• Tuberculosis and Respiratory Diseases
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• 제58권4호
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• pp.404-409
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• 2005

기관지흉막루는 수술적 치료를 고려해야 하나 대부분의 환자들이 전신상태가 불량하고 기저질환으로 인해 수술을 시행할 수 없는 경우가 많다. 이런 환자들에게 있어서 굴곡성 기관지내시경을 이용하여 누공을 폐쇄시키는 다양한 방법들이 시도되고 있다. 저자들은 폐렴 및 농흉이 동반된 고령의 환자에서 흉관삽입 후 발생한 원위부 기관지 흉막루를 굴곡성 기관지내시경을 이용한 EWS 삽입으로 치료에 성공한 1례가 있어 보고하는 바이다.

• 여성건강간호학회지
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• 제2권2호
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• pp.284-297
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• 1996

A maternity ward in a hospital in Seoul has an educational program for postpartal mothers since its opening, but evaluation on the program has not been done. This study was to find whether the educational program contributed to increase of knowledge and confidence of the post-partal mothers in the area of postpartal self-care and the newborn baby care or not. This study aimed at improvement of the educational program for posrpartal mothers and the newborn babies. Subjects were 40 primiparae who were admitted to the obstetric ward in a general hospitals in Seoul from August 20th to September 10th, 1995. Subjects were those who had no labor pain at the admission time, had no complications during labor and delivery, gave a birth to a healthy baby, and agreed to participate in this study. All subjects were well educated and were in well-to-do group. Most of them received antenatal care adequately. They were tested on knowledge and self-confidence in the area of postpartal self-care and infant care two times, one at the admission time and the other prior to discharge. After the first test, nurses in a maternity ward and nursery taught them on postpartal self-care and infant care. Education consisted of a 1 hour planned program and incident teachings done at bed side. Four tools were developed by authors based literature review. The test tool for knowledge of postpartal self-care consisted of 15 items which included the definition of postpartum, dangerous symptoms in postpartum, lochia, time to begin coitus, postpartum exercise, sitz-bath, and perineal care. The test tool for self-confidence in postpartal self-care included such items as emergency care on dangerous symptoms in postpartum, sexual life and contraception after postpartum, self-confidence in postpartum exercise and perineal care. The test tool for knowledge of newborn baby care consisted of 18 items which included bathing, umbilical cord care, vaccination, breast feeding, abnormal symptoms of neonate. The test tool for self confidence in the newborn baby care included umbilical cord care, vaccination, breast feeding, emergency care for baby. Analysis of demographic data were analyzed with calculation of percentage. Score differences between the first test and the second test were analyzed with paired t-test. SAS / PC (Release 6.04 for DOS) program are as follows. 1. Mothers' knowledge of postpartal self-care increased significantly after education (t=10.04, df=38, p=0.0001). 2. Mothers' self-confidence in postpartal self-care increased significantly after education (t=6.53, df=38, p=0.0001). 3. Mother's knowledge of the newborn abay care increased significantly after education (t=9.74, df=38, p=0.0001). 4. Mothers' self-confidence in the newborn baby care increased significantly after education(t=8.22, df=38, p=0.0001) Suggestions for further studies and nursing practice were as follows. 1. We suggest studies by randomized control-group pretest-posttest design or nonequivalent control group pretest-posttest design will be done. 2. We suggest follow-up studies to find if mothers's confidence will last or not after discharge. 3. We suggest general hospitals to establish a phone-counseling system.

• 한국보건간호학회지
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• 제4권1호
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• pp.5-16
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• 1990

