• Title/Summary/Keyword: Clinical adaptation

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Experience of Adaptation to Work In Comprehensive Nursing Service Units of Nurses (간호·간병통합서비스병동 간호사의 업무 적응 경험)

  • Suhyun Park;Seohyun Won;Bosun Kim;Jinhyang Yang;Seonhye Heo
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.3
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    • pp.69-88
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    • 2024
  • Purpose : This study was conducted to examine the Experience of Adaption to Work in Comprehensive Nursing Service Units of Nurses. Methods : Empirical data were collected from 8 nurses through in-depth interviews. Eight participants who had more than 6 months of clinical experience in the general ward and had more than 6 months of work experience in Comprehensive Nursing Service Units were selected as participants. The main question was what does it mean to work in Comprehensive Nursing Service Units? All interviews were recorded and transcribed, and then analyzed using Giorgi's interview. Results: As a result of the analysis, five topics were derived. 'Facing a changed work environment', 'A sense of unexpected heterogeneity in work', 'Evaluation of immediate reality.', 'Finding strategies and promoting balance', 'Growing up as a professional nurse.' Conclusion: Based on these findings, There is a need to build a system that can adapt to work and continue to develop programs for capacity building in Comprehensive Nursing Service Units of Nurses.

Effect of Shift Interval for the Clinical Nurse on the Circadian Rhythm (임상 간호사의 교대근무 기간이 circadian rhythm 변화에 미치는 영향)

  • 황애란;정현숙;임영신;이혜원;김조자
    • Journal of Korean Academy of Nursing
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    • v.21 no.2
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    • pp.129-149
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    • 1991
  • Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entrainment of the pacemaker timing the human circadian sleep - wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. This study was a quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to a weekly shift group and another ten to a biweekly shift group engaged in a semi -continuous shift schedule(sunday off) with a backward direction, that is, morning -evening - night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking tim, sleep - wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep- wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep -wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : λ=0.121, p<0.01, λ=0.112, p<0.01, biweekly shift group : λ=0.116, p<0.01, λ=0.084, p<0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t=-2.28, p<0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=5.79, p<0.01, F=4.56, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05), Physical fatigue, neurosensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=12.65, p<0.01, F=7.77, p<0.01, F=9.68, p<0.01). There was a significant difference between the shift groups and the control group(p<0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmatic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.79, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05) . The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.68, p<0.05, F=5.55, p<0.01), and both showed a significant difference between the shift groups and the control group(p<0.05). Accordingly, this study showed that during night duty, the waking time, sleep- wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the -first day, but the waking time, sleep- wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.

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Association of p53 Expression with Metabolic Features of Stage I Non-Small Cell Lung Cancer

  • Kang, Shin-Myung;Koh, Won-Jung;Suh, Gee-Young;Chung, Man-Pyo;Han, Joung-Ho;Kim, Ho-Joong;Kwon, O-Jung;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.417-424
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    • 2011
  • Background: Recent evidences have revealed metabolic functions of p53 in cancer cells; adaptation or survival to metabolic stress and metabolic shift toward oxidative phosphorylation. However, further studies in clinical setting are needed. We investigated whether p53 protein expression, as a surrogate marker for loss of p53 function, is associated with metabolic features of stage I non-small cell lung cancer (NSCLC), focusing on tumor necrosis and maximal standardized uptake value (SUVmax) on $^{18}F$-fluorodeoxyglucose positron emission tomography. Methods: Clinical information was obtained from retrospective review of medical records. p53 expression was assessed by immunohistochemical staining. Results: p53 protein expression was detected in 112 (46%) of 241 NSCLC cases included in this study. p53 expression was independently associated with the presence of necrosis (odds ratio [OR], 2.316; 95% confidence interval [CI], 1.215~4.416; p=0.011). Non-adenocarcinoma histology (OR, 8.049; 95% CI, 4.072~15.911; p<0.001) and poorly differentiation (OR, 6.474; 95% CI, 2.998~13.979; p<0.001) were also independently associated with the presence of necrosis. However, p53 expression was not a significant factor for SUVmax. Conclusion: p53 protein expression is independently associated with the presence of necrosis, but not SUVmax.

