• Title/Summary/Keyword: First-visit Patients

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A Study on the Lived Experiences of Homecare Nurses (가정간호사의 실무체험 연구)

  • 서문자;김소선;신경림;강현숙;김금순;박호란;김혜숙
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.84-97
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    • 2000
  • The Necessity and Purpose of the Study Recently the number of patients with chronic diseases and the aged patients is increasing steadily. Furthermore, due to the expansion of health insurance system, the number of patients hospitalized in the general hospital is increasing at a surprising speed. However, hospitals urge the early discharge of the patients for the efficiencies of hospital administration, and therefore, the number of patients who must be taken care of in their home is also increasing. Homecare nursing is one of the health care service for the patients at home who require continual attention and care, and now increasing attentions are given to it as one of the professional nursing fields. However, it was almost impossible to find a study on the actual experiences of the homecare nurses written by their own language in Korea, that it also posed a great difficulty in understanding their diverse experience. Considering these situation, this study will help understanding of them, and provide the fundamental data on their experiences for making policies to develop homecare nursing. Methods of Research Phenomenological research method was employed to analyze the lived experiences of homecare nurses fundamentally. Data collection Data were collected from August 1998 to December 1998 from ten homecare nurses who worked for patients under the homecare nursing setting as model cases designated by Seoul Nurses Association and who agreed to the purpose of this study after listening to and understanding the explanation completely. The in-depth interview was carried at the time which was convenient both for the researcher and participants for one or two hours, and recovered with the approval participants. The first interview covered diverse and broad areas like the situation of homecare nursing, and their feelings and thoughts over it, and in the second and third interviews, more specific questions are asked. Data Analysis For the phenomenological analysis, contents analysis was employed. The data collected from the participants were analyzed into the following procedures according to Van Manen 's phenomenological analysis. 1) Reserve the preconception of the researcher by restricting it inside parenthesis. 2) Make a thorough observation of the lived experiences by insight process. 3) Analyze the contents (Find out the repetitive factors) 4) Interpret the essence found. 5) State the meaning of the interpretation. Results and discussion 1. Fear and expectation for the first visit. (unfamiliarity, awkwardness, anxiety, shivering) 2. Mingle with the family (feeling friendly with the family, becoming like a family member) 3. Being proud of her own know-how (learning the know-how, organizing alternatives, building up confidence) 4. Pity for the poor. (criticizing the current government, feeling ashamed, feeling anger) 5. Difficulty of constructing cooperative system with physicians (strenuousness, frustration) 6. Helplessness due to the lack of support system (difficulty to get supplies, annoyance, embarrassment by institutional restraints) 7. Anxiousness for heavy traffic and parking (annoyance, hastiness) 8. Ethical conflicts (pity for the patients and family, skepticism about lengthening life maintenance) 9. Burden for the possible accident (pressure, anxiety, conflict, physical exhaustion) 10. Establishment of identity as a professional (fulfillment, worth, joy) 11. Being distressed at other's ignorance

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A Study on the Perceived Stress Level of Mothers in the Neonatal Intensive Care Unit Patients (신생아 중환자실에 입원한 환아 어머니의 스트레스)

