• Title/Summary/Keyword: Group Replacement

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심장판막수술 후 프로트롬빈 INR 모니터링형 자가관리프로그램 개발 및 적용 (Development and Application of a Self-management Program based on Prothrombin INR Monitoring for Patients with Cardiac Valve Replacement)

  • 전현례;박정숙
    • 대한간호학회지
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    • 제45권4호
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    • pp.554-564
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    • 2015
  • Purpose: The purpose of this study was to develop and evaluate a self-management program based on INR monitoring for patients with cardiac valve replacement. Methods: This program was comprised of five weekly sessions based on Sousa's Enhance-Behavior Performance Model. The first session included individual teaching, and the other four sessions included Prothrombin Time International Normalized Ratios (PT INR) self-monitoring, telephone counseling and self-management checklist recording. Participants were patients who had cardiac valve replacement. They were randomly assigned to the experimental or control group. Sixteen in the experimental group participated in the self-management program and seventeen in the control group participated in general care. Self-management knowledge, self-efficacy, self-management behavior and PT INR were measured as dependent variables. Data were analyzed using Mann Whitney U-test, t-test and ANCOVA. Results: The experimental group showed significantly higher post-test scores in self-management knowledge (t=5.86, p<.001), self-efficacy (F=18.32, p<.001), and self-management behavior (t=3.44, p=.002) compared to the control group. Also, the experimental group showed significantly higher frequency in maintaining the treatment range of PT INR compared to the control group (${\chi}^2=4.80$, p=.028). Conclusion: The results of the research on the self-management program based on PT INR monitoring showed that it is effective in improving self-management knowledge, self-efficacy, and self-management behavior as well as maintaining treatment range of PT INR of patients with cardiac valve replacement.

동영상 CD를 이용한 슬관절 전치환술 환자의 재활교육 프로그램이 관절가동범위 및 일상활동 수행에 미치는 효과 (Effects of a Video CD Rehabilitation Program for Total Knee Replacement on Range of Knee Angle and Activities of Daily Living Function)

  • 남문희;이정은
    • 한국의료질향상학회지
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    • 제16권1호
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    • pp.79-89
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    • 2010
  • Background : This study was identified the effects of a video CD Rehabilitation program on the range of knee angle and activities of daily living in patients with a total knee replacement Method : The data was collected from March 1 to May 31 2009 for the control group and from July 1 to September 31 2009 for the experimental group. The control and experimental groups contained 19 subjects each. A video CD Rehabilitation program configured to 8 minutes in length was shown 8 times every other day. Result : 1. On the day of Hemovac removal, the knee angle and CPM angle in the experimental group increased significantly, but they remained relatively constant on post operation day 21. 2. The activities of daily living were significantly different in the experimental group. Conclusion : 1. On the day of Hemovac removal, the knee angle and CPM angle in the experimental group increased significantly, but they remained relatively constant on post operation day 21. 2. The activities of daily living were significantly different in the experimental group.

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슬관절 전치환술 후 조기 슬관절 운동 교육 프로그램이 통증, 슬관절가동범위, 환자만족도에 미치는 영향 (The Effects of an Early Knee Joint Exercise Education Program on Pain, Knee Range of Motion, and Satisfaction in Patients after Undergoing Total Knee Replacement Arthroplasty)

  • 신이슬;이영희
    • 임상간호연구
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    • 제24권3호
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    • pp.283-292
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    • 2018
  • Purpose: This study was conducted to evaluate the effects of early knee joint exercise education program on pain, knee ROM, and satisfaction among patients with a total knee replacement arthroplasty. Methods: An experimental study with non-equivalent groups was conducted using 32 patients for an experimental group and 32 patients for a control group. The experimental group received knee joint exercise education including systemic continuous passive motion (CPM) exercise and knee exercise. The control group received conventional CPM exercise. Pain, flexion and flexion contracture range of motion, and patient satisfaction were evaluated by $x^2$ test, Fisher's exact test, t-test, and repeated measures ANOVA using the SPSS 23.0 Windows program. Results: There were a significant improvement in patients' knee flexion and satisfaction in the experimental group compared to the control group. There was no significant difference in pain and flexion contracture between the two groups. Conclusion: The findings suggest that the proposed education program is efficient and effective when providing nursing care after a total knee replacement arthroplasty.

