• The Korean Nurse
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• v.29 no.3
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• pp.25-35
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• 1990

It is a fact that there are recent increasing trends or incidence of the colorectal carcinoma among other colorectal diseases. In such trend, the early detection remain to be most important by the air contrast barium enema and total colonofiberscopy. There are several ways to prepare the colon for barium enema and colonofiberscopy which include several agents. The mechanical cleansing have been used most frequently since Brown's method was adapted to be most perfect for colon deansing. The ideal laxatives and enema solutions were limited to adequate dose, it's effectiveness, patient's diet and bowel habit, minimal side effect, low cost and simple to perform. In order to compare the effectiveness of various cleansing solutions, six experimental methods were formed as shown; 1. normal saline enema, 2. castor oil with normal saline enema, 3. castor oil with soap suds enema, 4. magnesium citrate with normal saline, 5. magnesium citrate with soap suds enema and 6. ingestion of Golyetly solution. The authors have compared and determined the degree of cleanness by an experienced endoscopist. The total number of patients was 247, age distribution was $43{\pm}15$ years old, and sex distribution was 133 males and 114 females. The grade I and II represented no difficulties at performing the colonofiberscopy, but grade ill and N had some difficulties, even unable to perform the colonofiberscopy. The effectiveness the cleansing agents, represented with grade I and II was 95.9% (47/49) in method 6, 93.2%(54/58) in method 2, 83.3%(30/33) in method 3, 70.0%(28/10) in method 5, 66.7%(16/24) in method i, and 45.7%(18/40) in method 4. Method 2 and 6 were the most effective in normal bowel habit patients. In constipated patients, method 6 was the most effective and all method except method 11 were effective in diarrhea patients. The degrees of less mucosal irritation by various bowel cleansing method were in the order of method 6(100%), 1(100%), 5(74%), 2(69%). In subjective symptoms and cleansing groups, abdominal distension, pain, nausea and vomiting were complained, and that's subject symptoms were in the order of method 3(88.9%), 6 (79.6%), 1(75%), 5(72.5%), 2(72.4%), 4(67.5%). In conclusion, we believe that the Golytely of the mechanical cleansing solution for colonofiberscopy was the most effective, but others depended on the patient's condition und bowel habit.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.2
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• pp.185-191
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• 2013

Case of ischemic colitis after enema for bowel cleansing have been rarely reported, but there has been no case report of a patient on modiefied fasting therapy. A 26-year old male patient with obesity admitted Korean medical hospital of Kyung Hee university for losing weight. He is on a special diet called modiefied fasting therapy, only took the fermented herbal drink. At 2nd day, he received an enema for bowel cleansing. A few hours after enema, he had a bloody diarrhea with lower abdominal pain. His colonoscopic and histologic findings presented ischemic colitis. He was advised to fast for two days and couldn't complete his diet program. We suggest 4 possible reasons : Increased intraluminal pressure by enema, vascular spasm caused by room-temperature glycerin solution colder than intraluminal temperature, predisposition to bleeding disturbances by taking selective serotonin reuptake inhibitor(SSRI) for depression history and mucosal injury by osmotic effect of glycerin solution itself. For reducing the risk of bowel cleansing, glycerin enema should be carefully prescribed and practiced concerning the condition of each patient.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.3
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• pp.532-543
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• 1999

