• 제목/요약/키워드: Clinical observation

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중환자실 환자의 물리적 억제대 적용 여부에 따른 신체손상, 정서반응, 우발적 치료기구 자가 제거 발생 비교 (Comparison of Physical Injury, Emotional Response and Unplanned Self-Removal of Medical Devices According to Use of Physical Restraint in Intensive Care Unit Patients)

  • 이미미;김금순
    • 임상간호연구
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    • 제18권2호
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    • pp.296-306
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    • 2012
  • Purpose: This study was done to compare the physical injury, emotional response and unplanned self-removal of medical devices in patients with physical restraints and patients not restrained. Methods: Eighty patients admitted to the intensive care unit (ICU) of a university hospital in Seoul participated in this study. Forty patients made up each group and the group not restrained was matched with the restraint group for age and history of smoking and alcohol consumption. Data on occurrence of physical injury, intensity of anxiety, stage of agitation and unplanned self-removal of medical devices were collected by observation and medical chart review using a structured instrument. Statistical processing of collected data was done with the SPSS WIN 17.0 program. Results: The physically restrained group experienced more physical injuries and recorded significantly higher levels of anxiety and agitation than the unrestrained group. However, there were no significant differences between the groups in occurrence of unplanned self-removal of medical devices. Conclusion: Results indicate a need for critical care nurses to carefully monitor physical injuries and emotional responses of physically restrained patients and to develop nursing interventions to prevent adverse effects associated with restraint use. There is also a need to develop patient safety guidelines when using physical restraints.

신생아중환자 분류도구 개발을 위한 간호활동 규명 및 표준간호시간 조사연구 (A Study on Identifying Nursing Activities and Standard Nursing Practice Time for Developing a Neonatal Patient Classification System in Neonatal Intensive Care Unit)

  • 고범자;유미;강진선;김동연;복정희;장은경;박선자;오순자;최윤진
    • 임상간호연구
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    • 제18권2호
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    • pp.251-263
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    • 2012
  • Purpose: It was necessary for developing a neonatal classification system based on nursing needs and direct care time. This study was, thus, aimed at identifying nursing activities and measuring the standard nursing practice time for developing a neonatal patient classification system in Neonatal Intensive Care Unit (NICU). Methods: The study was taken place in 8 general hospitals located in Seoul and Kyungi province, South Korea from Dec, 2009 to Jan, 2010. By using 'the modified Workload Management System for critical care Nurses' (WMSN), nursing categories, activities, standard time, and task frequencies were measured with direct observation. The data were analyzed by using descriptive statistics. Results: Neonatal nursing activities were categorized into 8 areas: vital signs (manual), monitoring, activity of daily living (ADL), feeding, medication, treatment and procedure, respiratory therapy, and education-emotional support. The most frequent and time-consuming area was an ADL, unlike that of adult patients. Conclusion: The findings of the study provide a foundation for developing a neonatal patient classification system in NICU. Further research is warranted to verify the reliability and validity of the instrument.

한방병원에 내원한 악관절 환자 52명에 관한 임상적 고찰 (The Clinical Study of 52 Patients with Temporomandibular Disorder who Visited Oriental Medical Hospital)

  • 이진혁;설무창;민관식;진은석;정해찬
    • 척추신경추나의학회지
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    • 제4권1호
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    • pp.65-73
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    • 2009
  • Objectives : The propose of this study is to analyze characteristics with sex, age, motivation, symptom, Impression, treatment effect about temporomandibular disorder patients. Method : We performed a retrospective study of 52 patients who visited the Jaseng Hospital of Oriental Medicine, from August 2008 to October 2008. Result : Women occupied the most part. And 27 persons in the 20th are the most distribution of age. The majority of patients occured the symptom for no reason. In the distribution of symptoms, TMD pain(88.46%), Click sound(82.69%), neck pain(52.92%), headache(38.46%), lumbago(21.15%) happened. In the impression through radiological diagnoses, The majority of patients diagnosed Straightening of cervical lordotic curvature. Oriental medical treatment showed a very valuable effect on improvement of TMD symptom. Conclusion : The results showed a valuable treatment effect of temporotandibular disorders on Oriental medical treatment. Therefore this work have the necessity of continuous study and observation and will help us to understand the features of patients who visiting the TMD clinic of Jaseng Hospital of Oriental medicine.