Receiver DCB Estimation and Analysis by Types of GPS Receiver

  • Choi, Byung-Kyu;Chung, Jong-Kyun;Cho, Jeong-Ho
    • Journal of Astronomy and Space Sciences
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    • 제27권2호
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    • pp.123-128
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    • 2010
  • This paper analyzes that the global positioning system (GPS) receiver differential code bias (DCB) has effect on the estimation the ionosphere total electron content (TEC). The data from nine permanent GPS sites of the Korea Astronomy and Space Science Institute (KASI) were used for the estimation of the receiver DCB before (Trimble 4000 SSi) and after (Trimble NetRS) the receiver replacement, using the singular value decomposition method. The results showed that the estimated mean value of the receiver DCB varied from 0.11 ns (nanosecond) to 7.54 ns before the receiver replacement, but the receiver DCBs shoed large values than 20 ns except some stations after the replacement. The receiver DCB showed a relatively large difference by types of the receivers, and, as a result, it had a great effect on the estimation the ionosphere TEC using GPS.

감염성 심내막염에 대한 외과적치료 (Surgical Treatment of Infective Endocarditis)

  • 왕옥보;박주철
    • Journal of Chest Surgery
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    • 제25권10호
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    • pp.1055-1060
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    • 1992
  • Clinical experience of 21 patients with infective endocarditis was reviewed. Endocarditis involved the left-sided valve in 16 cases, the right-sided valve in 2, and PDA in the remaining 3 patients. Valve abnormalities included leaflet perforation in 9 patients, chordal rupture in 2,; annular abscess in 6; and aorticoleft atnal perforation in 2. Sixteen patients underwent valve replacement[aortic valve replacement in 7 patients, mitral replacement in 4 and double valve replacement in 5], two had VSD closure with pulmonary valve excision, three had ductus arteriousus closure. The patients were classified into two groups. I ] Healed endocarditis group: including the patients who had completed a planned cou-rseof antibiotic therapy[N=10], II ] Active endocarditis group: patients in which operations were performed prior to completetion of antibiotic treatment course[N=11]. The indications for operation included congestive heart failure, embolism, and persistent sepsis. Organisms were predominantly streptococcus[N=5] and staphylococcus [N=4] followed by candida, moraxella, and E-coli. By NYHA functional classification, all patients were in Class III or IV preoperatively. There was only one operative mortality in patient from group II. All patients substantially, improved postoperatively with NYHA classification in class I or II. This study shows that early surgical intervention in patients with active endocarditis has desirable outcome.

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자궁절제술 후 호르몬 대치요법을 받는 여성의 성 역할정체성과 삶의 질 (Gender Role Identity and Quality of life of Hysterectomy Women Receiving Hormone Replacement Therapy)

  • 이현주;박형숙;김남희
    • 여성건강간호학회지
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    • 제15권4호
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    • pp.320-327
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    • 2009
  • Purpose: The purpose of this study was to investigate the degree of the gender role identity and quality of life of women applying hormone replacement therapy with hysterectomy and to identify the relation among these variables. Methods: The subjects were 121 outpatients applying hormone replacement therapy with hysterectomy at a university hospital in Busan province. The data were collected using self-reported questionnaire and medical record, from September to October 2008. Results: There were statistically significant differences in the degree of quality of life according to the age, educational level, occupation, family economic status, Body Mass Index (BMI), menopause state, duration to restarting intercourse from hysterectomy, discomfort from intercourse, satisfaction from intercourse and duration, sources, and formulation of hormone replacement therapy (HRT). The femininity identity group occupied the largest proportion (31.4%), and then the masculinity identity group (28.1%), the undifferentiated identity group (26.4%), and finally the androgyny identity group (14.1%). There was a positive correlation between femininity and quality of life (r=.276, p=.002). Conclusion: These results indicate that HRT helps the women's sense of loss caused by hysterectomy to be reduced, the postmenopausal symptom after hysterectomy to be relieved and the quality of life to be improved.

