• Title/Summary/Keyword: Frequent pattern

Search Result 612, Processing Time 0.024 seconds

Multidetector CT Characteristics of Fumarate Hydratase-Deficient Renal Cell Carcinoma and Papillary Type II Renal Cell Carcinoma

  • Ling Yang;Xue-Ming Li;Ya-Jun Hu;Meng-Ni Zhang;Jin Yao;Bin Song
    • Korean Journal of Radiology
    • /
    • v.22 no.12
    • /
    • pp.1996-2005
    • /
    • 2021
  • Objective: To investigate the multidetector computed tomography (MDCT) features of fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) with germline or somatic mutations, and compare them with those of papillary type II RCC (pRCC type II). Materials and Methods: A total of 24 patients (mean ± standard deviation, 40.4 ± 14.7 years) with pathologically confirmed FH-deficient RCC (15 with germline and 9 with somatic mutations) and 54 patients (58.6 ± 12.6 years) with pRCC type II were enrolled. The MDCT features were retrospectively reviewed and compared between the two entities and mutation subgroups, and were correlated with the clinicopathological findings. Results: All the lesions were unilateral and single. Compared with pRCC type II, FH-deficient RCC was more prevalent among younger patients (40.4 ± 14.7 vs. 58.6 ± 12.6, p < 0.001) and tended to be larger (8.1 ± 4.1 vs. 5.4 ± 3.2, p = 0.002). Cystic solid patterns were more common in FH-deficient RCC (20/24 vs. 16/54, p < 0.001), with 16 of the 20 (80.0%) cystic solid tumors having showed typical polycystic and thin smooth walls and/or septa, with an eccentric solid component. Lymph node (16/24 vs. 16/54, p = 0.003) and distant (11/24 vs. 3/54, p < 0.001) metastases were more frequent in FH-deficient RCC. FH-deficient RCC and pRCC type II showed similar attenuation in the unenhanced phase. The attenuation in the corticomedullary phase (CMP) (76.3% ± 25.0% vs. 60.2 ± 23.6, p = 0.008) and nephrographic phase (NP) (87.7 ± 20.5, vs. 71.2 ± 23.9, p = 0.004), absolute enhancement in CMP (39.0 ± 24.8 vs. 27.1 ± 22.7, p = 0.001) and NP (50.5 ± 20.5 vs. 38.2 ± 21.9, p = 0.001), and relative enhancement ratio to the renal cortex in CMP (0.35 ± 0.26 vs. 0.24 ± 0.19, p = 0.001) and NP (0.43 ± 0.24 vs. 0.29 ± 0.19, p < 0.001) were significantly higher in FH-deficient RCC. No significant difference was found between the FH germline and somatic mutation subgroups in any of the parameters. Conclusion: The MDCT features of FH-deficient RCC were different from those of pRCC type II, whereas there was no statistical difference between the germline and somatic mutation subgroups. A kidney mass with a cystic solid pattern and metastatic tendency, especially in young patients, should be considered for FH-deficient RCC.

A Study on Decision Rules for Qi·Blood·Yin·Yang Deficiency Pathogenic Factor Based on Clinical Data of Diagnosis System of Oriental Medicine (한방진단설문지 임상자료에 근거한 기혈음양 허증병기 의사결정규칙 연구)

