• Safety and Health at Work
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• 제12권2호
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• pp.268-271
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• 2021

Lung granulomas are uncommon in Thailand. The disease typically develops from an occupational environment and is mostly caused by infection. Herein is a case report of a female patient, aged 48, working as a nurse in an Accident and Emergency Department at a hospital. Eighteen years prior to admission the patient was diagnosed with myasthenia gravis and pulmonary tuberculosis. The chest X-ray and CT scans showed a solitary pulmonary nodule in the lower left lung. The patient received an open thoracotomy with a left lobectomy. Granulomatous and nonseptate hyphae were found in the pathology diagnosis. The patient was thus diagnosed as having a lung granuloma. The galactomannan antigen test was positive. The solitary pulmonary nodule-found from the use of a Polymerase Chain Reaction (PCR) test-was an Aspergillus spp. The fungus culture was collected from air samples. The air samples were collected by the impaction technique using a microbial air sampler. Three types of Aspergillus spp. were found as well as Penicillium spp. and Monilia sitophila. The Aspergillus spp. was a match for the patient's disease. The patient was diagnosed as having a lung granuloma possibly Aspergillus nodule which was caused by airborne Aspergillus spp. from the occupational environment.

• Journal of Korean Academy of Fundamentals of Nursing
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• 제1권2호
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• pp.173-191
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• 1994

This descriptive-correlational study was conducted to exam if there were relation between noise level and reaction to noise of inpatient. The purpose of this study was to provide a basic data for comfort of patient hospitalized. The hypotheses of the study are : 1. The higher perceived noise level of inpatient, the higher reaction level to noise. 2. The higher perceived noise level of inpatient, physiological reaction level to noise. 3. The higher perceived noise level of inpatient, the higher emotional reaction level to noise. The participant were 153 patients hospitalized in one general hospital. The research instruments used for this study were noise scale and reaction of patient scale developed by the author. Data was collected over a period of 10 days from the 9th of July to the 18th of July, 1994. Statistical analysis of the data included percentage, t-test, ANOVA and Scheffe test. Examination of the hypotheses was done by use of pearson correlation coefficient. The results are summarized as follows ; 1. The mean score of noise level was 2.24. Among noise factors reported by the subjects, that which ranked highest was 'Conversation of Visitors'(2.82). Next were 'noise of handling receptacle'(2.73), 'the others noise from outside'(2.73) and 'Conversation of supporter'(2.71). 2. The mean score of reaction level to noise was 2.19, physiological reaction level 2.04 and emotional reaction level 2.37. Among Physiological reaction to noise reported by the subjects, that which ranked highest was 'tired'(2.39). Next were 'sweating'(2.22) and 'headache'(2.20). Among emotional reaction to noise reported by the subjects, that which ranked highest was 'to irritate nerve'(2.53). Next were 'disturbing rest'(2.51) and 'to disturb sleep'(2.46). 3. The relationship between perceived noise level of inpatient and reaction to noise was statically significant (r=0.599, p=.0001). The relationship between perceived noise level of inpatient and physiological reaction to noise was statically significant (r=0.554, p=.0001). The relationship between perceived noise level of inpatient and emotional reaction to noise was statically significant(r=0.535, p=.0001). Thus hypothese 1, 2, 3 were supported. 4. There were significant differences between noise level of inpatient, admission periods, mobility of physical condition and exposure level to noise. 5. There were significant differences between physiological reaction level to noise, admission periods, mobility of physical condition and operation Yes or No. 6. There were significant difference between emotional reaction level to noise, admission periods, mobility of physical condition and exposure level to noise.

• Journal of Acupuncture Research
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• 제19권6호
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• pp.35-48
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• 2002