This study was conducted to provide the basic data necessary for the improvement of the teaching method for basic nursing practice as well as the effectiveness of the practice by examining the students' competency in cleansing enema after doing the self study instead of the traditional education. To examine the competency in cleansing enema after the self study, this study is an one group pretest-posttest design that subjects did the enema practice through the self study. The subjects were 89 sophomore students at Y University. College of Nursing. In basic nursing lab practice class, cleansing enema self study module was given to the students which was developed by the researcher based on the literature review and asked them to finish doing the pre study and checking the self study evaluation criteria after reading the goal, learning activities and theoretical guideline. After watching the video tape, students practiced the process in the module by themselves. For the competency in cleansing enema. repeated autonomous practices were done during the open lab other than the regular class. Whenever the practice was done, the frequency and time were measure and documented. When the student felt confident through repeated practices, the competency was evaluated by the researcher and two assistants based on the evaluation criteria. And the process was repeated till the student could perform all the items on evaluation criteria completely. The data were collected for 42 days from Oct. 15 to Nov. 26 in 1996. Collected data were analyzed by frequency, percentage, Pearson correlation coefficient and variance analysis. The results are summarized as follows : 1. 43.2% of the students were favorable to nursing and 63.6% like lecture, but 71.6% like practice. So they were more interested in practice than in lecture. 2. 62.3% of the students scored high in written test, 97.8% scored high in practice. So the practice score was better. 3. The frequency of repeated practice to pass the test ranged from 1 to 4 and the average is 2.2. 4. The average time needed in preparation and the performance was nearly the same regardless of the frequency. It took 5 to 38 minutes for those who passed the test after practicing once and the average was 16 minutes. 5 to 60 minutes were taken for those who practiced twice to pass the test and the average was 21 minutes. Those who passed the test after three practices needed 8 to 30 minutes and the average was 15 minutes, which was similar to the time that the students who passed the test for the first trial. Only one student passed the test after 4 practices and it took 10 minutes. 5. 64% of the students agreed that the context and the content of the module were appropriate for the self study and 68.2% were satisfied. And 71.9% said that the module helped them to practice the enema self study 6. Though only 42% of the students were satisfied with the video. 50.6% said that it was helpful for the self study. 7. 52.3% of the students were satisfied with the self study method, and 86.6% obtained self-confidence when performing the enema. 8. The lower the student's practice score was, the more practices were needed for them to pass the test(r=-.213, P<.05). As a result, for performing the enema practice competently, two or more practice opportunities were needed to be given. And it is possible to obtain the less complex nursing skills through the self study, when enough learning resources and assistance such as learning guidance or video tapes are provided. Based on this study. I want to suggest that. 1. There must be college policy that can support the new method instead of the traditional learning method for the students to attain the proficiency in basic nursing skills. 2. The assistant materials should be developed as soon as possible to promote the self study of basic nursing skills.

• Journal of Korean Medicine for Obesity Research
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• v.5 no.1
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• pp.31-45
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• 2005

Background and Objectives : Constipation is a common digestive disorder and enema is one of the external intervention for constipation. Coffee enema was originated by Dr. Gerson for the purpose of colon cleansing and detoxification. However there has been no study about the effect of coffee enema on constipation. Therefore, this study was planned to evaluate the effect of coffee enema on constipation in the terms of constipation degree and satisfaction questionnaire. Methods : 42 patients were treated of the coffee enema 2 times a week. The constipation score(Constipation Assessment Scale) and frequency of defecation were checked 3 times (before treatment, 1 week and 1 month later). The satisfaction score was also checked 1 week and 1 month later. The interval differences of constipation score between pre- and post-treatment according to body mass index were also analyzed. Results and Conclusions : The constipation scores, frequency of defecation scores checked 1 week and 1 month later were significantly(p<0.01) improved as compared with those before the treatment. The satisfaction scores were close to 'moderately satisfied' 1 week and 1 month later. The scores of 6 parameters in constipation assessment scale, frequency of defecation scores and satisfaction scores were maintained until 1 month later. There was no significant difference in the change of constipation scores between normal BMI and overweight group. 4.2% of the patients reported adverse effects, which were nausea, abdominal distension each.