  • Kim Tae Im
    • Child Health Nursing Research
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    • v.6 no.2
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    • pp.224-239
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    • 2000
  • This descriptive study was conducted to understand the contents and degree of parental stress level in the NICU patients, and to give a baseline data in developing nursing intervention program. Subjects were the 62 mother of hospitalized newborn in NICU of 1 University Hospital in Taejon City from May 1st, 1999 to November 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales : NICU(PSS:NICU) developed by Miles et al. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior(19 items), parental role alteration and relationship with their baby(10 items), communication with health team(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from (1) to (5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's α coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers was slightly high(3.6±.7). The highest scored dimension was 'appearance and behavior of the baby'(3.9±1.5), and next were 'relationship with their baby and parental role change'(3.5±1.4), 'communication with health team'(3.4±.9), 'sight and sounds of NICU'(3.2±.8). 2. Two variables were statistically significant with PSS:NICU total scale ; mother's perceived severity of the baby's condition (r=.482, P=.002) and mother's religious attendance(t=2.83, P=.01). The more the mother perceive their baby's condition severe, the higher the total stress score. There were high stress score noted in the mother of no religious attendance. 3. Four variables were statistically significant with NICU environment subscale ; mother's educational background(F=3.45, P=.04), religious attendance(t=2.28, P=.04), sex of the baby(t=2.83, P=.01) and NICU patients' hospital day(r=.359, P=.004). That is mother with high educational background and girl baby were high NICU environment subscale score. 4. Four variables were statistically significant with appearance and behavior of the baby subscale ; when first saw baby(F=3.52, P=.04), incubator care(t=2.83, P=.01), mother's perceived severity of the baby's condition(r=.303, P=.017), number of NICU visit(r=.441, P=.002). That is, seeing the baby first in the NICU and recieved incubator care was very stressful. Also, the more the mother perceive their baby's condition severe and more NICU visit, the higher the appearance and behavior of the baby subscale stress score. 5. Four variables were statistically significant with relationship with their baby and parental role change subscale ; when first saw baby(F=3.37, P=.04), sex of the baby(t=2.36, P=.03), incubator care(t=5.60, P=.00), mother's perceived severity of the baby's condition(r=.401, P=.001). That is, seeing the baby first in the NICU and girl baby was very stressful. Also, the more the mother perceive their baby's condition severe, the higher the relationship with their baby and parental role change subscale stress score. 6. Three variables were statistically significant with communication with health team subscale ; mother's educational background (F=3.63, P=.04), incubator care(t=4.24, P=.00), gestational age(r=-.394, P=.047), and birth weight(r=-.460, P=.004). That is, mother with high educational background and receiving incubator care were high communication with health team subscale score. Also, the shorter the gestational age and smaller the baby's birth weight, the higher the communication with health team subscale score. In conclusion, information about physical environment of NICU, the mother's perceived severity of baby's illness state, maternal role change related variables and the knowledge of characteristics of NICU patients must be included in nursing intervention program of mother's of NICU patients in reducing the maternal stress and anxiety level.

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The Effects of Foot Reflex Zone Massage on Patients Pain and Sleep Satisfaction Following Mastectomy (발반사 마사지가 유방암 환자의 수술 후 통증과 수면만족도에 미치는 효과)

  • Park, Ji-Won;Yoo, Hye-Ra;Lee, Hong-Suk
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.13 no.1
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    • pp.54-60
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    • 2006
  • This study, a quasi-experimental study using a nonequivalent control group pretest-posttest design. conducted a survey on 30 patients test group and control group of IS patients sampling an adjacent population at random - who are operated on the breast cancer and are in the A University Hospital located in Suwon, to examine into the effects of foot reflex zone massage on their pain and sleep satisfaction through the nursing interventions. It gave them a foot reflex zone massage for the total 30 minutes-basic massage 10 minutes and reflex massage 20 minutes required to alleviate their pain day in day out covering a two-month period from the first of July to the first of September 2004. for the purpose of collecting data. It launched into a two-round foot reflex zone massage at 6 and 24 hours since mastectomy through a direct visit at the hospital room to measure pain intensity, physiological index(pulse and blood pressure) and sleep satisfaction of them. The results are as follows. First, it showed that there is all the difference between pain intensity of test group and that of control group. In result, the first hypothesis, pain of test group. which measure at 6(p=.000) and 24 hours(p=.001) since mastectomies, will be bigger than that of control group, was established. Second, it showed that there is all the difference between physiological index of test group and that of control group. In result. the second hypothesis, pulse(p= .025, p= .002), systolic blood pressure(p= .004, p=.012) and diastolic blood pressure(p=.004. p= .003) of test group, which investigate at 6 and 24 hours since mastectomies, will be bigger than that of control group, was established. Third, it showed that there is a significant difference between sleep satisfaction of test group and that of control group(p=.000). In result, the fourth hypothesis, sleep satisfaction of test group. which examine in the morning after mastectomies, will be bigger than that of control group, was established. In the result. a foot reflex zone massage is seen to be effective in the pain reduction and sleep promotion of patients who are operated on breast cancer, and in providing them with more qualitative care by improving confidence between them and nurses through a physical touch. Also, it can be applied to a clinical examination through an independent nursing intervention.