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중환자 통증사정 도구의 타당성 평가 (Validation of Critical Care Non-verbal Pain Scale for Critically Ill Patients)

  • 최은희;김진희;고미숙;김지양;권은옥;장인순
    • 임상간호연구
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    • 제19권2호
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    • pp.245-254
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    • 2013
  • Purpose: This study was done to examine predictive validity of Critical Care Non-verbal Pain Scale (CNPS) and develop criteria for pain assessment using CNPS with critically ill patients who have communication problems. Methods: Data were collected from intensive care units at three major general hospitals in Seoul and Kyunggi province. During each observation, a nurse assessed pain severity using CNPS ratings (range 0-9) at four treatment stages: at rest, during central catheter dressing change (nonpainful procedure), position change and suctioning (routine painful procedures). Patients also assessed their pain using a self-report 4-point VRS-4. Results: There were significant differences between the four treatment stages except between "at rest" and "nonpainful procedure". Strong correlations were found between CNPS and VRS-4 for "at rest" (r=.552, p<.001), central catheter dressing change (r=.505, p<.001), position change (r=.709, p<.001), and suctioning (r=.662, p<.001). ROC curve analysis of CNPS based on 3 point on VRS-4 showed the cutoff point was 3 for CNPS, the starting point for pain management with 73% sensitivity, 92.2% specificity, 73% positive predictive value, and 92.8% negative predictive value. Conclusion: Results indicate that CNPS is a valid tool for measuring pain in critically ill patients with communication problems and 3 point should be the standardized pain treatment point.

한국형 낙상 위험 사정도구의 타당성 평가연구 (Validation of Adult Fall Assessment Scale Korean Version for Adult Patients in General Hospitals in Korea)

  • 최은희;고미숙;이신애;박정하
    • 임상간호연구
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    • 제26권2호
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    • pp.265-273
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    • 2020
  • Purpose: The purpose of this study was to test the predictive validity of the Fall Assessment Scale-Korean version (FAS-K) and to find the most appropriate cutoff score to screen high-risk fall groups in adult patients in general hospitals in Korea. Methods: We performed a prospective evaluation study in medical and surgical ward patients at two major general hospitals in Seoul. Data were collected from Nov. 1, 2018 to Feb. 28, 2019, nurses performed 651 observation series. The researcher measured the fall risk assessment score by applying FAS-K, MFS (Morse Fall Scale), and JHFRAT (Johns Hopkins Hospital Fall Risk Assessment tool) to the patients twice a week between 10 am and 12 noon. Data were analyzed using Pearson's corelation coefficients, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The FAS-K was positively correlated with the MFS (r=.70, p<.001) and the JHFRAT (r=.82, p<.001). According to the receiver operating characteristics (ROC) curve analysis of the FAS-K, sensitivity, specificity, and positive and negative prediction values were 85.3%, 49.4%, 8.5%, and 98.4%, respectively, when the FAS-K score was 4. Therefore, the cut-off score of the FAS-K to identify groups with high fall risk was 4. Conclusion: The FAS-K is a valid tool for measuring fall risk in adult inpatients. In addition, the FAS-K score, 4, can be used to identify high-risk fall groups and know specific points in time to provide active interventions to prevent falls.

관절8호방이 Collagen 유발 관절염에서 DBA/1J 생쥐에 미치는 영향 (Effects of Gwanjul8-bang on Collagen Induced Arthritis in DBA/1J Mice)

  • 김종국;오민석
    • 한방재활의학과학회지
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    • 제20권2호
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    • pp.17-34
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    • 2010
  • Objectives : This study was carried out to know the effects of Gwanjul8-bang(here in after reffered to GJ8) on the inhibition of arthritis induced by collagen on DBA/1J mice. Methods : For this purpose, GJ8 was orally administered to mouse with arthritis induced by collagen II. Cytotoxicity, hepatotoxicity, arthritis index, value of immunocyte in draining lymph node(DLN) and paw joint, cytokine in serum were measured in vivo. Results : 1. The arthritis index was decreased significantly. 2. In total cell counts of DLN and paw joint, the cells in DLN increased significantly while there was a significant decrease in paw joint. 3. In lymph nodes, $CD19^+$, $CD3^+$, $CD4^+/CD25^+$ cells increased significantly, and $B220^+/CD23^+$ cells decreased significantly. 4. In joints, $CD3^+$, $CD4^+$, $CD11b^+/Gr-1^+$ cells decreased significantly. 5. The levels of $TNF-{\alpha}$, IL-6, IL-17, MCP-1 and vascular endothelial growth factor(VEGF) in serum was significantly decreased compared with control. 6. Anti-collagen II in serum was significantly decreased compared with control. 7. The degree of arthritis induced damage of joint of GJ8 group is slight compared with control group in histopathologic observation(hematoxylin & eosin(H&E), Masson-Trichrome(MT) staining). Conclusions : Comparison of the results for this study showed that GJ8 had immunomodulatory effects. So we expect that GJ8 should be used as a effective drugs for not only rheumatoid arthritis but also another auto-immune disease. Therefore there seems to be many clinical research needed in the future.

