• Title/Summary/Keyword: Care phase

Search Result 352, Processing Time 0.029 seconds

A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness (만성질환자 배우자의 돌봄 경험에 대한 이론 구축)

  • Choi, Kyung-Sook;Eun, Young
    • Journal of Korean Academy of Nursing
    • /
    • v.30 no.1
    • /
    • pp.122-136
    • /
    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

  • PDF

Sepsis induces variation of intestinal barrier function in different phase through nuclear factor kappa B signaling

  • Cao, Ying-Ya;Wang, Zhong-Han;Xu, Qian-Cheng;Chen, Qun;Wang, Zhen;Lu, Wei-Hua
    • The Korean Journal of Physiology and Pharmacology
    • /
    • v.25 no.4
    • /
    • pp.375-383
    • /
    • 2021
  • The intestinal barrier function disrupted in sepsis, while little is known about the variation in different phases of sepsis. In this study, mouse models of sepsis were established by caecal ligation and puncture (CLP). The H&E staining of sections and serum diamine oxidase concentration were evaluated at different timepoint after CLP. TUNEL assay and EdU staining were performed to evaluate the apoptosis and proliferation of intestinal epithelium. Relative protein expression was assessed by Western blotting and serum concentrations of pro-inflammatory cytokines was measured by ELISA. The disruption of intestinal barrier worsened in the first 24 h after the onset of sepsis and gradually recovered over the next 24 h. The percentage of apoptotic cell increased in the first 24 h and dropped at 48 h, accompanied with the proliferative rate of intestinal epithelium inhibited in the first 6 h and regained in the later period. Furthermore, the activity of nuclear factor kappa B (NF-κB) presented similar trend with the intestinal barrier function, shared positive correction with apoptosis of intestinal epithelium. These findings reveal the conversion process of intestinal barrier function in sepsis and this process is closely correlated with the activity of NF-κB signaling.

A Qualitative Study for Foreign Workers Exposed hazard Chemical Materials in Korean Industry (유해화학물질 취급 외국인 근로자의 적응과정)

  • Kim, Hyun Li;Kim, Jeong Hee;Song, Yeon Ee;Yi, Ggodme;Jung, Hye Sun;Hyun, Hye JIn;Kim, Hee Girl
    • Korean Journal of Occupational Health Nursing
    • /
    • v.15 no.2
    • /
    • pp.94-103
    • /
    • 2006
  • Purpose: This study was to understand foreign workers' experiences exposed hazard chemical materials in korean industry. Method: The research subjects were 92 foreign workers worked in seoul, namyangju, ansan, suwon, pocheon, incheon, jincheon, and daejeon. It was that grounded theory method as qualitative approach was applied with in-depth interview, recording and dictation, and collected data was analysed line-by-line by research teams. The analysis process of in depth interview data was three phase. Results: The first phase was that find out meaningful data and confronted data for meaningful data was 53 meaningful items. The second phase was coding process of meaningful data, total coding items were 9, difficulty of new environment, existence of health hazard factors originated in work, performance of basic health management, management of hazard materials in work-site, self care of hazard materials in work-site, discrimination of disaster-compensation originated in work, perception of work stress, motivation of leaving position, satisfaction for present life. The third phase was 5 adaptation process, copying phase for new environment, management phase for health hazard factors, health change phase, life change phase, illegal stay phase. Conclusion: In summary, as a results it was concluded that foreign workers was experienced new environment and then has various problems in working site. But these evidences were not different from korean workers basically, undoubtedly reality of a korean small and medium enterprise. And foreign workers with long time stay have had many health problems probably, but they have want to long stay and so reach an unexpected result, illegal long stay. Therefore, we should make efforts for adequate foreign workers' health management at work-site and overall life in governmental and industrial nursing level.

  • PDF

Development of the Critical Pathway for Cesarean Section Patient (제왕절개술 환자를 위한 Critical Pathway 개발)

  • Chung Kyung-Hee;Jang Keum-Seung
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.4 no.1
    • /
    • pp.66-80
    • /
    • 1998
  • With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.

