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Study on the Determination of Nursing Hours by Self-Care Status of Patients (환자의 신체기능적 능력(Self-Care Status)별 소요되는 간호시간 결정에 관한 연구)

  • 박정숙;김주희
    • Journal of Korean Academy of Nursing
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    • v.12 no.2
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    • pp.57-66
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    • 1982
  • This study was undertaken to delineate the relationship between numerical score and the amount of nursing hours required in the nursing process. Score was a numerical description of the patients functional nursing needs. Therefore this study focused on standard nursing hours required by patient's self-care status. This study observed the 62 patients and 15 R.N. in H. university hospital from Aug. 7, 1982 to Aug. 13, 1982. 1. For the first time, each head nurse assessed self-care status by Schoening's self-care score-Minimal care patient (self-care score: 23, 24) was placed in Group Ⅰ, intermediate care patient (self-care score: 11∼22) was Group Ⅱ, and special care score: 0∼10) was Group Ⅲ. 2. We observed and recorded the nursing care received from nurses according to patient's group. (8AM∼4PM) 3. And, We observed and recorded the activities of nurses in order to determine standard nursing hours required. (8AM∼4PM) 4. If we apply the content of paragraph 3 to paragraph 2, we will predict the number of patient that nurse can care during day time by self-care status. The following results were obtained: 1) Patient's mean self-care score were Group I : 23.9 score Group Ⅱ:17.8 score Group Ⅲ : 1.6 score 2) Nursing hours required by patient's physical function(self-care status) status were Group I : 35 min. Group Ⅱ: 47.5 min. Group Ⅲ : 104.6 min. 3) Nurse's nursing time and distribution required in nursing activities during day duty were A.D.L. : 84.3min. (17.56%) Functional nursing activities : 279.9min. (58.31 %) Education & Emotional support : 11.3min. (2.35%) Task unrelated patients : 54min. (11.25%) Non Productive nursing care : 50. 5min. (10.52%) 4) Mean nursing hours required by each patient and the number of patient that nurse can rare during day duty by self-care status were Group I : 38.6min. 11.1 patients/1 nurse Group Ⅱ : 51.1min: 8.4 patients/1 nurse Group Ⅲ: 108.2min. 4 patients/1 nurse It seems reasonable that this could be done effectively as each-unit has an established standard for hours required, This not only allows time for planning of staff but helps to avoid the very human inclination to predict excessive staffing requirements by placing the majority of patients in high care group.

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A Clinical Study on Amenorrhoea(經閉) Patients (경폐(經閉)(무월경(無月經))에 관(關)한 임상적(臨床的) 고찰(考察))

  • Lee, Jin-Moo;Lee, Kyung-Sub;Song, Byoung-Key
    • The Journal of Korean Medicine
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    • v.17 no.2 s.32
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    • pp.405-417
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    • 1996
  • An amenorrhoea means the pathologic condition that menstruation stops before the post menopausal period. Clinically, this is classified to both primary amenorrhoea and secondary amenorrhoea. Primary amenorrhoea indicate what has no first menstruation until 14 without secondary sexual sign or what has no first menstruation until 16 with secondary sexual sign before the time. Secondary amenorrhoea is diagnosised when a women with normal menstrual cycle before the onset doesn't have a menstruation over 6 months or appeals amenorrhoea for three times of her normal menstrual cycle. This clinical study was done on the patients who had come to gynecology department of oriental Hospital of Kyung Hee Medical Center from August 1, 1994 to July 31, 1995, complaining of amenorrhoea. The results obtained were as follows: 1. The amenorrhoea patient rate among outpatients who came to the deptment of gynecology was 3.4%. 2. The ratio between primary amenorrhoea and secondary amenorrhoea was 1 : 6.5. 33. The patient rate via other hospitals was 75% and Unremarkable finding(47.6%) was most numerous according to other hospital's diagnosis and hyperprolactinemia(11.9%), premature menopause(11.9%) were the second numerous diagnosis. 4. Unremarkable history(56.7%) was most numerous and among history, the fast(weight loss; 30%) was most numerous. 5. The most general symptom of amenorrhoea patient was indigestion(51.7%). 6. The most frequently used prescribtion for non-insurance was Onpojongoktang(溫胞種玉湯 ; 55%), for insurance was Gamisoyosan(加味逍遙散 ; 16.7%). 7. 25% patient show menstruation in their therapy and among this, 80% patient show menstruation within 40 days. 8. 26.9% secondary amenorrhoea patient show menstruation in their therapy and only one primary amenorrhoea patent(12.5%) shows the same result. 9. Among the effective used prescribtion, Onpojongoktang(溫胞種玉湯 ; 46.7%) is most numerous.