Thrombocytopenia in Moderate- to High-Risk Sutureless Aortic Valve Replacement

  • Thitivaraporn, Puwadon;Chiramongkol, Sarun;Muntham, Dittapol;Pornpatrtanarak, Nopporn;Kittayarak, Chanapong;Namchaisiri, Jule;Singhatanadgige, Seri;Ongcharit, Pat;Benjacholamas, Vichai
    • Journal of Chest Surgery
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    • 제51권3호
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    • pp.172-179
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    • 2018
  • Background: This study aimed to compare preliminary data on the outcomes of sutureless aortic valve replacement (SU-AVR) with those of aortic valve replacement (AVR). Methods: We conducted a retrospective study of SU-AVR in moderate- to high-risk patients from 2013 to 2016. Matching was performed at a 1:1 ratio using the Society of Thoracic Surgeons predicted risk of mortality score with sex and age. The primary outcome was 30-day mortality. The secondary outcomes were operative outcomes and complications. Results: A total of 277 patients were studied. Ten patients (50% males; median age, 81.5 years) underwent SU-AVR. Postoperative echocardiography showed impressive outcomes in the SU-AVR group. The 30-day mortality was 10% in both groups. In our study, the patients in the SU-AVR group developed postoperative thrombocytopenia. Platelet counts decreased from $225{\times}10^3/{\mu}L$ preoperatively to 94.5, 54.5, and $50.1{\times}10^3/{\mu}L$ on postoperative days 1, 2, and 3, respectively, showing significant differences compared with the AVR group (p=0.04, p=0.16, and p=0.20, respectively). The median amount of platelet transfusion was higher in the AVR group (12.5 vs. 0 units, p=0.052). Conclusion: There was no difference in the 30-day mortality of moderate-to high-risk patients depending on whether they underwent SU-AVR or AVR. Although SU-AVR is associated with favorable cardiopulmonary bypass and cross-clamp times, it may be associated with postoperative thrombocytopenia.

탄성밴드운동이 슬관절전치환술 환자의 통증, 관절가동범위, 낙상두려움에 미치는 효과 (Effects of Elastic Band Exercise on Pain, Range of Motion, and Fear of Falling in Patients with Total Knee Replacement)

  • 여형남;김영경;강미애;신정순
    • 임상간호연구
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    • 제21권2호
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    • pp.266-275
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    • 2015
  • Purpose: The objective of this study was to verify the effects of elastic-band exercise on pain, range of motion, and fear of falling in patients with total knee replacement. Methods: The study design was a nonequivalent control group non-synchronized quasi-experimental design. Data were collected from December 10, 2014 to January 10, 2015 in an orthopedic specialty hospital located in the C city. Forty-eight patients participated in the study, and each twenty-four were assigned to the experimental group and the control group. The elastic-band exercise was used with the experimental group for 10 days. The numeric rating scale was used to measure pain, goniometer to measure range of motion, and a questionnaire to measure fear of falling. The data were analyzed using $x^2-test$, Fisher's exact, t-test and paired t-test. Results: Compared to the control group, pain in the experimental group decreased (t=-2.89, p=.006), range of motion increased (t=2.98, p=.005), and fear of falling decreased (t=-4.63 p<.001). Conclusion: The elastic-band exercise for total knee replacement patients is considered to be an effective nursing intervention to decrease pain and fear of falling, and to increase range of motion.