  • PDF

Review of Clinical Cancer Research Methodology of Botanical Agents (한약 및 천연물의 항암 임상연구 방법론에 대한 고찰)

  • Oh, Hye Kyung;Lee, Jee Young;Ryu, Han Sung;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
    • /
    • v.20 no.1
    • /
    • pp.11-21
    • /
    • 2015
  • Objectives : The cancer incidence and cancer burden is increasing. In addition, the use of botanical agents in cancer care is increasing. This article aims to review a research strategy for botanical agents. Methods : The clinical studies of anticancer botanical agents and the papers about clinical research methodology of botanical agents were reviewed. Results : In phase I study, safety confirmation, optimal dose determination and drug interaction study are important. Most botanical agents have low toxicity and some have non-monotone dose response. Therefore, dose-response curve must be evaluated separately from the dose-toxicity curve to determine optimal dose. Although anticancer botanical agents can't shrink tumor size rapidly, they do extend survival. So, in phase II study, response should be evaluated by the survival. Conclusions : Clinical research of botanical agents in cancer is different from traditional methods and strategies. Considering the characteristics of botanical agents and experimental mechanism is necessary in conducting botanical based clinical trials.

Concept Development of Resilience - Focusing on Cancer Patients - (극복력(resilience) 개념 개발 - 암 환자를 중심으로 -)

  • Hong, Sung-Kyung
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.15 no.1
    • /
    • pp.109-119
    • /
    • 2009
  • Purpose: This study was done to develop the concept of resilience focusing on cancer patients in Korea. Methods: This study was done in three phases sugggested in the Hybrid Model; theoretical phase, fieldwork phase, and analytical phase. Eight cancer patients participated in the fieldwork phase. Results: The antecedent of the concept of resilience was the crisis or adversity that threatens life or changes the quality of life. The attributes of resilience were psychosocial, relational, situational confrontation and faith (philosophical) characteristics. 1) Psychosocial : self worth, self efficacy, self-confidence, independence, optimistic & positive mind, strong will, and responsibility, 2) Relational : relation-oriented, intimacy, and social interests, 3) Situational confrontation : appraisal of stress situation, problem-oriented coping, and ability to applicate a new situation, 4) Faith (philosophical) : the belief that self-knowledge is valuable, finding positive meanings, religious belief, a belief that lives are worthwhile and meaningful, and a balanced perspective of one's life. The consequences of resilience were acceptance of adversity, getting through one's dread and apprehensions, and gratitude & sharing life. The contributing factor of resilience is positive family support. Conclusion: The concept of resilience is necessary in order to manage cancer patients for promoting quality of life so that its application may have a positive impact on the patients care.

Experiences of Treatment-Related Side Effects and Supportive Care with Korean Medicine in Women with Breast Cancer - A Focus Group Study (유방암 환자의 항암 치료 부작용 및 한의학적 보완치료 경험에 관한 포커스 그룹 연구)

  • Han, Sola;Jang, Bo-Hyoung;Hwang, Deok-Sang;Suh, Hae Sun
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.30 no.1
    • /
    • pp.85-94
    • /
    • 2017
  • Objectives: To explore experiences of treatment-related side effects and supportive care among Korean breast cancer survivors (BCS). Methods: Focus group interview was conducted with six Korean women with breast cancer. Participants were recruited through snow-balling. Interview was audio-recorded and transcribed verbatim. NVivo-11 was used to code the data into themes. Results: Two major themes were identified: (1) experiences of Western medicine, including treatment, side effects, needs and costs; (2) experiences of supportive care with Korean medicine, including the same as above. All participants experienced Western medicine in treatment phase and reported impairment of physical, emotional, and social functioning during and after Western medicine treatment. Only three participants used Korean medicine after treatments end. The negative responses from Western medicine doctors were the most important factor keeping participants from accessing Korean medicine when treatment-related side effects occurred. For this reason, some participants used Korean medicine without disclosure. Participants usually acquired information about Korean medicine from online community or other BCS, which was another important factor because it raised concerns about side effects and credibility of Korean medicine. High cost was also reported as barrier in using Korean medicine. During the cancer treatment, participants tended to endure their treatment-related side effects. Conclusions: Korean BCS may be at high risk of physical or emotional distress during treatment period. Findings suggest that there is a high need for supportive care to relieve treatment-related side effects and improve patients' quality-of-life. Furthermore, developing a systematic guidance or credible information sources should be warranted to help patients find the best supportive care options including Korean medicine.

