• Title/Summary/Keyword: Critical Care

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Reliability and Validity of a Korean Version of the Critical Care Pain Observation Tool (CPOT) for ICU Patients Unable to Self Report (자가보고 능력이 없는 중환자의 통증사정을 위한 한국어판 Critical Care Pain Observation Tool의 신뢰도와 타당도 검증)

  • Lee, Hee Og;Kim, Yeon Su;Lee, Chang Ok;Hur, Sung Yi;Kwon, In Gak
    • Journal of Korean Critical Care Nursing
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    • v.6 no.1
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    • pp.1-10
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    • 2013
  • Purpose: The purpose of this study was to examine the reliability and validity of a Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: Data were collected from a convenience sample of 30 critically ill patients admitted to a medical ICU in a hospital. The CPOT was tested at before, during and 20 minutes after changing a position and suction. Upon establishment of content and translation equivalence between the English and Korean version of CPOT. Results: The interrater reliability was found to be acceptable with the kappa coefficients of .76-1. The construct validity of the pain scores were increased from 0.43 to 2.5 in changing a position (t=-8.60, p<.001)and 0.1 to 3.23 (t=-9.36, p<.001) in suctioning. The pain scores were decreased from 6.06 to 4.01 in changing a position (t=-10.19, p<.001) and 6.45 to 4.13 (t=-10.39, p<.001) in suctioning. The concurrent validity the correlations between pain scores and physiological indicators, and a increased in Heart rate before and after changing a position (r=.65, p<.001). Conclusion: The CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal a medical ICU patients.

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A Case of IgG4-Related Disease Presenting as Massive Pleural Effusion and Thrombophlebitis

  • Choi, Jong Hyun;Sim, Jae Kyeom;Oh, Jee Youn;Lee, Eun Joo;Hur, Gyu Young;Lee, Seung Heon;Lee, Sung Yong;Kim, Je Hyeong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Min, Kyung Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.4
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    • pp.179-183
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    • 2014
  • Immunoglobulin (Ig) G4-related disease is a recently recognized systemic fibroinflammatory condition characterized by a lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells with elevated circulating levels of IgG4. The disease can either be localized to one or two organs, or present as diffuse multi-organ disease. Furthermore, lesions in different organs can present simultaneously or metachronously. In the pulmonary manefestations, lesions associated with IgG4-related disease have been described in the lung parenchyma, airways and pleura, as well as the mediastinum. We report a case of IgG4-related disease presenting as massive pleural effusion and thrombophlebitis.

Mediastinal Lymphangioma in Adults : Three Case Reports (성인에서 발생한 종격동 림프관종 3례)

  • Kim, Kyung Chan;Koh, Won-Jung;Kwon, O Jung;Lee, Byoung-Hoon;Hwang, Jung Hye;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Han, Joungho;Ko, Young Hyeh;Kim, Jhingook;Kim, Tae Sung;Lee, Kyung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.3
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    • pp.303-310
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    • 2003
  • Background : Lymphangioma of the mediastinum is an uncommon benign tumor of lymphatic origin that is most often seen in children, is very rare in adults and is frequently discovered incidentally on chest x-ray exams. While radiology (CT and MRI) may suggest the diagnosis and allow an assessment of the operative difficulties, the histology of the surgical specimen is required for precise diagnosis. Complete resection is the only treatment; however, in some patients resection was incomplete because of the infiltrating character of these tumors, leading to recurrence. We report three cases of mediastinal lymphangioma with a review of the literature.

Work Performance of Critical Care Nurses Based on the Job Characteristics Model (직무특성모형에 근거한 중환자실 간호사의 간호업무성과 설명요인)

  • Seong, Ji-Suk;Song, Rhayun
    • Journal of Korean Critical Care Nursing
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    • v.9 no.2
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    • pp.36-47
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    • 2016
  • Purpose: The study examined core job characteristics and job preference to explain work performance among critical care nurses. The theoretical model was constructed based on the job characteristics model with core job characteristics as exogenous variables, and work performance and job preference as endogenous variables. Methods: A total of 228 hospital nurses participated in the study from May to September, 2015. Data were collected through structured questionnaires and analyzed using structural equation modeling. Results: The model showed a good fit to the data with $x^2/df=2.90$, goodness of fit index = .91, root mean square residual = .20, comparative fit index = .93, and incremental fit index = .93. The core job characteristics explained 64% of the variance in job preference. The core job characteristics and job preference explained 52% of the variance in work performance. Conclusions: The core job characteristics can explain the work performance among critical care nurses through job preference. Effective strategies to improve the work performance among critical care nurses should focus on the application of the core job characteristic into a productive work environment. Further studies are warranted to explore the role of job preference of critical care nurses in promoting their work performance.

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Critical Care before Lung Transplantation

  • Lee, Jin Gu;Park, Moo Suk;Jeong, Su Jin;Kim, Song Yee;Na, Sungwon;Kim, Jeongmin;Paik, Hyo Chae
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.197-205
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    • 2018
  • Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.