Objective : The study was performed to evaluate the effect of treatment for thoracolumbar compression fracture by using Bee Venom Acupuncture that is well known for anti-inflammatory and analgesic effect. Methods : We investigated 39 cases of patient with thoracolumbar compression fracture. The patients with thoracolumbar compression fracture were treated at the department of acupuncture & moxibustion of Kyung-Won University Oriental Hospital from 1st January 2001 to 30th August 2002. We selected for two groups. One group was treated by Bee Venom Acupuncture therapy(Bee Venom Acupuncture Group : BAG), the other group was treated by Filiform Acupuncture therapy(None Bee Venom Acupuncture Group : NBAG). Results : 1. The distribution showed female predominance in sex and 70's predominance in age. The largest group was "accidental fall" and the next was "lifting heavy objects" in causes, and within 2 weeks in the duration of disease 2. In the duration of admission, the largest group was within 4 weeks. In regard to level of injury, T12 was found to be most predominant, followed in turn by L1, L2, L5. In regard to grade of clinical symptoms, Grade III was most predominant, followed by Grade II, Grade IV. 3. In the results of treatment, 87.5% were above "Good" in BAG and 47.8% in NBAG. 4. In the result of treatment due to the grade of clinical symptoms, BAG was more excellent than NBAG on the whols grade. 5. In the result of treatment due to duration of admission, the duration of admission was not in proportion to the results of treatment. 6. In the change of lumber flexion, the improvement above $80^{\circ}$ was 50% in BAG and 21.7% in NBAG 7. In the stability of treatment, the BAG and NBAG did't show any detrimental change in GOT, GPT, r-GTP, BUN, creatinine. Conclusions : In the treatment of thoracolumbar compression fracture, the Bee Venom Acupuncture can be regarded as more effective treatment than Filiform Acupuncture in the clinical practice. This is expected to be available for clinical use.

• Journal of The Korean Society of Emergency Medicine
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• 제29권5호
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• pp.408-414
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• 2018

Objective: Patients with low acuity who need hospitalization may be at risk if they do not receive proper treatment in overcrowded emergency rooms. This study was conducted to investigate factors affecting the hospitalization of patients with low acuity of Korean Triage and Acuity Scale (KTAS). Methods: This study was a retrospective chart review analysis of patients aged 15 years or older who had triaged as KTAS 4 and 5 grades when visiting a local emergency medical center from January 1, 2016 to December 31, 2017. Multivariate logistic analysis was performed to analyze the effects of age, sex, reasons for visiting, visiting route, ambulance utilization, KTAS grade and major category on patient admission. Results: A total of 10,540 patients were enrolled and the odds ratio (OR) increased with age from those aged over 34 years (P<0.001). Patients that triaged as KTAS grade 5 (adjusted OR, 1.57; 95% confidence interval [CI], 1.36-1.82), had a condition caused by disease (adjusted OR, 2.31; 95% CI, 2.00-2.68), and visited by using an ambulance (public: adjusted OR, 1.05; 95% CI, 0.91-1.22; private: adjusted OR, 4.60; 95% CI, 3.85-5.49) were more likely to be hospitalized. Individuals in the "general" major category were more likely to be hospitalized than those falling into other major categories (P<0.001). Conclusion: The factors influencing the hospitalization of patients with low acuity were age, reasons for visiting, visiting route, ambulance utilization, KTAS grade and major category on patient admission.

• Tuberculosis and Respiratory Diseases
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• 제84권2호
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• pp.125-133
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• 2021

Background: The coronavirus disease (COVID-19) can manifest in a range of symptoms, including both asymptomatic systems which appear nearly non-existent to the patient, all the way to the development of acute respiratory distress syndrome (ARDS). Specifically, COVID-19-associated pneumonia develops into ARDS due to the rapid progression of hypoxia, and although arterial blood gas analysis can assist in halting this deterioration, the current environment provided by the COVID-19 pandemic, which has led to an overall lack of medical resources or equipment, has made it difficult to administer such tests in a widespread manner. As a result, this study was conducted in order to determine whether the levels of oxygen saturation (SpO₂) and the fraction of inhaled oxygen (FiO₂) (SF ratio) can also serve as predictors of ARDS and the patient's risk of mortality. Methods: This was a retrospective cohort study conducted from February 2020 to Mary 2020, with the study's subjects consisting of COVID-19 pneumonia patients who had reached a state of deterioration that required the use of oxygen therapy. Of the 100 COVID-19 pneumonia cases, we compared 59 pneumonia patients who required oxygen therapy, divided into ARDS and non-ARDS pneumonia patients who required oxygen, and then investigated the different factors which affected their mortality. Results: At the time of admission, the ratios of SpO₂, FiO₂, and SF for the ARDS group differed significantly from those of the non-ARDS pneumonia support group who required oxygen (p<0.001). With respect to the predicting of the occurrence of ARDS, the SF ratio on admission and the SF ratio at exacerbation had an area under the curve which measured to be around 85.7% and 88.8% (p<0.001). Multivariate Cox regression analysis identified that the SF ratio at exacerbation (hazard ratio [HR], 0.916; 95% confidence interval [CI], 0.846-0.991; p=0.029) and National Early Warning Score (NEWS) (HR, 1.277; 95% CI, 1.010-1.615; p=0.041) were significant predictors of mortality. Conclusion: The SF ratio on admission and the SF ratio at exacerbation were strong predictors of the occurrence of ARDS, and the SF ratio at exacerbation and NEWS held a significant effect on mortality.