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Ultrasound-guided erector spinae plane block for pain management after gastrectomy: a randomized, single-blinded, controlled trial

  • Jeong, Heejoon;Choi, Ji Won;Sim, Woo Seog;Kim, Duk Kyung;Bang, Yu Jeong;Park, Soyoon;Yeo, Hyean;Kim, Hara
    • The Korean Journal of Pain
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    • v.35 no.3
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    • pp.303-310
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    • 2022
  • Background: Open gastrectomy causes severe postoperative pain. Therefore, we investigated the opioid-sparing effect of the ultrasound-guided bilateral erector spinae plane block (ESPB) after open gastrectomy. Methods: Adult patients undergoing open gastrectomy were randomly assigned to either the ESPB group (ESPB + fentanyl based intravenous patient-controlled analgesia [IV-PCA]) or a control group (fentanyl based IV-PCA only). The primary outcome was total fentanyl equivalent consumption during the first 24 hour postoperatively. Secondary outcomes were pain intensities using a numeric rating scale at the post-anesthesia care unit (PACU) and at 3, 6, 12, and 24 hour postoperatively, and the amount of fentanyl equivalent consumption during the PACU stay and at 3, 6, and 12 hour postoperatively, and the time to the first request for rescue analgesia. Results: Fifty-eight patients were included in the analysis. There was no significant difference in total fentanyl equivalent consumption during the first 24 hour postoperatively between the two groups (P = 0.471). Pain intensities were not significantly different between the groups except during the PACU stay and 3 hour postoperatively (P < 0.001, for both). Time to the first rescue analgesia in the ward was longer in the ESPB group than the control group (P = 0.045). Conclusions: Ultrasound-guided ESPB did not decrease total fentanyl equivalent consumption during the first 24 hour after open gastrectomy. It only reduced postoperative pain intensity until 3 hour postoperatively compared with the control group. Ultrasound-guided single-shot ESPB cannot provide an efficient opioid-sparing effect after open gastrectomy.

Orthostatic Intolerance Ambulation in Patients Using Patient Controlled Analgesia

  • Park, Kwang Ok;Lee, Yoon Young
    • The Korean Journal of Pain
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    • v.26 no.3
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    • pp.277-285
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    • 2013
  • Background: Opioid analgesics are widely used to reduce postoperative pain and to enhance post-operative recovery. However, orthostatic intolerance (OI) induced by opioid containing intravenous patient controlled analgesia (IPCA) may hinder postoperative recovery. This study investigated factors that affect OI in patients receiving IPCA for postoperative pain control. Methods: OI was instantly evaluated at the time of first ambulation in 175 patients taking opioid containing IPCA after open and laparoscopic subtotal gastrectomies. Patients were classified as having OI if they experienced dizziness, nausea/vomiting, blurred vision, headache, somnolence and syncope. Factors contributing to OI were assessed with logistic regression analysis. Results: Out of 175 patients, 61 (52.6%) male and 44 (74.6%) female patients experienced OI at the time of first ambulation. The frequency of OI related symptoms were dizziness (97, 55.4%), nausea (46, 26.3%), headache (9, 5.1%), blurred vision (3, 1.7%) and vomiting (2, 1.1%). Significant risk factors for OI were gender (P=0.002) and total amount of opioids administered (P=0.033). Conclusions: The incidence of OI is significantly higher in male than in female patients and is influenced by the opioid dose.

The Effect of Watsu Therapy on Muscle Tone in Adult Hemiparesis Patient After Stroke (Watsu 치료가 뇌졸중 이후 성인 편부전마비환자의 근긴장도에 미치는 영향)

  • Chon, Seung-Chul
    • Journal of Korean Physical Therapy Science
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    • v.11 no.2
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    • pp.46-56
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    • 2004
  • The purpose of this study was to investigate the effect of watsu therapy on muscle tone in adult hemiparesis patient after stroke. The subject was a 66 year old patient with left hemiparesis whose self gait was independent with minimal assist. The subject was ambulatory with some degree of limitation and demonstrated a little tremor and asymmetry in the body. A multiple treatment design(A-B-C-B) for a single-subject research was used for this study. The watsu therapy consisted of basic moves, head cradle, underfar leg, near leg cradle in watsu I (transition flow), for 25 minutes, which lasted 12 sessions for a total 21 sessions. A baseline was conducted for a first time and a general ROM exercise was conducted after the first watsu therapy. Tone assessment scale was tested : 1. posturing at rest 2. response to passive movement 3. associated reaction Comparing to the baseline and general ROM exercise, The results showed that the watsu therapy had some positive effects on improvement of three tests and there was a more positive effects of both response to passive movement and associated reaction.