A Qualitative Content Analysis of the Person-Centered Care Experienced by Critical Care Patients (중환자실 환자가 경험한 인간중심 간호에 관한 질적 내용분석)

  • Hong, Hee Jin;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.11 no.2
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    • pp.21-33
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    • 2018
  • Purpose : To explore the person-centered care (PCC) experienced by critical patients. Method : This qualitative study deductively examined the attributes of the PCC model proposed by Jakimowicz and Perry. The participants were 16 patients who were recently discharged from intensive care units at a university hospital. Data were collected through in-depth interviews and were analyzed using the deductive method of content analysis. Results : A total of 4 categories, 16 subcategories, and 33 codes were generated from 171 meaningful statements. The final 4 categories were "compassionate presence," "professional interaction," "outstanding competency," and "patient identity." These were consistent with the main attributes of Jakimowicz and Perry's model. However, most of the codes belonged to the "compassionate presence" and "patient identity" categories. Among the attributes of the model, "continuity of nursing," "therapeutic relationship," "expert knowledge," "clinical knowledge," "evidence-based intervention," and "patient's rights" were not derived as codes. Conclusion : These findings deepen the understanding of the PCC model from the patient's point of view. The main attributes of PCC identified in the current study can be applied to the development of practical guidelines for intensive care nursing. In addition, we recommend the development of a PCC measurement tool for critical care patients.

A Case of Chronic Necrotizing Pulmonary Aspergillosis Obscured by Cavitary Pulmonary Tuberculosis (공동성 폐결핵으로 오인된 만성 괴사성 폐 아스페르길루스증 1예)

  • Min, Joo-Won;Yoon, Young Soon;Park, Jong Sun;Kim, Hye-Ryoun;Rhee, Ji young;Yoo, Chul-Gyu;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yim, Jae-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.368-371
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    • 2007
  • Pulmonary cavities are caused by bacterial pneumonia, fungal diseases, lung cancer, and tuberculosis (TB). However, in Korea, patients with cavitary lung lesions are generally considered to have pulmonary TB, where the incidence of TB is approximately 70/100,000 per year. We report a case of chronic necrotizing pulmonary aspergillosis that was obscured by multidrug-resistant pulmonary TB.

2 Cases of a Benign Pulmonary Metastasizing Leiomyoma

  • Lee, Eun Joo;Jeong, Hye Cheol;Lee, Sung Yong;Kim, Je Hyeong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa;Lee, Sang Hoon;Kim, Han-Kyeom;Oh, Yu Whan
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.6
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    • pp.551-555
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    • 2009
  • A benign pulmonary metastasizing leiomyoma is a recognized clinical entity that has been infrequently reported in the medical literature. We report two cases of a benign pulmonary metastasizing leiomyoma. A 35-year-old woman who underwent myomectomy and a cesarean section approximately 6 years earlier visited our hospital for further evaluation of incidentally revealed multiple lung nodules. A diagnostic percutaneuous biopsy was performed. Finally she was diagnosed with a benign metastasizing leiomyoma. The patient then received LH-RH and has been followed up since. The other 44-year-old woman presented after an initial radiology evaluation revealed the presence of multiple, small-sized lung nodules. She underwent a right middle lung wedge resection to confirm the diagnosis. Finally she diagnosed with a benign metastasizing leiomyoma. The multiple lung nodules have been followed up closely.

Nontuberculous Mycobacterial Lung Disease Caused by Mycobacterium lentiflavum in a Patient with Bronchiectasis

  • Jeong, Byeong-Ho;Song, Jae-Uk;Kim, Wooyoul;Han, Seo Goo;Ko, Yousang;Song, Junwhi;Chang, Boksoon;Hong, Goohyeon;Kim, Su-Young;Choi, Go-Eun;Shin, Sung Jae;Koh, Won-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.4
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    • pp.187-190
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    • 2013
  • We report a rare case of lung disease caused by Mycobacterium lentiflavum in a previously healthy woman. A 54-year-old woman was referred to our hospital due to chronic cough and sputum. A computed tomography scan of the chest revealed bilateral bronchiectasis with bronchiolitis in the right middle lobe and the lingular division of the left upper lobe. Nontuberculous mycobacteria were isolated twice from three expectorated sputum specimens. All isolates were identified as M. lentiflavum by multilocus sequence analysis based on rpoB, hsp65, and 16S rRNA fragments. To the best of our knowledge, this is the first documented case of M. lentiflavum lung disease in an immunocompetent adult in Korea.

A Case of Nonspecific Interstitial Pneumonitis Improved After Cyclosporin Therapy (Cyclosporin 치료로 호전된 비특이성 간질성 폐렴 1예)

  • Ahn, Sang Mi;Jo, Suk Kyoung;Lim, Seung Kwan;Song, Young Jun;Choi, Jun Hyuk;Sheen, Seung Soo;Oh, Yun Joung;Choi, Young Hwa;Park, Kwang Ju;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.631-635
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    • 2003
  • Idiopathic interstitial pneumonia is a group of lung disease classified by clinical, radiological and pathologic findings. Steroid is described in many reports as an effective treatment for the idiopathic interstitial pneumonitis. For the treatment of steroid non-responders, immuno-suppressive or cytotoxic agents are used as second line drug of choice. We experienced a case of nonspecific interstitial pneumonitis who was treated initially with glucocorticoid and antibiotics without effects, but later did respond to cyclosporin treatment. This 63 year-old patient was admitted due to dyspnea, cough, and sputum production. He was started on glucocorticoid and antibiotics after he was diagnosed as having nonspecific interstitial pneumonitis by open lung biopsy. The initial steroid treatment was not effective, however, after cyclosprin treatment, the patient showed clinical and radiologic improvements.