  • Soo Hyung Jeon;In Seon Lee;Gyoo yong Chi;Jong Won Kim;Chang Wan Kang;Yong Tae Lee
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.37 no.6
    • /
    • pp.172-177
    • /
    • 2023
  • In order to deduce the pathogenic factor(PF) diagnosis logic of underlying in pattern identification of Korean medicine, 2,072 cases of DSOM(Diagnosis System of Oriental Medicine) data from May 2005 to April 2022 were collected and analyzed by means of decision tree model(DTM). The entire data were divided into training data and validation data at a ratio of 7:3. The CHAID algorithm was used for analysis of DTM, and then validity was tested by applying the validation data. The decision rules of items and pathways determined from the diagnosis data of Qi Deficiency, Blood Deficiency, Yin Deficiency and Yang Deficiency Pathogenic Factor of DSOM were as follows. Qi Deficiency PF had 7 decision rules and used 5 questions: Q124, Q116a, Q119, Q119a, Q55. The primary indicators(PI) were 'lack of energy' and 'weary of talking'. Blood deficiency PF had 7 decision rules and used 6 questions: Q113, Q84, Q85, Q114, Q129, Q130. The PI were 'numbness in the limbs', 'dizziness when standing up', and 'frequent cramps'. Yin deficiency PF had 3 decision rules and used 2 questions: Q144 and Q56. The PI were 'subjective heat sensation from the afternoon to night' and 'heat sensation in the limbs'. Yang deficiency PF had 3 decision rules and used 3 questions: Q55, Q10, and Q102. The PI were 'sweating even with small movements' and 'lack of energy'. Conclusively, these rules and symptom information to decide the Qi·Blood·Yin·Yang Deficiency PF would be helpful for Korean medicine diagnostics.

Comparison of Molecular Characterization and Antimicrobial Resistance in Carbapenem-Resistant Klebsiella pneumoniae ST307 and Non-ST307 (Carbapenem 내성 Klebsiella pneumoniae ST307과 Non-ST307의 분자 특성 및 항균제 내성 비교)

  • Hye Hyun Cho
    • Microbiology and Biotechnology Letters
    • /
    • v.51 no.4
    • /
    • pp.500-506
    • /
    • 2023
  • Carbapenem-resistant Klebsiella pneumoniae (CRKP) is emerging as a worldwide public health threat. Recently, Klebsiella pneumoniae carbapenemase-2 (KPC-2)-producing sequence type (ST) 307 was identified main clone of CRKP, and dissemination of ST307 was reported in South Korea. This study examined the molecular characteristic and antimicrobial resistance pattern of 50 CRKP isolated from a tertiary hospital in Daejeon, from March 2020 to December 2021. Epidemiological relationship was analyzed by Multilocus sequence typing (MLST) and antimicrobial susceptibility test was determined using disk-diffusion method. PCR and DNA sequence analysis were performed to identify carbapenemase genes. CRKP infections were significantly more frequent in males and the patients aged ≥ 60 years. Among the 50 CRKP isolates, 46 isolates (92.0%) were multidrug-resistant (MDR), and 44 isolates (88.0%) were carbapenemase-producing K. pneumoniae (CPKP). The major carbapenemase type was KPC-2 (36 isolates, 72.0%) and New Delhi metalloenzyme-1 (NDM-1) and NDM-5 were identified in 7 isolates (14.0%) and 1 isolate (2.0%), respectively. In particular, 88.9% (32/36) of KPC-2-producing K. pneumoniae belonged to ST307, whereas 87.5% (7/8) of NDM-1,-5-producing K. pneumoniae belonged to non-ST307. These results suggest that proper infection control and effective surveillance network need to prevent not olny the spread of ST307, but also the development of non-ST307.

Effect of Arctic Oscillation and Sea Surface Temperature on Cold Surges over the Korean Peninsula (북극진동과 해수면온도가 한반도 한파에 미치는 영향)

  • Sang-Hyun An;Da-Huin Chong;Sung-Min Yeo;El Noh;Joowan Kim
    • The Korean Journal of Quaternary Research
    • /
    • v.33 no.1_2
    • /
    • pp.37-48
    • /
    • 2021
  • The cold surge is an important extreme weather in East Asia during winter, and is largely affected by behavior of the Siberian high Arctic Oscillation, which represents undulation of large-scale pressure pattern in the Arctic region. Recent studies also revealed that the synoptic low pressure system developing in the eastern boundary of the Asian continent is sensitive to sea surface temperature (SST) and plays an important role in strengthening the cold advection over the Korean Peninsula during cold surges. In this study, we analyzed the Arctic Oscillation affecting the large-scale background of cold surge in East Asia, and the sea surface temperature in the coast of East Asia is examined focusing on its role on synoptic low-inducing cold advection. For the analysis, the days with the bottom 3% of the average daily temperature, measured at five surface stations in Korean Peninsula during 49 years (1969/70-2017/18), were used for the cold surge cases. During the negative phase of the Arctic Oscillation, a strong trough is observed over East Asia, and the inflow of cold air from the polar region is strengthened, which lead to frequent cold surges. In addition, anomalously high SST in the eastern coast of Asia increases sensible and latent heat release from the ocean, therefore, it enlarges the likelihood of synoptic low-inducing extreme cold surges.