'What is nursing' this question could always be arised and such a question could bring forth the new possibility to definete the nursing concept more clearly. At the middle of 19th Centry, Mrs. Nightingale defined the concept of nursing as follows; 'Nursing is a kind of treatment act to aid the patient so that the health of patients may be recovered naturally, as keeping the most comfortable circumstances.' But after then, the role and function of nurses about purpose and method of nursing has continuously been studied, as the social circumstance has been changed. The fact that care provider and client have the same concept about nursing is very important at the first step of assessment. But at the present time, the care provider and client have not same concept yet, so the difference of unrsing concept between care provider and client is analyzed in this study. This study would be belived to be helpful for the advance of nursing in the future. In this study, 20 questionare from nursing objectives developed by Abdellah(basic care needs, sustenal care needs, remedial care needs and restorative care needs) are used for adult. The data of this study by the 6 point rating scale are analyzed by SAS as follows; 1. Respondent's view is that nursing is necessary in case of group(school or company) rather than private and in case of abnormal conditions rather than normal conditions. 2. Every questionares of nursing objectives are divided into 4 points of view such as basic care needs, sustenal care needs, remedial care needs and restorative care needs are examined. The evaluation by 6 point rating scale revealed that $5.08\pm0.65$ point in basic care needs $4.93\pm0.68$ point in sustenal care needs $4.91\pm0.80$ point in remedial care needs and $4.61\pm0.91$ point in restorative care needs. While basic care needs and substenal care needs that need more physical care show high points, remedial care needs and restorative care needs that need more psychological, social and spiritual care show low points. 3. It was checked whether there is any significant difference between above 4 point of views in nursing objectives and qeneral characteristics or not. As a result, there is significant difference between 4 point of view and ages, educational level, marriage, composition of children. And also there is significant difference between religion and basic care needs, remedial care needs and restorative care needs. But there is no significant difference between any point of view and sex, occupation, experience of admission and experience of family admission. As this study is based on the data gethered from a restricted area, the result can not represent the opinion of all the clients. Therefore the same kind of study should be carried out on many areas repeatedly and also it should be tried to extract objective concept. And also periodical study is needed to observe the changing process of nursing concept.

• 가정간호학회지
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• 제15권2호
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• pp.106-114
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• 2008

Purpose: We analyzed the self-care behavior and metabolic control rates in diabetic patients based on the National Health and Nutrition Examination Survey in Korea (2005). Methods: The study group included 311 patients who were over 126 mg/dL on the FBS test. Data were analyzed using SPSS PC WIN 12.0. Results: The average score of self-care behavior was $12.08{\pm}1.05$ points, and significantly different according to DM treatment status, disease duration (years), admission experiences (within 1 year) and education about DM. Glucose, total cholesterol, triglycerides were decreased in self care subjects, but not significantly. Conclusion: An educational program for diabetic patients would help maintain metabolic control rates to improve self-care behavior.

• 한국임상약학회지
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• 제26권4호
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• pp.318-323
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• 2016

Background: Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD) complications in dialysis patients. Methods: This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product ($cCa{\times}P$), and the prescription rate of non-calcium based P-binders. Results: A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target $cCa{\times}P$ level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher $cCa{\times}P$ levels than $55mg^2/dL^2$ (P <0.001). Conclusion: It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.254-260
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• 2012

Purpose: Ongoing treatment and care, as well as initial stabilization, are required for trauma patients. With increasing number of sickest trauma patients and shortage of surgeons, the need for advanced practice nurse to provide and coordinate trauma care has been greater. The purpose of this study is to analyze the effect of hiring a trauma clinical nurse specialist and its influence on the treatment of trauma patients. Methods: Based on the employment of the clinical nurse specialist in December 2010, the patients were divided into two groups: patients admitted from January 1, 2010 to November 30, 2010 and patients admitted from December 1, 2010 to December 31, 2011. Retrospectively, data were collected using electronic medical records. The general characteristics, clinical courses, and ICU re-admission rates, collaboration (transfers to other departments and collaborative surgery) were compared. Results: To have a clinical nurse specialist on the trauma team resulted in a statistically significant reductions in the length of general ward hospital stay (p<0.05), the ICU re-admission rate, (p<0.03), the lead-time before transfer to other departments (p<0.05). Conclusion: The clinical nurse specialist, as a professional practitioner, improved the quality of treatment through early detection and management of problems. In addition, as a coordinator, the clinical nurse specialist maintained a cooperative relationship with multi-disciplinary medical personnel. The trauma clinical nurse specialist contributed to the treatment of trauma patients positively through a decrease in ICU re-admission rate and length of hospital stay.