• Korean Journal of Radiology
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• v.21 no.4
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• pp.422-430
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• 2020

The Korean Society of Urogenital Radiology (KSUR) aimed to present a consensus statement for patient preparation, standard technique, and pain management in relation to transrectal ultrasound-guided prostate biopsy (TRUS-Bx) to reduce the variability in TRUS-Bx methodologies and suggest a nationwide guideline. The KSUR guideline development subcommittee constructed questionnaires assessing prebiopsy anticoagulation, the cleansing enema, antimicrobial prophylaxis, local anesthesia methods such as periprostatic neurovascular bundle block (PNB) or intrarectal lidocaine gel application (IRLA), opioid usage, and the number of biopsy cores and length and diameter of the biopsy needle. The survey was conducted using an Internet-based platform, and responses were solicited from the 90 members registered on the KSUR mailing list as of 2018. A comprehensive search of relevant literature from Medline database was conducted. The strength of each recommendation was graded on the basis of the level of evidence. Among the 90 registered members, 29 doctors (32.2%) responded to this online survey. Most KSUR members stopped anticoagulants (100%) and antiplatelets (76%) one week before the procedure. All respondents performed a cleansing enema before TRUS-Bx. Approximately 86% of respondents administered prophylactic antibiotics before TRUS-Bx. The most frequently used antibiotics were third-generation cephalosporins. PNB was the most widely used pain control method, followed by a combination of PNB plus IRLA. Opioids were rarely used (6.8%), and they were used only as an adjunctive pain management approach during TRUS-Bx. The KSUR members mainly chose the 12-core biopsy method (89.7%) and 18G 16-mm or 22-mm (96.5%) needles. The KSUR recommends the 12-core biopsy scheme with PNB with or without IRLA as the standard protocol for TRUS-Bx. Anticoagulants and antiplatelet agents should be discontinued at least 5 days prior to the procedure, and antibiotic prophylaxis is highly recommended to prevent infectious complications. Glycerin cleansing enemas and administration of opioid analogues before the procedure could be helpful in some situations. The choice of biopsy needle is dependent on the practitioners' situation and preferences.

• Korean Journal of Adult Nursing
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• v.19 no.2
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• pp.237-247
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• 2007

Purpose: This study was a randomized single-blind trial of whole versus split-dose PEG solutions for colonoscopy preparation to compare the patient compliance, quality of bowel cleansing, and endoscopist's satisfaction. Methods: The participants were recruited from outpatients who planned to receive colonoscopy of C hospital in Busan. Sixty participants were randomly assigned to receive either a spit-dose group(n=30) consuming $2{\ell}$ of PEG solution twice, or a whole-dose group(n=30), consuming $4{\ell}$ of PEG solution once. These participants completed the questionnaire to assess their compliance before colonoscopy. The quality of bowel cleansing was assessed using the Ottawa Scale with the endoscopist who was blinded to the type of preparation, and their satisfaction by using VAS. Results: The participants who did not completely consume $4{\ell}$ of PEG solution were less in split-dose than in whole-dose group (0% vs 13.3%). The split-dose group complained less about abdominal pain(t=2.644, p=0.009) and abdominal bloating(t=2.802, p=0.013) with a statistical significance. For the quality of bowel preparation, there were no significant differences in the bowel cleansing scores and the endoscopist's satisfaction between two groups. Conclusion: Colonic preparation with split-dose of PEG solution could be a more useful method for better patient compliance, with no significant impact on bowel cleansing quality.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.2
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• pp.1264-1272
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• 2015

This study was performed to compare the perceived importance and performance frequency of the core nursing skills between general and special department. Subjects were 182 nurses who work on the hospital. Data was collected using items made by Korean accreditation board of nursing education and analyzed by frequency, mean and t-test. There were differences of importance and frequencies about nursing core skill between general and special wards. Core nursing skills of general wards were higher importance on intradermal injection(p=.011), transfusion(p=.028), simple catheterization(p=.047), cleansing enema(p=<.001), preoperative and postoperative care(p=.035), management administration(p=.027) and oxygenation with cannular(p=.002) than special wards. Actual performance frequency core nursing skills of general wards were higher similar on transfusion(p=.002), intermittent tube feeding(p=.032), simple catheterization(p=<.001), cleansing enema(p=<.001), preoperative care(p=.001), postoperative care(p=<.001), management administration(p=.001), protection equipment for quarantine room and waste disposal(p=.021), oxygenation with cannular(p=<.001) than special wards. It is needed to develop efficient and sequential program to learning the nursing core skills for nursing students.