Effect of Breed (Lean or Fat Pigs) and Sex on Performance and Feeding Behaviour of Group Housed Growing Pigs in a Tropical Climate

  • Renaudeau, D.;Giorgi, M.;Silou, F.;Weisbecker, J.L.
    • Asian-Australasian Journal of Animal Sciences
    • /
    • v.19 no.4
    • /
    • pp.593-600
    • /
    • 2006
  • The effects of breed and sex on individual growth performance and feeding behaviour were studied between 45 and 90 kg BW in two replicates of forty group-housed pigs. The first and the second replicates were carried out during the warm season (i.e. between February and April 2003) and during the hot season (i.e. between August and October 2003), respectively. During the warm season, ambient temperature and relative humidity averaged $25.3^{\circ}C$ and 86.0%. The corresponding values for the hot season were $27.9^{\circ}C$ and 83.6%. The pigs were grouped in pens of 10 animals on the basis of breed (Creole or Large White) and sex (gilt or castrated male) and given ad libitum access to a grower diet (9.0 MJ/kg net energy and 158 g/kg crude protein) via feed intake recording equipment (Acema 48). An ear-tag transponder was inserted into each pig and this allowed the time, duration, and size of individual visits to be recorded. The growth performance and feeding pattern were significantly affected by breed, sex, and season. The Creole pigs (CR) had a lower average daily gain (ADG) (642 vs. 861 g/d, p<0.01) and carcass lean content ($LC_{90kg}$) (35.4 vs. 54.5%; p<0.01) and a higher backfat thickness at 90 kg BW ($BT_{90kg}$) (23.4 vs. 10.4 mm; p<0.01) than Large White pigs (LW) whereas the average daily feed intake (ADFI) was not affected by breed (2.34 vs. 2.22 kg/d, respectively for CR and LW pigs; p>0.10). Consequently, the food:gain ratio was higher in CR than in LW (3.65 vs. 2.58; p<0.01). CR had less frequent meals but ate more feed per meal than LW (5.9 vs. 8.8 meals/d and 431 vs. 279 g/meal; p<0.01). The rate of feed intake was lower (27.6 vs. 33.9 g/min; p<0.01) and the ingestion time per day and per meal were higher in CR than in LW (87.1 vs. 69.7 min/d and 15.8 vs. 8.4 min/meal; p<0.01). The ADFI and BT90 kg were higher (2.38 vs. 2.17 kg/d and 18.1 vs. 15.9 mm; p<0.05) and LC90 kg was lower (43.5 vs. 46.4%; p<0.01) in castrated males (CM) than in gilts (G) whereas ADG was not affected by sex (p = 0.12). The difference in lean content between CM and G was greater in CR than in LW. The ADFI and ADG were reduced during the hot season (2.18 vs.2.38 kg/d and 726 vs. 777 g/d, respectively; p<0.05) whereas feed conversion and carcass lean content were not affected by season (p>0.05). Average feeding time per meal and meal size decreased during the hot season (10.9 vs. 13.2 min/meal and 316 vs. 396 g/meal; p<0.01) whereas the rate of feed intake was not affected by season (p = 0.83). On average, 0.69 of total feed intake was consumed during the diurnal period. However, this partition of feed intake was significantly affected by breed, sex, and season. In conclusion, the breed, sex and season significantly affect performance and feeding pattern in growing pigs raised in a tropical climate. Moreover, the results obtained in the present study suggest that differences observed in BW composition between CR and LW are associated with difference in feeding behaviour, in particular, the short-term regulation of feed intake.