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The Prevalence of Chronic Degenerative Disease and Utilization of Medical Facility in Rural Population (농촌지역(農村地域) 주민(住民)의 만성퇴행성질환(慢性退行性疾患) 유병률(有病率) 및 이용의료기관(利用醫療機關))

  • Ann, Kil-Soo;Chun, Byung-Yeol;Yeh, Min-Hae
    • Journal of agricultural medicine and community health
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    • v.21 no.2
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    • pp.209-220
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    • 1996
  • This study was performed to investigate the prevalence of chronic disease and utilization of medical facility in rural area. 5,797 persons were randomly selected from 28,883 rural residents who were over 30 years old and living in Moonkyung city in Kyungsangpook Province during the period October 1 1983 to February 28 1994. The person prevalence rate was 336 per 1,000. The prevalence rate in men(278 per 1,000) was higher than that(388 per 1,000) in women. The spell prevalence rate in men(367) was significantly higher than that(429) in women (p<0.05). The prevalence was increased with the age, 106 in the 30's. 223 in the40's, 336 in the 50's, 407 in the 60's, and 457 in the age group of 70 above. Of all chronic diseases, the prevalence of neuralgia ranked first(128), chronic gastrointestinal disorders(64), degenerative arthritis(54). hypertension (44) and diabetes (14) were followed in descending order. In men, the prevalence of neuralgia ranked first, chronic gastrointestinal disorders, degenerative arthritis, hypertension and bronchial asthma were followed in descending order. In women, the prevalence of neuralgia ranked first, degenerative arthritis, chronic gastrointestinal disorders, hypertension and diabetes were followed in descending order. The prevalences of neuralgia, degenerative arthritis and hypertension were significantly higher in women than those in men, however, those of cardiovascular disease, pulmonary tuberculosis and liver cirrhosis in men were significantly higher than those in women(p<0.05). Most patients with chronic diseases were more likely to utilize hospital and/or local clinics than public health facility or community health providers. Patients with neuralgia, degenerative arthritis and bronchial asthma tended to utilizing local clinics initially, however, they were changed to visit public health facility or community health providers afterwards. Patients with hypertension or pulmonary tuberculosis were more likely to visit public health facility, however, those with diabetes, cancer, heart failure, CVD, liver cirrhosis were more likely to visit hospital.

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Estimating the Economic Burden of Osteoporotic Vertebral Fracture among Elderly Korean Women (우리나라 노인여성의 골다공증성 척추골절로 인한 경제적 부담 추계)

  • Kang, Hye-Young;Kang, Dae-Ryong;Jang, Young-Hwa;Park, Sung-Eun;Choi, Won-Jung;Moon, Seong-Hwan;Yang, Kyu-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.287-294
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    • 2008
  • Objectives : To estimate the economic burden of osteoporotic vertebral fracture (VF) from a societal perspective. Methods : From 2002 to 2004, we identified all National Health Insurance claims records for women ${\geq}50$ years old with a diagnosis of VF. The first 6-months was defined as a "clearance period," such that patients were considered as incident cases if their first claim of fracture was recorded after June 30, 2002. We only included patients with ${\geq}$ one claim of a diagnosis of, or prescription for, osteoporosis over 3 years. For each patient, we cumulated the claims amount for the first visit and for the follow-up treatments for 1 year. The hospital charge data from 4 hospitals were investigated to measure the proportion of the non-covered services. Face-to-face interviews were conducted with 106 patients from the 4 study sites to measure the out-of-pocket spending outside of hospitals. Results : During 2.5 years, 131,453 VF patients were identified. The patients had an average of 3.38 visits, 0.40 admissions and 6.36 inpatient days. The per capita cost was 1,909,690 Won: 71.5% for direct medical costs, 20.6% for direct non-medical costs and 7.9% for indirect costs. The per capita cost increased with increasing age: 1,848,078 Won for those aged 50-64, 2,084,846 Won for 65-74, 2,129,530 Won for 75-84and 2,121,492 Won for those above 84. Conclusions : Exploring the economic burden of osteoporotic VF is expected to motivate to adopt effective treatment options for osteoporosis in order to prevent the incidence of fracture and the consequent costs.