우연한 협죽도(Nerium indicum) 복용에 의한 디지털리스양(digitalis-like) 중독 증상 (Digitalis-like Toxic Symptoms Occurring after Accidental Nerium indicum Poisoning)

  • 송예완;안정환;이정아;김기운;최상천;정윤석
    • 대한임상독성학회지
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    • 제7권1호
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    • pp.19-22
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    • 2009
  • Although Nerium indicum poisoning is a globally rare occurrence, Nerium oleander poisoning is known to occur frequently in the Mediterranean regions. To our knowledge, this is the first reported case of accidental Nerium indicum poisoning in Korea. Its poisoning symptoms and signs are similar to that of digitalis poisoning, because of the presence of cardiac glycosides in Nerium indicum. A 16-year-old boy was admitted to the emergency department four hours prior to the accidental ingestion of Nerium indicum petals. The patient complained of nausea, vomiting, and dizziness. His initial vital signs were stable; laboratory blood test results were within normal levels, except for the blood digoxin level (1.5 ng/dL). An electrocardiogram (ECG) analysis showed normal sinus rhythm, progressive PR prolongation and second-degree Morbiz type I AV block. Conservative treatments including activated charcoal administration were conducted, because toxic symptoms and signs were not severe. The patient was admitted to the intensive care unit for close observation. His ECG was converted to normal rhythm after 1 day and the toxic symptoms and signs were completely resolved after 4 days.

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저위교합된 임플란트 보철물 재수복 증례 (Reconstruction of implant prostheses under infraocclusion: a case report)

  • 김주형;백장현;노관태;김형섭;우이형
    • 대한치과보철학회지
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    • 제54권1호
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    • pp.28-34
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    • 2016
  • 임플란트 술식은 선천적인 다수치 결손을 보이는 환자에 있어서 효과적인 치료옵션이 되어왔다. 하지만 식립 시기에 있어서는 명확한 지표가 없는 실정이어서 논란은 여전히 진행 중이다. 성장기 이후에도 나타날 수 있는 악골 성장은 임플란트 저위교합(infraocclusion)으로 이어질 수 있으며 나아가 기능, 심미적인 면에서 복합적인 문제점을 보이기도 한다. 이를 해결하기 위해서는 임시 수복물을 통해 기능과 심미를 회복하고 적응되는 기간을 거친 후 최종 보철물로 그대로 이행하는 것이 중요하다. 이에 임시 수복물을 최신 CAD/CAM 기술로 복제하여 임시 수복물의 정보를 담고 있는 단일 구조 지르코니아 보철물을 제작하였고 이를 구강내 장착하였다. 치료 종결 후 3개월간의 임상 관찰에서 만족스러운 결과를 얻었다.

단일치아 결손시 $TiUnite^{TM}$ 표면처리한 임플란트의 생존율에 대한 후향적 단기연구 (A 3 year-retrospective study of survival rate in single $Br{\aa}nemark$ $TiUnite^{TM}$ implant)

  • 양승민;박선혜;신승윤;계승범
    • Journal of Periodontal and Implant Science
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    • 제37권4호
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    • pp.671-679
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    • 2007
  • Background: $TiUnite^{TM}$ is a highly crystalline and phosphate enriched titanium oxide surface which has a unique porous surface structure. This improved implant surface enhances bone response and reduces healing period. It also assures early stability of implant. These help to increase the success of implant. The aim of this study is to evaluate the survival rate of $TiUnite^{TM}$ surfaced single implant. Materials and methods: A retrospective analysis of 89 $TiUnite^{TM}$ surfaced implants replacing a single tooth was assessed according to their dental record. The age of the patients ranged from 17 to 82 years (mean age: $45.8{\pm}14.6)$. Data were recorded regarding the survival rate of these implants. Results: Fifty-two implants (57%) were placed in the maxilla, and 37 (43%) in the mandible. Over 75% were placed in the posterior area. Of the placed implants, 67% were the wide type. while 25% were the regular type and only 8% were of the narrow type. The single implants produced an overall clinical survival rate of 96.6% over the observation period (mean 17.9 months). Among 89 implants, only 2 implants were removed and one implant was submerged. Conclusion: According to these data, $TiUnite^{TM}$ surfaced implant in a single tooth restoration showed favorable survival rate although this study was done in a short term period.

심한 치관 손상이 발생한 치관-치근 파절 치아의 일회 내원 치근관형성술 및 파절편 재부착 : 증례 보고 (One-visit Apexification Using MTA and Reattachment of a Crown-root Fractured Tooth with Severe Coronal Damage: A Case Report)

  • 박영준;이제우;라지영
    • 대한소아치과학회지
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    • 제45권4호
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    • pp.521-527
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    • 2018
  • 치아의 외상에서 파절편의 재부착은 본래 치아의 형태, 질감, 색, 방사선투과성을 재현하여 우수한 심미성을 제공한다. 9세의 남자 환자가 상악 우측 중절치의 복잡 치관-치근 파절로 내원하였다. 심한 치관 손상과 골 연하로 연장된 파절로 인해 예후가 불량했지만 환자의 나이를 고려하여 치아 파절편을 재부착하기로 결정하였다. Mineral trioxide aggregate(MTA)를 이용한 일회 내원 치근관형성술 후에 골절제술과 포스트 식립을 동반하여 치아 파절편을 재부착하였다. 정기적인 관찰결과 임상 및 방사선학적으로 양호한 결과를 나타냈기에 보고하고자 한다.