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Current Practices and Future Directions in Patient Safety Education and Curriculum in Medical Schools (의과대학에서의 환자안전 교육과정 도입을 위한 환자안전 교육현황조사 및 향후 운영방안)

  • Oh, Hae Mi;Lee, Won;Jang, Seung Gyeong;Kim, So Yoon
    • Korean Medical Education Review
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    • v.21 no.3
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    • pp.143-149
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    • 2019
  • In 2018, The Ministry of Health and Welfare announced its first comprehensive plan for patient safety, which included the imperative to develop a patient safety curriculum for students studying to become health professionals. The aim of this study is to assess current patient safety education and points of consideration for introducing new curriculum. An online survey was used to understand the status of patient safety education in medical schools, and key informant interviews and focus group interviews were used to collect qualitative data on the experience of patient safety education. The results of the online survey from 16 out of 40 medical schools (40% response rate) and the qualitative data analysis were integrated and analyzed. Twelve schools (75%) had established courses related to patient safety. The qualitative responses suggest that patient safety education is appropriate both before and after clinical training through a variety of educational methods, and that the topics should be linked with clinical training. The challenge of securing lecture time to address patient safety was mentioned as a realistic obstacle. When patient safety education is integrated in future curriculum, it is necessary to consider it as a priority. Moreover, in the early stages of introducing patient safety education, a step-by-step, policy-based approach is required for seamless adoption and settlement.

Patients Satisfaction with Nursing Care in the Emergency Department (응급실 이용현황과 환자의 간호만족도 조사연구)

  • Kim, Do-Sun
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.405-418
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    • 1998
  • The purpose of this study was to describe patients satisfaction with nursing care in the emergency department and factors influencing satisfaction rates. 1. The mean score of patient satisfaction with nursing care in the emergency departments was 2.70. The mean scores of patient satisfaction with different aspects of nursing care services were 3.05 for nursing services for psychological safety: 2.67 for technical competence: 2.49 for information giving: and 1.35 for discharge teaching. 2. Patient satisfaction with nursing care services provided. according to the general characteristics of the patients. was revealed as being significantly high for the groups of patients made up of those who were male. those over 51years of age. married subjects. those with an education level of high school or below level. housewives. Buddhists. and those in the middle economic level. Patient satisfaction with nursing care according to their service utilization in the emergency departments revealed that satisfaction was significantly high for patients who were in internal medicine. neurology or psychiatry. those admitted for the first time. those for whom the distance from the department to home was less than 30 minutes. patients who visited between monday and Friday and between 8AM and 4PM. patients who did not have to wait to be seen and those who stayed in the department less than 24 hours. 3. The correlation between the patients' general characteristics. nursing service utilization of the patients in the department and their satisfaction with nursing care showed that patients with longer waiting time had lower satisfactory scores for nursing service. 4. The registered nurses working in the emergency department reported that the main reasons for low satisfaction rates included 'over worked nurses' and 'too many patients' in the emergency department. In conclusion. the results of this study suggest the necessity of developing relevant nursing interventions for discharge teaching to increase patient satisfaction with nursing care services in emergency departments: and the need for adequate support from hospital administrators to improve patients' service utilization.