Analysis of Imidazoline Type Cationic Surfactants (Imidazoline계 양이온 계면활성제 분석)

  • Bak, Hong-Soon;Choi, Kyu-Yeol;Lee, Jae-Duk;Kim, Yeo-Kyung;Ahn, Ho-Jeong
    • Applied Chemistry for Engineering
    • /
    • v.9 no.3
    • /
    • pp.404-406
    • /
    • 1998
  • Analysis for the imidazoline type cationic surfactants was performed by the gas chromatography(GC) and high performance liquid chromatography(HPLC). The composition of the alkyl chain distribution was investigated by GC after base/Acid hydrolysis of the imidazoline ring. The distribution of total alkyl chain was separated clearly by a Bondclone C18/NOVA-Pak C18 HPLC column using 50% acetonitrile in methanol containing 0.1M sodium perchlorate as a mobile phase. Alkyl chain distribution and average molecular weight of imidazoline type cationic surfactants were obtained based on these analytical methods. The agreement of results from GC and HPLC was good. The detection limit of imidazoline by HPLC method was 10ng without pretreatment.

  • PDF

Effects of Rooming-in on Continuation of Breastfeeding and Maternal Identity (모자동실과 모자별실에 따른 모유수유 실천 및 모성정체감 비교 연구)

  • Shin, Gye-Young;Kim, Oh-Jin;Park, Ju-Hyueon;Lee, Jueng-Rim
    • Women's Health Nursing
    • /
    • v.8 no.3
    • /
    • pp.402-411
    • /
    • 2002
  • Purpose: The objective of this study was to identify the effectiveness of continued breast feeding and maternal identity between rooming-in and not rooming-in groups of mothers in post partum care. Method: The subjects were selected by convenient sampling, with 95 women in childbirth completing a questionnaire. The data were collected on the 2nd day after delivery by questionnaire, and after the 4th and 8th weeks by telephone interview. Measures used in this study included general characteristics, breast feeding related characteristics, and the maternal identity scale revised by Koh(1996). The data were analyzed with the SPSS program, and the Chi-test and t-test were used to identify the effect on breast feeding and maternal identity. Results: Continued breast feeding up to 4 weeks after deliverly was not statistically significant between rooming-in and not rooming-in group, but beyond 8 weeks of deliverly, it was significantly different in rooming-in group(p<.01). Maternal identity was significantly higher in rooming-in group than in not rooming-in group(<.01). Conclusion: Mothers preferred rooming-in system because it helped breast feeding and baby care. Rooming-in system provides self confidence in taking care of baby, knowledge about breast feeding and stimulates early phase lactation. We recommend rooming-in system in hospitals to promote breast feeding and maternal identity. Nurses are encouraged to discuss prenatal breast feeding before delivery and rooming-in care should be planned individually for continuation of breast feeding and formation of maternal identity.

  • PDF

Utility of Serum Procalcitonin for Diagnosis of Sepsis and Evaluation of Severity (혈청 프로칼시토닌(serum procalcitonin) 측정을 통한 패혈증 진단 및 중등도 평가의 유용성)

  • Park, Tae-Jin;Lim, Chae-Man;Koh, Youn-Suck;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
    • /
    • v.70 no.1
    • /
    • pp.51-57
    • /
    • 2011
  • Background: Early recognition and treatment of sepsis would improve patients' outcome. But it is difficult to distinguish between sepsis and non-infectious conditions in the acute phase of clinical deterioration. We studied serum level of procalcitonin (PCT) as a method to diagnose and to evaluate sepsis. Methods: Between 1 March 2009 and 30 September 2009, 178 patients had their serum PCT tested during their clinical deterioration in the medical intensive care unit. These laboratories were evaluated, on a retrospective basis. We classified their clinical status as non-infection, local infection, sepsis, severe sepsis, and septic shock. Then, we compared their clinical status with level of PCT. Results: The number of clinical status is as follows: 18 non-infection, 33 local infection, 39 sepsis, 26 severe sepsis, and 62 septic shock patients. PCT level of non-septic group (non-infection and local infection) and septic group (sepsis, severe sepsis, septic shock) was $0.36{\pm}0.57$ ng/mL and $18.09{\pm}36.53$ ng/mL (p<0.001), respectively. Area under the curve for diagnosis of sepsis using cut-off value of PCT >0.5 ng/mL was 0.841 (p<0.001). Level of PCT as clinical status was statistically different between severe sepsis and septic shock ($^*severe$ sepsis; $4.53{\pm}6.15$ ng/mL, $^*septic$ shock $34.26{\pm}47.10$ ng/mL, $^*p$ <0.001). Conclusion: Level of PCT at clinical deterioration showed diagnostic power for septic condition. The level of PCT was statistically different between severe sepsis and septic shock.