• 간호행정학회지
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• 제6권2호
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• pp.195-209
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• 2000

The purpose of this study is to estimate the population requiring nursing home services among elderly people in Korea. This study identifies the need of nursing home services determined by health care professionals and estimates the proportion of elderly people requiring nursing home service according to the admission criteria. Surveys were conducted on health care professionals including medical doctors, home care nurses, and nurse practitioners. They were asked to assess nursing home need based on four content areas: Physical function (Activities of Daily Living), chronic disease, Physical symptoms (incontinence), mobility, eating, and sensory function. Based on the professionally determined need criteria the proportion of elderly people requiring nursing home services was estimated using secondary data from the 1994 Survey on the Living Status of the Korean Elderly. The number of study subjects to estimate nursing home need who were 60 and older totaled 2,058. The most important factor contributing to the admission eligibility criteria was the elderly living alone. Other factors related were the elderly being unable or having difficulty carrying out activities, and having insufficient help from other our activities, and having insufficient help from other members of the household. Using only physical function, the proportion of elderly people requiring nursing home was $8{\sim}9%$. When only chronic disease was used, proportions varied widely; for the doctor's group, the proportion was over 30%. Using all areas, the proportions of elderly people requiring nursing home were between 13% and 38%. The estimate using chronic disease and physical function was similar to the on using all areas.

• Asian Pacific Journal of Cancer Prevention
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• 제15권10호
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• pp.4251-4254
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• 2014

Background: Treatment of anemia is an important issue in the palliative care setting. Blood transfusion is generally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancer cases is less far established. Objective: We aimed to outline the use of transfusions and to find the impact of blood transfusion on survival in patients with advanced cancer and very near to death. Design: Patients dying in 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data including age, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusion history of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who had transfusion at admission were compared with the group who were not transfused. Survival was defined as the time between the admission of last hospitalisation period and death. Results: Three hundred and ninety eight people with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the time of last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during the last hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longer in patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001). Conclusions: Patients who had blood transfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. This study remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.

• 기본간호학회지
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• 제13권2호
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• pp.190-199
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• 2006

Purpose: To provide basic data and to identify the risk of pressure ulcers among neurological patients in ICU. Method: The participants in the study were on 78 neurological patients in the ICU of 3 hospitals. Data were collected every other day from 24 hours after admission, for up to 40 days or until discharge. The total period of data collection was 3 months. The risk assessment scales used for pressure ulcer were the Cubbin & Jackson(1991) scale and the National Pressure Ulcer Advisory Panel(1989) skin assessment tool. Results: There was a significant relationship between having a pressure ulcers and weight, skin condition, mental status, respiration, hygiene and hemodynamic status compared to not having a pressure ulcer. The incidence rate of the pressure ulcer was 28.2%(n=22). Of these patients the mean number of hospitalization days until pressure ulcer development was 5.2 days. The most common pressure ulcer site was the coccyx(39.3%). Based on a cut-off point of 24, 9 patients with risk scores <24 on admission also showed risk score for development of pressure ulcers, 10 patients with pressure ulcer scores ${\geq}24$ were older, hospitalized for a longer time, had low serum albumin, low hemoglobin, diabetes mellitus and surgery. Conclusion: In order to make the Cubbin & Jackson risk assessment scales more useful, there is a need to determine the reliability of the upper cut-off point 24. The result also showed a need to assess other risk factors and for early identification of at-risk patients in order to provide preventive care from admission to discharge.

• Neonatal Medicine
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• 제25권2호
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• pp.66-71
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• 2018

Purpose: Respiratory morbidity is the most common problem among neonates admitted to neonatal intensive care units. Therefore, the aim of this study was to make a differential diagnosis between transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and pneumonia through comparison of clinical features and test results. Methods: This retrospective study was conducted in 86 infants with TTN, RDS, or pneumonia. These were infants who had respiratory distress, were born after ${\geq}34$ weeks of gestation, and transferred to the neonatal intensive care unit of Kosin University Gospel Hospital between June 1, 2011 and June 30, 2016. Results: The numbers (percentage) of infants with TTN, RDS, and pneumonia were 51 (59.3%), 20 (23.3%), and 15 (17.4%), respectively. Late-preterm and early-term newborns accounted for 65.1% of the infants. Tachypnea was observed in 74.4% of the neonates. The median age at admission was 4 hours (0 to 116) after birth. The infants with RDS had significantly lower birth weights, pH levels, base excess and oxygen saturation levels at admission, longer duration of total ventilator therapy, and hospital stay than those in the other two groups. The infants with pneumonia showed significantly high initial high-sensitivity C-reactive protein levels and significant chest radiographic findings. Conclusion: Early differential diagnosis for TTN, RDS, and pneumonia is challenging because they show similar respiratory symptoms at an early stage. Clinical features and test results can be used to determine the etiology of respiratory distress and early antibiotic treatment.