• Korean Journal of Radiology
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• 제24권5호
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• pp.434-443
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• 2023

Objective: To investigate the association between pelvic bone computed tomography (CT)-derived body composition and patient outcomes in older adult patients who underwent surgery for proximal femur fractures. Materials and Methods: We retrospectively identified consecutive patients aged ≥ 65 years who underwent pelvic bone CT and subsequent surgery for proximal femur fractures between July 2018 and September 2021. Eight CT metrics were calculated from the cross-sectional area and attenuation of the subcutaneous fat and muscle, including the thigh subcutaneous fat (TSF) index, TSF attenuation, thigh muscle (TM) index, TM attenuation, gluteus maximus (GM) index, GM attenuation, gluteus medius and minimus (Gmm) index, and Gmm attenuation. The patients were dichotomized using the median value of each metric. Multivariable Cox regression and logistic regression models were used to determine the association between CT metrics with overall survival (OS) and postsurgical intensive care unit (ICU) admission, respectively. Results: A total of 372 patients (median age, 80.5 years; interquartile range, 76.0-85.0 years; 285 females) were included. TSF attenuation above the median (adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.41-4.05), GM index below the median (adjusted HR, 2.63; 95% CI, 1.33-5.26), and Gmm index below the median (adjusted HR, 2.33; 95% CI, 1.12-4.55) were independently associated with shorter OS. TSF index (adjusted odds ratio [OR], 6.67; 95% CI, 3.13-14.29), GM index (adjusted OR, 3.45; 95% CI, 1.49-7.69), GM attenuation (adjusted OR, 2.33; 95% CI, 1.02-5.56), Gmm index (adjusted OR, 2.70; 95% CI, 1.22-5.88), and Gmm attenuation (adjusted OR, 2.22; 95% CI, 1.01-5.00) below the median were independently associated with ICU admission. Conclusion: In older adult patients who underwent surgery for proximal femur fracture, low muscle indices of the GM and gluteus medius/minimus obtained from their cross-sectional areas on preoperative pelvic bone CT were significant prognostic markers for predicting high mortality and postsurgical ICU admission.

• Journal of Korean Academy of Nursing
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• 제17권2호
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• pp.122-136
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• 1987

A group of studies revealed that family members of the seriously ill patient had some needs during the period of patient's hospitalization. Needs of the seriously-ill patient family could be classified into three aspect, i. e. needs on the prognosis of patient, needs on the well-being of family members themselves and needs on hospital environment. Several instrument were developed to measure the needs of the seriously ill patient, but their content tended to overemphasize the aspect of the prognosis of patient. The purpose of this study was to develop a new instrument to measure the needs in the aspect of the seriously ill patient's family themselves in details to increase the cummulative Percentage of the scale. Subjects were 134 family members of the seriously-ill patients, who were bung cared in ICU of seven university hospitals and data were collected from march 16, 1987 to April 11, 1987. The instrument used in this study was made by the author on the basis of results of literature review. Content valitity of the instrument was tested by a professor majoring in nursing and reliability by calculation of Cronbach's α with data of the respondents. Data was analyzed as follows, using SAS, computer system. Factor structures of the seriously ill patients' family needs were elicited by factor analysis. The programme was the Principal Component Factor Analysis Method of factoring employing Varimax Orthogonal Rotation. The influences of the demographic variables on the degree of the seriously-ill patients' family need were analyzed by t-test and P-test. Results were as follows. 1. Needs of the seriously-ill patients' family elicited and their cummulative percentage were: Needs to be supported emotionally, 29.2% Needs to be informed on facilities available, 9.6% Needs to be informed on the patient's prognosis, 7.7%. Needs to be supported spiritually, 5.1%. Needs to be informed on hospital environment, 4.2%. Needs to be helped to spare time, 3.9%. Needs to be informed on their role, 3.5%. Needs to be present near patient, 3.3%. 2. Educational background was found to influence on some factors. College-graduate group had higher Bevel of needs to be . informed on facilities available to be informed on the patient's prognosis, needs to be supported spiritually, needs to be helped to spare time, needs to be informed on their role than high school graduate group. 3. Among the parents, sons and daughters and the relative groups, the parents of the seriously ill patient had highest level of needs to be present near patient. Suggestions for further studies were as follows. 1. As the instruments used in the previous studies had high cummulative percentages in the aspect of the prognosis of patient and that in this study in the aspect of the prognosis of patient and that in this study in the aspect of the seriously ill patient's family themselves, development of a new instrument which combined the items of both of them is needed. 2. A study to clarify the influence of type and number of admission on need to be supported emotionally is needed.