A Comparative Study of Clinical Sffects Following Periodontal Surgery with and without Dressing (치주수술후 치주포대의 사용유무에 따른 임상적 효과에 대한 비교논문)

  • Bae, Sang-Bum;Lim, Sung-Bin;Chung, Chin-Hyung
    • Journal of Periodontal and Implant Science
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    • v.29 no.3
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    • pp.693-703
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    • 1999
  • Since they were introduced by Ward in 1923, periodontal dressing have been routinely used following the periodontal surgery to avoid pain, infection, desensitizing teeth, inhibiting food impaction of the surgical areas, and immobilizing injured areas. Recently, however, the value of periodontal dressings and their effects on periodontal wound healing have been questioned, several authors have been reported that the use of dressing has little influence on healing following periodontal surgical procedures. In addition, there is evidence that when good flap adaptation is achieved, the use of a periodontal dressing does not add to patient comfort nor promote healing. The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of periodontal dressing following periodontal surgery. Twenty-eight patients, 11 male and 17 female. were selected for this study; The age range was 31 to 56, with an average of 40.2years. Patient selection was based on existence of two bilateral sites presenting similar periodontal involvement, as determined by clinical and radiographic assessment, and requiring comparable bilateral surgical procedures. Using a splitmouth dressing. one site received a periodontal dressing while the other site did not. Pain assessment was made according to a horizontal, rating scale(0-10). After at least a two-week period, the second surgical precedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered, and were asked of their preference of either, dressed or undressed. The results were as follows: 1. A similar trend for mean pain and discomfort scores as assessed by patients both dressed and salinetreated procedures was evident during 7-day postsurgical period. 2. Statistical analysis of differences between the dressed side and salinetreated side with respect to pain, discomfort and patient's experiences revealed that both treatment sides behaved similarly at any postoperative day(P>0.05). 3. Considering the patient's preference, on the basis of pain and discomfort experienced, 43% preferred the saline-mouthwash and 32% preferred the dressing, 25% showing no preference for either the dressing or the saline-mouthwash. There is evidence to support the use of a periodontal dressing in retention of an apically positioned flap by preventing coronal displacement, or its use to provide additional support to stabilize a free gingival graft. However, there will always be a use for periodontal dressing although routine use of dressings may decrease because of better surgical techniques and the use of antibacterial mouth rinses.

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Introduction of Questionnaires for Quality of Life of Patients with Malignant Tumors of the Central Nervous System into Neurosurgical Practice in the Republic of Kazakhstan

  • Akshulakov, Serik;Aldiyarova, Nurgul;Ryskeldiyev, Nurzhan;Akhmetzhanova, Zauresh;Gaitova, Kamila;Auezova, Raushan;Doskaliyev, Aidos;Kerimbayev, Talgat
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.873-876
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    • 2016
  • Background: Studies of quality of life (QoL) of oncological patients is carried out using questionnaires approved in many international clinical studies. The European Organization for Research and Treatment of Cancer EORTC QLQ-C30 (Quality of Life Questionnary-Core 30) and its special brain cancer module EORTC QLQ-BN20 are widely used in the world neurooncologic practice. They are available in more than 80 official versions of 30 languages of the world. Previously we used the official versions in Russian, which often causes difficulty in understanding for native Kazakh language speakers, who comprise more than 60% of our respondents. This was the reason for creating a version of Kazakh language. Therefore, in 2014 for the first time the process of adaptation of questionnaires to the Kazakh language was initiated. Materials and Methods: The translation process of questionnaires to Kazakh language was held in accordance with the requirements of the European Organization for Research and Treatment of Cancer EORTC on QoL and consisted of the following stages: preparation - translation - pilot testing - approval. The official permission of authors and "Guideline on translation" was obtained which was developed by the working group of the EORTC on QoL. The pilot testing of EORTC QLQ-C30 and QLQ-BN20 questionnaires was conducted on the basis of the Department of Central Nervous System Pathology of the "National Centre for Neurosurgery" in patients with malignant tumors of the central nervous system. Results: The official versions of the EORTC QLQ-C30 and QLQ-BN20 questionnaires in Kazakh language were introduced and adapted in practical neurosurgical operations in Kazakhstan. Conclusions: The approved versions of the questionnaires in Kazakh language are now available for mainstream use on the official website EORTC.com. The versions of these questionnaires can be used in domestic cohort studies and clinical practice in the Republic of Kazakhstan. The use of these tools for assessing QoL will help professionals in the planning of individual treatment strategies and selection of the necessary therapy.