A STUDY ON THE CHARACTERISTICS OF SEDATED PEDIATRIC DENTAL PATIENTS AND THEIR PARENTS VISITING KANGNUNG NATIONAL UNIVERSITY DENTAL HOSPITAL (강릉대학교치과병원 소아치과에 내원한 진정치료환아와 보호자의 특성에 대한 연구)

  • Kim, Ji-Hun;Seo, Hyun-Woo;Park, Ho-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.3
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    • pp.459-473
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    • 2004
  • Recently, many children have been treated under sedation in the department of pediatric dentistry of the dental hospital of Kangnung National University, and sedation cases are increasing gradually. So, in this study. the author analyzed and studied about the characteristics of sedated pediatric dental patients and their parents with patient chart and questionnaire at first visit, from 1999 to 2002 for the purpose of making pediatric dental treatment plan more effective and the improvement of behavior management for better pediatric dentistry. The results were follows : 1. The number of total pediatric and sedative patients increased from 1999 to 2002. 2. The sedated pediatric dental patients were younger than total pediatric dental patients(p<0.001). 3. In visit frequency per month, the sedated patients showed higher percentage on March, July, November contrast to non-sedated patients(p<0.001). 4. In parental occupation, there was a significant difference between sedated patients and non-sedated patients(p<0.001). 5. Caries treatment rather than preventive care or orthodontic treatment, was primarily composed of chief complaint of sedated patients(p<0.001). 6. The sedated patients showed worse response to previous treatment than non-sedated patients, and their parents also expected worse response contrast to non-sedated patients (p>0.001). 7. The patients who were introduced, occupied 31.2% of sedated pediatric dental patients and referral by the dentist were composed of the highest percentage(58.3%). 8. In case of uncooperative child at conventional behavior management, the parents of sedated pediatric dental patients prefered to sedation(50.9%). while the parents of non-sedated patients prefered to physical restraint(54.6%) (p<0.001).

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Effect of Scolopendrid Pharmacupuncture Therapy on Frozen Shoulder Patients (동결견(凍結肩) 환자의 오공약침(蜈蚣藥鍼) 치료에 대한 임상적 고찰)

  • Kim, Do-Ho;Kim, Hyun-Wook;Lee, Geon-Hui;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.26 no.1
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    • pp.1-14
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    • 2009
  • Objectives : The purpose of this research was to study the effect of Scolopendrid Pharmacopuncture on frozen shoulder patients. Methods : All of the 46 frozen shoulder patients who visited the department of Acupuncture & Moxibustion in Wonkwang Sanbon Medical Center from 1st March 2007 to 30th August 2008 had taken either the Scolopendrid Pharmacopuncture therapy or acupuncture therapy 10 times. There are 23 patients in each group. We evaluated the improvement of their shoulder pain and disability using the Visual Analog Scale(VAS), Shoulder Pain And Diability Index(SPADI), Range of Motion(ROM), and the Apley Scratch test at their first and last visit. Then we analyzed and compared the improvement shown by the two groups. Results : 1. Measures on all tests for the acupuncture group showed statistically significant improvement. 2. Measures on all tests for Scolopendrid Pharmacopuncture showed statistically significant improvement. 3. The Scolopendrid Pharmacopuncture group's VAS and ROM(external, internal rotation) showed statistically significant difference compared with those of the acupuncture group. SPADI, ROM(flexion, extension, abduction, adduction) and Apley scratch test had no statistically significant difference between the two groups. Conclusions : The above results show that Scolopendrid Pharmacopuncture therapy can be used as an effective treatment for reducing frozen shoulder pain.