A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal- (퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로)

  • Choi, Yun Soon;Kim, Dai Hyun;Storey, Margaret;Kim, Cho Ja;Kang, Kyu Sook
    • The Korean Nurse
    • /
    • v.31 no.4
    • /
    • pp.77-99
    • /
    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

  • PDF

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
    • /
    • v.3
    • /
    • pp.53-66
    • /
    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

  • PDF

The Utilization Pattern of a Rural Health Subcenter among Suburban Farmhouse Members (일 도시근교 농가구원의 보건지소 이용양상)

  • Sohn, Seok-Joon;Kwon, Sun-Seok;Kim, Sang-Won;Byun, Ju-Nam;Nam, Hae-Sung;Son, Myung-Ho
    • Journal of agricultural medicine and community health
    • /
    • v.24 no.1
    • /
    • pp.65-77
    • /
    • 1999
  • In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the farmhouse members in a suburban area, a questionnaire survey was carried out for objects of 696 population. The results observed were as follows: The annual utilization rate of rural health subcenter for a basic health service unit was 25.0 per 100 persons, and annual mean visiting times was 0.22 times. And the most frequent disease by annual health subcenter utilization illness was musculoskeletal disease(30.6%), and the next was respiratory disease(14.1%), gastrointestinal disease(13.9%) by order. Favorite reason for community health subcenter utilization were near distance from living place(49.6%), lower disease severity(18.9%) and lower medical cost(18.1%) by order. But disfavoring reasons for it were absence of specialist(20.2%), non effective treatment(19.2%) and insufficient equipment(14.7%) by order. And insufficient items about community health subcenter utilization were restriction of treatment limit(40.7%), lower reliance(22.5%) and difficulty in traffic(13.4%) by order. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization was educational level. The desirable works for the health subcenter in a suburban area were disease control of elderly and disease preventing service. These results suggested that to increase the utilization of rural health subcenter in a suburban area and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, improvement of medical quality and change of priority about health subcenter's works.

  • PDF

Effect of Market Basket Size on the Accuracy of Association Rule Measures (장바구니 크기가 연관규칙 척도의 정확성에 미치는 영향)

  • Kim, Nam-Gyu
    • Asia pacific journal of information systems
    • /
    • v.18 no.2
    • /
    • pp.95-114
    • /
    • 2008
  • Recent interests in data mining result from the expansion of the amount of business data and the growing business needs for extracting valuable knowledge from the data and then utilizing it for decision making process. In particular, recent advances in association rule mining techniques enable us to acquire knowledge concerning sales patterns among individual items from the voluminous transactional data. Certainly, one of the major purposes of association rule mining is to utilize acquired knowledge in providing marketing strategies such as cross-selling, sales promotion, and shelf-space allocation. In spite of the potential applicability of association rule mining, unfortunately, it is not often the case that the marketing mix acquired from data mining leads to the realized profit. The main difficulty of mining-based profit realization can be found in the fact that tremendous numbers of patterns are discovered by the association rule mining. Due to the many patterns, data mining experts should perform additional mining of the results of initial mining in order to extract only actionable and profitable knowledge, which exhausts much time and costs. In the literature, a number of interestingness measures have been devised for estimating discovered patterns. Most of the measures can be directly calculated from what is known as a contingency table, which summarizes the sales frequencies of exclusive items or itemsets. A contingency table can provide brief insights into the relationship between two or more itemsets of concern. However, it is important to note that some useful information concerning sales transactions may be lost when a contingency table is constructed. For instance, information regarding the size of each market basket(i.e., the number of items in each transaction) cannot be described in a contingency table. It is natural that a larger basket has a tendency to consist of more sales patterns. Therefore, if two itemsets are sold together in a very large basket, it can be expected that the basket contains two or more patterns and that the two itemsets belong to mutually different patterns. Therefore, we should classify frequent itemset into two categories, inter-pattern co-occurrence and intra-pattern co-occurrence, and investigate the effect of the market basket size on the two categories. This notion implies that any interestingness measures for association rules should consider not only the total frequency of target itemsets but also the size of each basket. There have been many attempts on analyzing various interestingness measures in the literature. Most of them have conducted qualitative comparison among various measures. The studies proposed desirable properties of interestingness measures and then surveyed how many properties are obeyed by each measure. However, relatively few attentions have been made on evaluating how well the patterns discovered by each measure are regarded to be valuable in the real world. In this paper, attempts are made to propose two notions regarding association rule measures. First, a quantitative criterion for estimating accuracy of association rule measures is presented. According to this criterion, a measure can be considered to be accurate if it assigns high scores to meaningful patterns that actually exist and low scores to arbitrary patterns that co-occur by coincidence. Next, complementary measures are presented to improve the accuracy of traditional association rule measures. By adopting the factor of market basket size, the devised measures attempt to discriminate the co-occurrence of itemsets in a small basket from another co-occurrence in a large basket. Intensive computer simulations under various workloads were performed in order to analyze the accuracy of various interestingness measures including traditional measures and the proposed measures.

