• Title/Summary/Keyword: Coronary intervention

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Concept Analysis of Resilience in Patients with Cardiovascular Diseases (심혈관질환자의 회복력에 대한 개념분석)

  • Shin, Su-Jin;Jung, Duk-Yoo;Hwang, Eun-Hee
    • Journal of Korean Academy of Nursing
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    • v.39 no.6
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    • pp.788-795
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    • 2009
  • Purpose: The purpose of this study was to define and clarify the concept of 'resilience' in patients with cardiovascular diseases. Methods: A hybrid model was used to develop the concept of resilience. The model included a field study carried out in Cheonan, Korea. The participants in this study were 9 patients with cardiovascular diseases who underwent a percutaneous coronary intervention. Results: The concept of resilience was found to be a complex phenomenon having meanings in two dimensions: the personal-dispositional and interpersonal dimensions. Four attributes and seven indicators were defined. Conclusion: A resilient person was defined as one who has a positive attitude toward restoration, the power to reconstruct and control his/her disease (personal dimension), and support from a supportive system with supportive persons (interpersonal dimension). In the clinical setting, resilience plays an important role in managing the care plans of cardiovascular patients. Therefore, nurses who work closely with patients suffering from cardiovascular diseases should be aware of the attributes and indicators of resilience to enhance the resilience of their patients.

Effects of Relaxing Music on Stress Response of Patients with Acute Myocardial Infarction (이완음악이 급성 심근경색증 환자의 스트레스 반응에 미치는 효과)

  • 이혜란
    • Journal of Korean Academy of Nursing
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    • v.33 no.6
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    • pp.693-704
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    • 2003
  • Purpose: The purpose of this study was to determine whether a relaxing music was effective in reducing stress response of patients admitted to a coronary care unit with the diagnosis of acute myocardial infarction. Method: The research design was the chosen convenience sample of a randomized control group pre-posttest quasi-experimental design. Forty patients, 20 for an experimental group and another 20 for control group. The study was to provide the patients three different kinds of relaxing music. The experimental group listened to relaxing music for a 20-minute one time a day for 3days. The control group was just provided with a 20-minute period of rest. Test for hypothesis was done by repeated measured ANOV A. Result: The experimental group which received relaxing music showed a significantly lower level of electrodermal response, myocardial oxygen consumption and respiration rate, and a higher level of peripheral skin temperature than the control group. The experimental group which received relaxing music showed a significant reduction in state anxiety than the control group. Conclusion: The results showed that relaxing music is an effective nursing intervention for reducing physiologic and psychologic stress response of the patients with acute myocardial infarction in a critical intensive care unit.

Weighting of Acute Myocardial Infarction Quality Indicators using Delphi Method (델파이기법을 이용한 급성심근경색증 질 평가지표 가중치 부여)

  • Kim, Hyung Seon;Cho, Yeon Hee
    • Journal of Korean Public Health Nursing
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    • v.28 no.3
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    • pp.565-573
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    • 2014
  • Purpose: Health Insurance Review & Assessment Service (HIRA) launched an Acute Myocardial Infarction(AMI) assessment for the Payment For Performance(Quality Incentives) Pilot Project from July 2007. Assessment measures of AMI were composed of five process measures and one outcome measure, and each measure was incorporated into one composite quality score to Pay for Performance. Method: For calculation of composite quality score, we considered weighting for the measures using the Delphi method. The questionnaire was composed of three measure groups, 'Reperfusion rate'(Fibrolytic therapy received within 60 minutes of hospital arrival, Primary Percutaneous Coronary Intervention within 120 minutes of hospital arrival), 'Medication prescription rate'(Aspirin at arrival, Aspirin prescribed at discharge, Beta-blocker prescribed at discharge) and 'Survival Index'(30-day mortality rate). Result: A panel composed of 18 and completed a questionnaire by allocation of 10 scores to the three above mentioned measure groups. The Delphi was carried out until three rounds of surveys. In conclusion, each measure group was weighted differently and the 10 scores were allocated as 4.5 to 'Reperfusion rate', 2.5 to 'Medication prescription rate', and 3.0 to 'Survival Index'. Conclusion: The results of this study proposed the calculation method for weighting of Acute Myocardial Infarction quality indicators.

