing charts and questionnaire of 23 clients with cancer between September, 2002 and November 2002 at an university hospital located in Seoul. Korea. The result are as follows: 1. Characteristics in the use of home care: After applying for home care service, patients were visiting an average of 1.88 days later. The major purpose of using home care service was to help recovery after hospitalization or to maintain present health. The average period for home care service was 14.6 days, with 4 visits over this period, for 35.78 minutes per visit. 2. Content of home care service: A total of 47 items of service were provided - basic nursing care, education and counseling, and therapeutic nursing care. On every visit, an average of 19 items of home care service were provided, and the majority (7 items) were therapeutic nursing care. 3. Satisfaction with home care services: Satisfaction was very high, an average of 3.88 on a scale of 4 points. Both patients and families expressed high satisfaction with all sub-domains of nursing care: guidance by the home care nurses, knowledge, skill, attitude, interpersonal relationships, emotional support, and accessibility. In conclusion, home care served basic nursing care, teaching and counseling, and therapeutic nursing to clients with cancer going through secondary or tertiary chemotherapy. Therefore they changed knowledge and attitude to disease and treatment which were difficult to change.

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일부 가톨릭교회와 연계된 병원중심 가정간호사업의 평가 (An Evaluation of the Home Care Nursing Services Conducted jointly by Catholic Churches and Hospital)

  • 김혜단;김순례
    • 가정∙방문간호학회지
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    • 제12권1권
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    • pp.41-69
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    • 2005
  • Purpose: This study was performed to evaluate the outcomes of the home care nursing program conducted jointly by thirty two catholic churches and C hospital in Seoul. Method: The subjects included 173 patients who registered for the program during a 4 month-period from November 1, 2004 to February 28, 2005 and received home care services for more than 4 times and 32 professional nurses participating in the program. Using the concept of medical outcome study (MOS), the structure, process, outcome elements were analyzed. Result: 1) A Catholic homecare nursing center and nurses of the C hospital played a central role in providing nursing care, and each church operated its own vehicle from its own office. Home care nurse's job satisfaction was 2.8 out of total score of 4. The major illness was cerebrovascular disease including stroke followed by skeletomuscular disease including degenerative arthritis cancer, and diabetes. Among reasons for accessing the home care nursing program, hypertension management was most prevalent. More than half of the registration was done through catholic churches. Most people who referred the patient to the program was through the church. Most patients received home care nursing 1-2 times a week for 30 to 60 minutes in average and the most frequent type of service provided was basic nursing. 3) The most frequent reason for terminating home care services was death. The change in PPS(Palliative Performance Scale) level from the time of registration and after 4 visits was the same in 45%, decreased in 30%, and improved in 25%. Patient satisfaction was very high, showing 3.4 out of total score of 4. Conclusion: These results proved that the home care nursing program was highly appreciated by subjects and nurses were providing professional care. Thus the two parties involved in the program were actively supporting the program to fulfill their mission. However, several areas needed to be improved such as relating with local community, relating with family doctor, and issue of improving the working conditions for home care nurses.

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