A Study Analyzing Nursing Diagnoses and Nursing Interventions used in a Demonstration Home Care Project (가정간호 시범사업 간호진단 및 간호중재 분석 연구)

  • Suh, Mi-Hae;Lee, Hae-Won;Chun, Choon-Young
    • The Korean Nurse
    • /
    • v.34 no.5
    • /
    • pp.52-67
    • /
    • 1996
  • As home care in developing and becoming part of the health care delivery system in Korea, it is necessary to examine the use of nursing diagnoses and related nursing interventions with a view to increasing the standardization of nursing recording. This study was done to examine the nursing diagnosis and related nursing interventions used in home care. Data were collected using a chart review of the nursing notes written for the home care given to 38 patients who had pulmonary diseases or traumatic brain or spinal cord injuries and who had received home care as part of a demonstration home care project in a college of Nursing in Seoul. Early on in the project discussions as to format and use to nursing diagnosis was done and a tool was developed based on Gordon's eleven functional catergories with the addition of categories to cover family and environment. This tool was used in the data collection. Data included nursing diagnosis, etiologies and interventions. Real numbers and percentages were used in the analysis. The results show that the most frequently used diagnoses were in the category of physical function (75.6%), followed by the category of emotional and social function (21.8%). The least frequently used category was the one for family and environment (2.6%). The order of the frequency of recorded nursing interventions was the same, 82.3% for physical function, 16.2% of emotional and social function and 1.5% for family and environment. Under the category of physical functioning the most frequently used nursing diagnoses were related to mobility (62.2%), nutrition (23.6%) and elimination (11.9%). The frequencies of nursing interventions for these three diagnostic categories were 69.8%, 16.0% and 10.8% respectively. For emotional and social functioning, the most frequently used diagnoses were for cognition-perception (37.1%), self-perception (30.6%) and perception of health (23.7%). The ordering of the frequency of nursing interventions varied slightly. The most frequently used interventions were for the category of self-perception (31.7%) followed by cognition-perception (24.1%) and perception of health (22.9%). Looking at individual diagnoses, it was found that within the categroy of physical functioning, the most frequently used diagnosis was "impaired physical mobility" (29.5%) and this diagnosis involved 43.9% of the interventions. This was followed by "ineffective breathing pattern" (19.4%) with 17.7% of interventions, and "alteration in nutrition, less than body requirements" (11.2%) with 8.1% of the interventions. For the emotional social category, noncompliance was the most frequently used nursing diagnosis (18.2%) with 19.2% of the interventions. This was followed by "anxiety" (13.4%) with 13.6% of the interventions and by "knowledge deficit" (13.4%) but with only 5.5% of the interventions. The other diagnoses and interventions did not follow this pattern of frequency. Although there were a large number of diagnostic and intervention events, the number of actual diagnoses and interventions used were relatively small ranging from six interventions for "knowledge deficit" to 40 interventions for "imparied physical mobility". From this it can be concluded that the results of this study could be used as basic data for the development of standardized charts with respect to nursing diagnosis and interventions for clients with pulmonary disease and clients with traumatic brain or spinal cord injuries. Interventions that were direct care activities (1178) were much more frequent that education (430), and assessment and observation (148). There were also few diagnoses or interventions related to the family and the environment. This suggests two areas that need to be developed in home care and that need to be considered in the development of standardized records for use in home care.

  • PDF