• Journal of Korean Academy of Nursing
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• 제11권1호
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• pp.65-87
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• 1981

The study is aimed at exploring concept held by clinical nurses of nursing. The data were collected from 225 nurses conviniently selected from the population of nurses working in Kang Won province. Findings include. 1) Nurse's Qualification. The respondents view that specialized knowledge is more important qualification of the nurse. Than warm personality. Specifically, 92.9% of the respondents indicated specialized knowledge as the most important qualification while only 43.1％ indicated warm personality. 2) On Nursing Profession. The respondents view that nursing profession as health service oriented rather than independent profession specifically. This suggests that nursing profession is not consistentic present health care delivery system nor support nurses working independently. 3) On Clients of Nursing Care The respondents include patients, family and the community residents in the category of nursing care. Specifically, 92.0％ of the respondents view that patient is the client, while only 67.1％ of nursing student and 74.7％ of herself. This indicates the lack of the nurse's recognition toward their clients. 4) On the Priority of Nursing care. Most of the respondents view the clients physical psychological respects as important component of nursing care but not the spiritual ones. Specially, 96.0% of the respondents indicated the physical respects, 93% psychological ones, while 64.1% indicated the spiritual ones. This means the lack of comprehensive conception on nursing aimension. 5) On Nursing Care. 91.6% of the respondents indicated that nursing care is the activity decreasing pain or helping to recover illness, while only 66.2% indicated earring out the physicians medical orders. 6) On Purpose of Nursing Care. 89.8% of the respondents indicated preventing illness and than 76.6% of them decreasing 1;ai of clients. On the other hand, maintaining health has the lowest selection at the degree of 13.8%. This means the lack of nurses' recognition for maintaining health as the most important point. 7) On Knowledge Needed in Nursing Care. Most of the respondents view that the knowledge faced with the spot of nursing care is needed. Specially, 81.3% of the respondents indicated simple curing method and 75.1%, 73.3%, 71.6% each indicated child nursing, maternal nursing and controlling for the communicable disease. On the other hand, knowledge w hick has been neglected in the specialized courses of nursing education, that is, thinking line among com-w unity members, overcoming style against between stress and personal relation in each home, and administration, management have a low selection at the depree of 48.9%,41.875 and 41.3%. 8) On Nursing Idea. The highest degree of selection is that they know themselves rightly, (The mean score measuring distribution was 4.205/5) In the lowest degree,3.016/5 is that devotion is the essential element of nursing, 2.860/5 the religious problems that human beings can not settle, such as a fatal ones, 2,810/5 the nursing profession is worth trying in one's life. This means that the peculiarly essential ideas on the professional sense of value. 9) On Nursing Services. The mean score measuring distribution for the nursing services showed that the inserting of machine air way is 2.132/5, the technique and knowledge for surviving heart-lung resuscitating is 2.892/s, and the preventing air pollution 3.021/5. Specially, 41.1% of the respondents indicated the lack of the replied ratio. 10) On Nurses' Qualifications. The respondents were selected five items as the most important qualifications. Specially, 17.4% of the respondents indicated specialized knowledge, 15.3% the nurses' health, 10.6％ satisfaction for nursing profession, 9.8% the experience need, 9.2% comprehension and cooperation, while warm personality as nursing qualifications have a tendency of being lighted. 11) On the Priority of Nursing Care The respondents were selected three items as the most important component. Most of the respondents view the client's physical, spiritual: economic points as important components of nursing care. They showed each 36.8%, 27.6%, 13.8% while educational ones showed 1.8%. 12) On Purpose of Nursing Care. The respondents were selected four items as the most important purpose. Specially,29.3% of the respondents indicated curing illness for clients, 21.3% preventing illness for client 17.4% decreasing pain, 15.3% surviving. 13) On the Analysis of Important Nursing Care Ranging from 5 point to 25 point, the nurses' qualification are concentrated at the degree of 95.1%. Ranging from 3 point to 25, the priorities of nursing care are concentrated at the degree of 96.4%. Ranging from 4 point to 16, the purpose of nursing care is concentrated at the degree of 84.0%. 14) The Analysis, of General Characteristics and Facts of Nursing Concept. The correlation between the educational high level and nursing care showed significance. (P < 0.0262). The correction between the educational low level and purpose of nursing care showed significance. (P < 0.002) The correlation between nurses' working yeras and the degree of importance for the purpose of nursing care showed significance (P < 0.0155) Specially, the most affirmative answers were showed from two years to four ones. 15) On Nunes' qualification and its Degree of Importance The correlation between nurses' qualification and its degree of importance showed significance. (r = 0.2172, p< 0.001) 0.005) B. General characteristics of the subjects The mean age of the subject was 39 ; with 38.6% with in the age range of 20-29 ; 52.6% were male; 57.9％ were Schizophrenia; 35.1% were graduated from high school or high school dropouts; 56.l％ were not have any religion; 52.6% were unmarried； 47.4% were first admission; 91.2% were involuntary admission patients. C. Measurement of anxiety variables. 1. Measurement tools of affective anxiety in this study demonstrated high reliability (.854). 2. Measurement tools of somatic anxiety in this study demonstrated high reliability (.920). D. Relationship between the anxiety variables and the general characteristics. 1. Relationship between affective anxiety and general characteristics. 1) The level of female patients were higher than that of the male patient (t = 5.41, p < 0.05). 2) Frequencies of admission were related to affective anxiety, so in the first admission the anxiety level was the highest. (F = 5.50, p < 0.005). 2, Relationship between somatic anxiety and general characteristics. 1) The age range of 30-39 was found to have the highest level of the somatic anxiety. (F = 3.95, p < 0.005). 2) Frequencies of admission were related to the somatic anxiety, so .in first admission the anxiety level was the highest. (F = 9.12, p ＜ 0.005) 0. Analysis of significant anxiety symptoms for nursing intervention. 1. Seven items such as dizziness, mental integration, sweating, restlessness, anxiousness, urinary frequency and insomnia, init. accounted for 96％ of the variation within the first 24 hours after admission. 2. Seven items such as fear, paresthesias, restlessness, sweating insomnia, init., tremors and body aches and pains accounted for 84% of the variation on the 10th day after admission.