The Effects of Individualized Cardiac Rehabilitation Education for Percutaneous Coronary Intervention (PCI) Patients (개별 심장재활교육이 경피적 관상동맥 중재술(PCI) 환자의 지식과 불안에 미치는 효과)

  • Kim Nam-Cho;Choi Kyung-Ok
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.1
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    • pp.42-49
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    • 2006
  • Purpose: This study was done to evaluate the effectiveness of cardiac rehabilitation education individualized to PCI patients in order to improve their knowledge of these diseases and to lessen their anxiety. Method: A Quasi experimental design with non-equivalent control group non-synchronized design was used. The experimental group had the PCI operation for ischemic heart disease and individualized cardiac rehabilitation education and counseling twice for 25 minutes each time using an educational booklet developed by the authors. The effects of the education were analyzed using a knowledge assessment tool, state anxiety inventory and anxiety visual analogue scale. Results: The experimental group who received the individualized cardiac rehabilitation education showed a high level of knowledge about diseases compared to the control group and particularly showed a significant difference in knowledge about the drugs used for treatment. However, no significant difference was observed between the two groups in the level of state anxiety and anxiety visual analogue scale. Conclusion: Individualized cardiac rehabilitation education did not reduce anxiety but it was effective in enhancing the participants' knowledge about the diseases. Thus, it can be utilized effectively in addressing risk factors in ischemic heart diseases by providing education individualized according to patients' demands and knowledge levels.

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Curcumin-Loaded PLGA Nanoparticles Coating onto Metal Stent by Electrophoretic Deposition Techniques

  • Nam, So-Hee;Nam, Hye-Yeong;Joo, Jae-Ryang;Baek, In-Su;Park, Jong-Sang
    • Bulletin of the Korean Chemical Society
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    • v.28 no.3
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    • pp.397-402
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    • 2007
  • Restenosis after percutaneous coronary intervention (PCI) continues to be a serious problem in clinical cardiology. To solve this problem, drug eluting stents (DES) with antiproliferative agents have been developed. Variable local drug delivery systems in the context of stenting require the development of stent manufacture, drug pharmacology and coating technology. We have worked on a system that integrates electrophoretic deposition (EPD) technology with the polymeric nanoparticles in DES for local drug delivery and a controlled release system. The surface morphology and drug loading amount of DES by EPD have been investigated under different operational conditions, such as operation time, voltage and the composition of media. We prepared poly-D,L-lactide-co-glycolic acid (PLGA) nanoparticles embedded with curcumin, which was done by a modified spontaneous emulsification method and used polyacrylic acid (PAA) as a surfactant because its carboxylic group contribute negative charge to the surface of CPNPs (?53.5 ± 5.8 mV). In the process of ‘trial and error' endeavors, we found that it is easy to control the drug loading amount deposited onto the stent while keeping uniform surface morphology. Accordingly, stent coating by EPD has a wide application to the modification of DES using various kinds of nanoparticles and drugs.

Non-surgical treatment of hemorrhagic shock caused by rupture of iatrogenic pseudoaneurysm (의인성 가성낭종 파열에 의한 출혈성 쇽의 비수술적 치료)

  • Kim, Soon Young;Kim, Tae Jun;Na, Seong Kyun;Park, Seung Ah;Jung, Dong Min;Kim, Yong Kyun;Jo, Sang-Ho
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.17-20
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    • 2014
  • Iatrogenic femoral artery pseudoaneurysm is a complication in patients undergoing catheterization. The risk increased when large-bore sheaths, concomitant anticoagulation therapy, and antiplatelet therapy are used during the intervention. Ultrasound-guided thrombin injection has become the treatment of choice. Rapid expansion, rupture, infection, and mass effect resulting in distal or cutaneous ischaemia or peripheral neuropathy, as well as failure of other treatment options are all indications for surgery. We report a 48-year-old man who developed hemorrhagic shock due to femoral pseudoaneurysm rupture after coronary angiography, and successfully treated by ultrasound-guided thrombin injection.

The Health Behavioral Experience of Patients with Myocardial Infarction during the Recovery Period (회복기 심근경색 환자의 건강행위 경험)

  • Kang, Kyung Ja;Kim, Moon Jeong
    • Korean Journal of Adult Nursing
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    • v.26 no.2
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    • pp.203-213
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    • 2014
  • Purpose: The purpose of this study was to understand and describe the every day life experience of patients with acute myocardial infarction (AMI) during the recovery period after Percutaneous Coronary Intervention (PCI) using a qualitative approach. Methods: Twelve patients with AMI participated in this study. Their age ranged from 42 to 75. The data were collected by individual in-depth interviews and all interviews were audio-taped and transcribed verbatim. The transcribed data were analyzed using traditional qualitative content analysis. Results: Six sub-themes emerged from the data as follows: Getting to know about illness, getting motivated for health behavior, putting an effort into health behavioral change, having difficulties maintaining health behavior, setting up coping strategies for health behavior and having a need for a tailored education. The results of this study showed how the health behaviors of patients with AMI are related to their every day life experiences. Conclusion: The results of this study could help health professionals to better understand patients with AMI and design effective educational interventions to improve their health behaviors.