CLASS II COMPOSITE RESIN RESTORATION USING ORTHODONTIC BANDS (교정용 밴드를 이용한 구치부 2급 와동의 복합레진 수복)

  • Park, Sung-Dong;Park, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.13-17
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    • 2005
  • Children and teenagers have a higher frequency of proximal surface caries in the posterior teeth than adults. For proximal restoration, class II amalgam or stainless steel crown has been widely used in the past, however composite resin restoration is getting ore popular due to it's superior cosmetic appearance. When applying composite resin on proximal area, various types of matrix bands can be utilized according to the operator's reference or skill. Such bands have several clinical effects including suitability for proximal margin, reduction of micro-leakage, moisture-control against saliva and ease finishing and polishing. In this case report, orthodontic bands were utilized instead of matrix bands as a remedy for proximal restorations in both primary and permanent teeth and their clinical advantages are as follows. 1. Orthodontic bands showed superior marginal adaptation compared to conventional matrix bands and moisture-control against saliva was excellent. 2. While applying composite resin, deformation of restoration material was estimated to be insignificant due to he rigidity of the orthodontic bands. 3. Natural tooth contour of the orthodontic bands facilitates to reproduce proximal tooth contour of the restoration. 4. In general, pediatric dentists are accustomed to applying orthodontic bands and this may allow pediatric dentists to make proximal composite restorations more efficiently than other dental specialists.

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Study on Compliance in Sleep Life Log: Observational Cohort Study (수면 라이프로그 순응도에 대한 연구)

  • Su-Min Seo;Young-Hwa Baek;Si-Woo Lee;Hyun-Chul Jang
    • Journal of Society of Preventive Korean Medicine
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    • v.27 no.1
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    • pp.89-98
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    • 2023
  • Objectives : This study collected sleep information by wearable device in the Korean medicine Daejeon citizen cohort (KDCC). It was measured based on the sleep record information measured by wearing a Fitbit, and the possibility of clinical use was examined for compliance with objective sleep collection. Based on compliance, the possibility of clinical use was examined. Methods : After surveying personal information and PSQI(Pittsburgh Sleep Quality Index), sleep information was collected by Fitbit for 14 days. Compliance was measured based on sleep record information by Fitbit. Compliance was analyzed by sex, age, BMI(Body Mass Index), and sleep group(deep/poor). Results : The number of participants was 730, and the compliance was 94.3%, and the compliance group was 675(92.5%). The age of the participants varied from 30 to 60 years old, and the average age was 46±6.7 years. There were 218 males and 512 females. Young people have high compliance. Males are more compliance than females. As the BMI score decreased in the 30s, the compliance was higher. The underweight group in all age groups had 100 compliance. The underweight group was all female. The low compliance groups were that 30 years males (obesity level2), 50 years females (overweight group), and 50 years females (obesity level2). There was no significant difference in compliance between deep sleep group and poor sleep group. In deep sleep group, females showed higher compliance. In poor sleep group, males showed higher compliance. The average duration of Fitbit usage among participants was 20.1 days. The compliant group wore the device for an average of 21.3 days, while the non-compliant group wore it for only 5.2 days. Of the compliant group, 86.9% (73.8% of all participants) continued to wear the Fitbit after the recommended 14-day period, and 50.8% wore it for more than 20 days. Conclusions : This study showed the possibility of adaptation for wearing a Fitbit for collecting objective sleep information. It is judged that the compliance is high because it was worn for more than 13.2 days out of the 14 days required. It is considered meaningful because the compliance was measured based on the sleep information by Fitbit, not the questionnaire. As the data on objective sleep time is collected automatically, we believe that the burden on participants after the study period is not significant for a certain period. Compliance may be even higher for cohorts related to illnesses and with doctor's orders, rather than for the general population.