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Comparative Study of Durability of Bioprosthetic Valve Considering Age of Patients (Ionescue-Shiley 조직판막의 환자 연령군에 따른 내구성에 관한 비교연)

  • 김진국
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.673-682
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    • 1987
  • The principal feature of bioprosthetic valve which remains to be completely defined is long-term durability, especially, with regard to the impact of patient age. This report provides extended data regarding valve durability derived from a data base of 515 patients who received lonescu-Shiley bioprosthetic valve between 1978 and 1985; cumulative duration of follow-up was 1562.3 patient-years, with a maximum follow-up duration of 8.7 years. The results of this survey showed as follows: 1] The actuarial freedom from valve failure at 6 years were 43*7% for 0-19 year-old group, 70*1% for 20-39 year-old group and 75*1% for over 40 year-old group separately. 2] Of the causes of valve failure, only the primary tissue failure was markedly influenced by patient`s age [p<0.001], but the prosthetic valve endocarditis was not [p>0.1]. 3] The linealized incidences of primary tissue failure were 7.31% per patient-year in 0-19 year-old group and 0.12% in 20-39 year-old group. 4] The primary tissue failure rate in 0-19 year-old group was 6.36% during first 4 years, but then increased upto 10.95% at postoperative 5 year. Thus we find that in bioprosthetic valve the primary tissue failure is apt to occur when patient is young [especially less than 20 years old] and the postreplacement time passes [especially over 5 years]. The rate of bioprosthesis failure among children and adolescents is clearly higher than that observed in adult patients; however, conclusive quantification of time-related risk for young patient is not yet possible on the basis of existing data. Therefore, the advisability of bioprosthesis implantation in children remains to be determined.

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The effect of arm sling during hemiplegic gait (팔걸이가 편마비 환자의 보행에 미치는 영향)

  • Lee, Ilsuk;Lim, Hyungmoon;Choi, Sanho;Oh, Jaegun;Sung, Kang-keyng;Lee, Sangkwan
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.14 no.1
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    • pp.80-89
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    • 2013
  • ■ Objectives The aim of study is to analyze the change of gait pattern by arm sling in a hemiplegic patient. ■ Methods We analyzed the change of gait pattern under three conditions using Treadmill Gait analysis equipment(Zebris Co.Ltd FDM-T) First, the patient didn't have arm sling on her upper limb, second, the patient have arm sling on her affected upper limb, third, patient have arm sling on her unaffected upper limb. ■ Results In terms of spatiotemporal gait values, swing phase, step time, step length of unaffected lower limb increased. Furthermore, stride time and stride length also increased when the patient had arm sling on her unaffected upper limb. In terms of displacement of Center of pressure(CoP), anterior/posterior position and lateral symmetry of CoP increased. Furthermore, lateral symmetry of decreased when the patient had arm sling on her affected upper limb. ■ Conclusion Arm sling applied on affected side would be advantage to gait improvement in hemiplegic patients.

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Study on Principle of Gimun (Jimen) & Application of Gimun-chimbub (Jimen-zhenfa) (기문(奇門)의 원리(原理)와 기문침법(奇門鍼法) 활용에 대한 연구)

  • Kim, Kwang-ho;Kang, Jung-soo
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.233-249
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    • 2000
  • Objectives : Gimun-chimbub(Jimen-zhenfa) is the method of needling which is based on Gimun-hak (Jimen-xue), and it is the most excellent method of needling than any other methods. In spite of the superiority of Gimun-chimbub(Jimen-zhenfa), there are few documents which explain it in details. The purpose of this study is to make clear principle of Gimun(Jimen) & apptication of Gimun-chimbub(Jimen-zhenfa) so many clinicians can make good use of it. Methods : Through investigation of many documents concerning Gimun(Jimen), Gimun-chimbub(Jimen-zhenfa) and Bosa(buxie), the author first explained principle of Gimun(Jimen) and then made clear how to apply it in needling and how to perform Bosa(buxie). Conclusions : 1. Gimun-hak(Jimen-xue) is constituted combinations of infinite change of Chen-Gy-In Samje(Tianrendi Sancai) and Hado lakse(Hetu Luoshu). Gimun-hak(Jimen-xue), is the study which shows us the change of space time e- ntangling at once, and it is applied to troublous times and critical situations. Gimun-chimbub(Jimen-zhenfa) combines of the method of needling with the time when Chen(Tian) opens and closes. So according to each cases, doctor must consider the adequate time. For example, in case of acute disease, the first day when the patient got ill is ta - ken. In case of chronic disease, the day when the patient came to see a doctor is taken. In Gimun-chimbub(Jimen-zhenfa), first it uses Jik-Sa-Mun(zhishimen) which can ac - cept Chen-Gi(tianqi). When needling, doctor must find the accurate acu-points and perform Bosa(buxie). Finally it uses Saeng-Mun(shengmen) which stirs up the vit - ality. Using Saeng-Mun(shengmen) decreases the rate of relapse of diseases.

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