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Basic Dental Health Survey on Cleft Lip and Palate Patients at Early Mixed Dentition and Early Permanent Dentition Period (초기혼합치열기, 초기영구치열기 구순, 구개열 아동의 기초치아건강실태에 관한 조사 연구)

  • Son Woo Sung;Jeon Jae Ho;Kim Jin Bom
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.2
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    • pp.69-89
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    • 2003
  • The purpose of this study was to examine and analyze the basic conditions of dental health of cleft lip and palate patients at early mixed dentition (7-year-old, experimental group A) and early permanent dentition period (12,13-year old, experimental group B) and compare them with those of normal children. The sample was consisted of 25 patients at the age of 7 years, 15 at the age of 12 years and 5 at the age of 13 years. Two trained dentists examined orthopantomographs and clinical photos at the first visit of each patient and distinguished the states by teeth and dental surface and filled them on the prescribed forms. DMF rate, DMF index, FT rate, mean number of permanent teeth with fissure sealants, DMFS index and mean percentage of caries experienced maxillary anterior 6 teeth by tooth type are calculated and compared to those of other studies examined normal children. Oral hygiene of experimental groups is poorer than control groups'. Preventive and treatment rate of experimental groups' are lower than control groups'. More concem and effort are needed about prevention and treatment of dental caries of cleft lip and palate patients.

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The Effect of Individual Education for Hypertensives at Home on Knowledge of Hypertension, Attitude about Chronic Disease, Self-care Management And Blood Pressue. (개별접촉 교육이 고혈압 환자의 지식$\cdot$태도와 자기건강관리 이행 및 혈압 변화에 미치는 영향)

  • Kim Myung Soon;Yang Young Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.2
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    • pp.52-68
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    • 1995
  • This is the quasi experimental study to evaluate the effect of individual health education for hypertensive patients at home on knowledge of hypertesnion, attitude about chronic disease, self-care management. The individual health education program was performed at each patient's home every one month through, 1 years. The first data collection was carried out in May 1991. and the last was done in July 1992 through questionaires. The study results were as follows; 1) The subjects were 22 hypertensive patients who agreed the participation of study among registered patients at a public health center in Incheon. They were consisted of thirteen males and nine females. And their duration of illness were average 5 years, their mean age were 65 years. The over all living conditions were poor and the average monthly income was 50 thousdand won. 2) The effect of individual health education through home visit was statistically significant. The Knowledge of hypertension (t= -4.40, p<.001), attitude about chronic disease (t=­2.65, p<.05), self-care management of the subjects were significantly improved. (t=-3.76, p<.001), and their blood pressure were decreased. 3) Between the knowledge of hypertesnion and the attitude about chronic disease showed significant positive relationship. But the self-care management had not relationship with these two factors. unexpectedly. 4) The knowledge of hypertension, attitude about chronic disease, and self-care management had not evenly influenced the control of hypertension. These results suggested that the effort needed to find out the other factors influencing self-care management and develop the self-care management measuring tool. And the health education programs for chronic patients were developed, systematically. And the standardized health education model was developed for home health care nursing intervention in community based.

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Follow-Up Consultations for Cervical Cancer Patients in a Mexican Cancer Center. Comparison with NCCN Guidelines

  • Serrano-Olvera, Alberto;Cetina, Lucely;Coronel, Jaime;Duenas-Gonzalez, Alfonso
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8749-8752
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    • 2014
  • Purpose: This study aimed to determine the patterns of follow-up visits for cervix cancer in a national cancer center in Mexico. Materials and Methods: The National Cancer Institute of Mexico is cancer center with 119 beds that mostly cares for an underserved and socially disadvantaged population. The medical records of cases of cervical cancer that had at least one year of clinical follow-up after being in complete response at the end of primary treatment were analyzed. We recorded the numbers of total and yearly follow-up visits and these were compared with the number of follow-up visits recommended by the National Comprehensive Cancer Network 2013, version 2 for cervical cancer. Results: Between March and June 2007, the medical records of 96 consecutive patients were reviewed. Twenty (21%) of these met inclusion criteria and were selected. In the first year the median number of visits was 11 (4-20). In the ensuing years, $2^{nd}$, $3^{rd}$, $4^{th}$ and $5^{th}$, the number of analyzed patients remaining in follow-up decreased to 17, 14, 13 and 9 respectively. There were 462 follow-up visits to primary treating services (Gynecology Oncology, Radiation Oncology and Medical Oncology) as compared to 220 suggested by the NCCN guidelines ($X^2$ test p<0.0001). There were 150 additional visits to other services. Conclusions: Our results suggest that in our institution there is an overuse of oncological services by cervical cancer patients once treatment is completed.