• Journal of Korean Academy of Nursing Administration
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• 제6권1호
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• pp.123-134
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• 2000

This study intended to analyze the effectiveness to obtain by developing the critical pathway presented as the method to improve the quality-betterment and cost effectiveness the through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. This study was designed to develop and effect the critical pathway for hysterectomy patients in the way to be possible the intergrated in patient management. It was adopted the process of seven phase to develop a critical pathway. To analyze the application effect of the developed critical pathway, this author offered health care service applying the critical pathway to the hysterectomy patient from July. 20 to Oct. 19. 1999. The study method had been done by investigating the experimental group and control group through the questionnaire on 40 patients who had been inpatient hysterectomy. Dependent variables were measured by modified from satisfaction, and cost and length of hospital stay. The data anlyzed by frequency, x2-test, t-test. The results of this study was as follows; 1. It was decided that the vertical line of the critical pathway was made up of eight items such as monitoring/assessment, treatment, activity, medication, consult. Lab test, diet, patient teaching and horizontal line was 7days from admission to discharge. 2. After the verifying the validity of the expert group about the critical pathway, the horizontal line was amended from hospitalization to five postoperative days and taking their consensus, some contents of the horizontal line was amended and deleted. 3. There was no significant differences in the experimental group and control group in the satisfaction, and significant differences in the cost, the length of hospital stay.

• The Journal of Korean Medicine
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• 제39권3호
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• pp.89-100
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• 2018

Objectives: Korean Standard Classification of Functioning, Disability and Health (KCF), a useful tool for a comprehensive consideration of the health-related overall implications, might be also promising way to validate the effectiveness of Korean medicine. This study reports the change of pre- and post-hospitalization using the KCF in a patient with spinal cord infarction who underwent rehabilitation plus Korean medicine treatment. This study aims to apply the KCF to this case, evaluate its applicability, and review its expected benefits and obstacles in the clinical practice of Korean medicine. Methods: The changes in the overall health status of the patient were assessed by the KCF as well as the chief complaints, diagnosis, neurological deficits, and activities of daily living (ADL), impairment scale etc. before and after admission to a Korean medicine hospital were investigated. Results: Most of the chief complaints of the patient were improved enough to perform her daily routine activities independently. These improvements were reflected in the neurological function and ADL scores, but could not change the diagnosis according to the Korean Standard Classification of Diseases nor the impairment scale. The KCF, on the other hand, was able to grasp the changes of the patient in various aspects in terms of body function, body structure, activity and participation, and environmental factors. Conclusions: Through this case, we found the applicability of the KCF in clinical practice of Korean medicine and the possibility that the KCF can be a promising tool to show the effectiveness and benefits of Korean medicine.