Nursing research issues and trends : views from Korea (우리나라 간호연구의 현황과 문제)

  • Oh, Kasil;Sin, Hee-Sun;Kim, Hee-Soon
    • The Korean Nurse
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    • v.31 no.3
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    • pp.76-87
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    • 1992
  • The purposes of study was: 1. To identify the direction and scope of research activities in Korean Nursing. 2. To discuss the unique problems present in Korea that warrant nursing research. 3. To delineate the factors that facilitate and/or hinder nursing research in Korea. This study was conducted at six colleges of nursing in Korea. The schools which were selected had doctoral programs at the time, the data were collected in 1990. Four of the schools were located in the metropolitan area of the capital city, Seoul, and two were in two other cities similar in size. The total population of the study was 283 nurses. The instrument for the research was the English version of Research Profile Questionnaire which was translated into Korean by the researchers and was validated in its translation by two professors. A pretest procedure was done before the data collection process. Of the population of 283, 210 subjects received the questionnaire and 150 subjects responded(71.4%). Excluding incomplete questionnaires, 141 questionnaires were utilized for data analysis. Data were analyzed using descriptive statistics. Responses to open-ended questions were content analyzed for themes and categories. Results of the study were as follows : Respondents currently , involved in nursing research numbered 108(76.6%), but 33(23.4%) did not have any research experience. The inexperienced respondenLs tended to be younger than the experienced subjects and most( 60.6%) were employed in hospitals, while 82.4 percent of the experienced nurses were employed in nursing schools. Among the respondents with research experience, 68.5 percent were involved in one to three projects and 31.5 percent were engaged in four or more projects. The experienced nurses indicated that nursing research in Korea is active. On the other hand, the responses of the inexperienced were that nursing research is not active. The most frequently selected research subjects were patients(76.9%, 83 respondents) followed by nurses, healthy persons and nursing students. The relatively high percentage of healthy persons as study subjects, could be explained as a concern of nurses for healthy persons as well as for ill patients. The aforememioned literature review showed a dramatic change in the kinds of study subjects; approximately 33 percent were patients but 25 percent were healthy subjects of various ages. The hospital was the prevailing research setting(67.6%) but at the same time various community settings were used. This is a changing phenomena in nursing research of Korea. Current research designed to build on previous studies amounted to 75 percent; about 39.8 percem were theory and hypothesis generated. Over 65 recommended additional research focusing on hypothesis-testing 0:' theory building. The previously quoted literature review found that only 4.0 percent of the study quescions were developed from a theoretical framework. The most frequently listed current major focus of nursmg research was stress and adaptation. Patients with cancer, pain, social support and care of the elderly were the next most frequently reported. These concerns may reflect problems associated with a technological and industrializing societyl. The most frequently identified problem was lack of clinical research. The need for replication research and research that contributes to the accumulation of nursing knowledge were found to be rare in Korean research. A need for theory testing and theory construction research was also identified. Although advanced statistical methods were often utilized in nursing research, the results were frequently considered by the interviewers not to be applicable in practice, and readers had difficulty in comprehending the findings. Even though the number of clinical nurses involved in research is increasing, it is still considered inadequate. Among 108 respondents, 83(76.9%) gave lack of time as a barrier to conducting nursing research. Over fifty percent of the respondents reported lack of funding or, personally, low confidence in research skills as barriers. The respondents offered 183 suggestions for future emphasis in nursing research. Among the 51 areas of emphasis, clinical research received the highest number and nursing intervention was next. The findings suggested that nursing research should be based on theory, be related to practice and relevant to the situation of a unique Korean culture.

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Korean Clinical Imaging Guidelines for the Appropriate Use of Chest MRI (한국형 흉부 MRI 영상 진단 정당성 권고안)

  • Jiyoung Song;Bo Da Nam;Soon Ho Yoon;Jin Young Yoo;Yeon Joo Jeong;Chang Dong Yeo;Seong Yong Lim;Sung Yong Lee;Hyun Koo Kim;Byoung Hyuck Kim;Kwang Nam Jin;Hwan Seok Yong
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.562-574
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    • 2021
  • MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

Art Therapy and Hospice & Palliative Care in Korea (한국의 예술치료와 호스피스 완화의료)

  • Kim, Chang Gon
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.85-96
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    • 2015
  • In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.