Serum Cholesterol and 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase (혈청 콜레스테롤과 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase)

  • Choi, Yong-Soon;Lee, Sang-Young
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.21 no.5
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    • pp.580-593
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    • 1992
  • Cholesterol have many essential functions as a component of cellular and subcellular membranes, metabolic precursor of bile acids and steroid hormones, and obligatory part of the metabolic systems involved in DNA synthesis and cell division. These essential funtions demand a continuous and appropriate supply of cholesterol to the tissues. Body cholesterol pool is maintained by the balance of acquirement from diets, de novo synthesis, and excretion either as bile acids or neutral steroids. In these metabolic process, cholesterol biosynthesis is controlled by the change in the activity of 3-hydroxy-3methylglutaryl coenzyme A (HMG-CoA) reductase. Under most physiological or nutritional situations, the activity of this enzyme is adroitly regulated to maintain tissue cholesterol balance. Excess cholesterol accumulation in the cells induces the decrease in the number of LDL-receptor, followed by the increase in the level of serum LDL-cholesterol. Increase in the level of serum cholesterol appears to be an important determinant for the incidence of the coronary heart disease. Dietary intervention may be helpful in alleviating an increase in the level of serum cholesterol or body cholesterol pool.

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Exploring modern machine learning methods to improve causal-effect estimation

  • Kim, Yeji;Choi, Taehwa;Choi, Sangbum
    • Communications for Statistical Applications and Methods
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    • v.29 no.2
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    • pp.177-191
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    • 2022
  • This paper addresses the use of machine learning methods for causal estimation of treatment effects from observational data. Even though conducting randomized experimental trials is a gold standard to reveal potential causal relationships, observational study is another rich source for investigation of exposure effects, for example, in the research of comparative effectiveness and safety of treatments, where the causal effect can be identified if covariates contain all confounding variables. In this context, statistical regression models for the expected outcome and the probability of treatment are often imposed, which can be combined in a clever way to yield more efficient and robust causal estimators. Recently, targeted maximum likelihood estimation and causal random forest is proposed and extensively studied for the use of data-adaptive regression in estimation of causal inference parameters. Machine learning methods are a natural choice in these settings to improve the quality of the final estimate of the treatment effect. We explore how we can adapt the design and training of several machine learning algorithms for causal inference and study their finite-sample performance through simulation experiments under various scenarios. Application to the percutaneous coronary intervention (PCI) data shows that these adaptations can improve simple linear regression-based methods.

Effect of Kale Juice on Serum Lipid Levels & Phospholipid Fatty Acid Composition in Hypercholesterolemic Men (케일녹즙이 고콜레스테롤혈증 성인남자의 혈청 지질수준 및 인지질 지방산 조성에 미치는 영향)

  • Chung, Eun Jung;Shim, Eugene;Kim, Soo Yeon
    • Journal of Life Science
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    • v.22 no.11
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    • pp.1538-1544
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    • 2012
  • The aim of this study was to evaluate the effect of kale (Brassica oleracea acephala) juice supplementation on serum lipid levels and phospholipid (PL) fatty acid compositions in hypercholesterolemic men. Thirty-two men with hypercholesterolemia (>200 mg/dl) were recruited among the faculty and staff at Y University after annual health examinations. The subjects consumed 150 ml of kale juice per day for a 12-week intervention period. Dietary and anthropometric assessments were performed before and after supplementation, respectively, to ensure that the subjects maintained their usual diet and lifestyle throughout the intervention. Serum concentrations of HDL-cholesterol and the ratio of HDL-cholesterol to LDL-cholesterol were significantly increased (p<0.001) after intervention. Serum LDL-cholesterol concentration and atherogenic index were significantly reduced (p<0.001). Levels of 12:0, 14:0, $18:1{\omega}9$, $18:3{\omega}6$, and sum of monounsaturated fatty acids (MUFA) in serum pholspholipid (PL) were significantly increased, while $22:4{\omega}6$ level was significantly reduced (p<0.05). It can be speculated that kale juice, containing large amounts of antioxidant nutrients, contributes to changes of serum-PL-fatty acid compositions and the improvements of serum lipid profiles. This study demonstrates the supplementation of regular meals with kale juice may favorably affect serum lipid profiles and serum-PL fatty acid compositions and, hence, could lower the risks of coronary artery disease in men with hypercholesterolemia.