기능적 마사지가 엉덩관절 전치환술 환자의 통증, 관절가동범위, 균형능력, 보행속도에 미치는 즉각적인 영향 (The Immediate Effect of Functional Massage on Pain, Range of Motion, Balance Ability and Gait Speed in Patients with Total Hip Replacement)

  • 박시현;정의용
    • 대한정형도수물리치료학회지
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    • 제28권1호
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    • pp.9-17
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    • 2022
  • Background: Functional massage is a therapeutic massage that incorporates joint motion in non-end-range to reduce pain and improve range of motion (ROM) in patients. This study was aimed at investigating the immediate effect of functional massage on pain, range of motion, balance ability and, gait speed of patients having undergone total hip replacement. Methods: Twenty patients were treated by one participating orthopedic manual physical therapist and randomly assigned to the control group (n=10) or the experimental group (n=10). To treat patients of each group, functional massage and range of motion exercises were used. The experimental group received a functional massage and the control group received range of motion exercise for minutes for one session. The visual analog scale was used for pain assessment. Balance ability was measured using a timed up and go test and a one-leg standing test for patients. The 10-meter walk test was used for the measurement of gait speed assessment of patients. Results: Significant improvements were observed in terms of balance ability (p<.05), gait speed (p<.05), and ROM (p<.05) after functional massage. There was no significant inter-group difference (p>.05). Conclusion: Application of the functional massage showed that statistically significant improvements in ROM, gait speed, and balance ability after a single treatment session. This technique may be a useful treatment in patients having undergone total hip replacement.

토끼 경부기관의 초냉동보관 동종이식편 기관 이식술 - 생육성 및 거부반응에 미치는 영향 - (Rabbit's Cervical Tracheal Replacement with Cryopreserved Homograft - Effects on the Viability and Rejection -)

  • 원태희;서정욱;성숙환
    • Journal of Chest Surgery
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    • 제31권12호
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    • pp.1127-1133
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    • 1998
  • 배경: 광범위한 기관의 병변시 이를 절제하고 기관을 대체시킬 수 있는 이상적인 대치물질로 현재 많이 연구되고 있는 기관의 초냉동보관 동종이식편의 상피세포 및 연골조직의 생육성 유지와 항원성의 변화를 토끼 기관을 이용하여 연구하였다. 대상 및 방법: 토끼 45마리를 각각 15마리씩 3개의 군으로 나누어 1군은 자가 이식술을 시행하였고 2군은 초냉동보관하지 않은 동종이식편으로 기관 대치술을 시행하였으며 3군은 영하 196$^{\circ}C$에서 1달간 보관한 초냉동보관 동종이식편으로 경부기관 정위치에 이식수술을 시행하였다. 수술 후 7일, 14일, 30일 후에 각군 당 5마리씩 무작위로 선별하여 기관 이식편의 조직학적 검사를 시행하여 상피세포 및 연골조직의 생육성 및 거부반응 정도를 조사하였다. 결과: 상피세포 재생정도에 있어서 7일째에는 세 군간에 차이가 없었으나 14일과 30일에는 1군에서 2군과 3군에 비해 상피세포 재생정도가 좋았다. 2군과 3군에서는 차이가 없었다. 수술 후 7일째까지 거부반응은 2군과 3군 모두에서 거의 나타나지 않았으나 14일과 30일째에는 7일째에 비해 2군과 3군 모두에서 통계학적으로 유의하게 거부반응이 많이 나타났다(P<0.05). 3군에 있어서 2군에 비해 거부반응이 적었으나 통계학적인 유의성은 없었다. 모든 경우에 연골세포는 생육성을 유지하고 있었으며 거부반응도 없었다. 결론: 1달 동안 초냉동보관 된 기관의 동종이식편은 상피세포와 연골의 생육성을 유지할 수 있으며 이는 초냉동보관 기관 동종이식편이 기관 대체물질로 사용할 수 있는 가능성을 보여준다고 할 수 있다. 그러나 초냉동보관으로 항원성을 완전히 없앨 수는 없으며 따라서 거부반응을 더욱 더 줄일 수 있는 방법에 대한 연구가 계속되어야겠다.

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