• 제목/요약/키워드: Hospital Strategy

검색결과 1,226건 처리시간 0.025초

간호사의 통증관리에 대한 주관성 연구 (A Study on the Subjectivity of Pain Management of Nurse)

  • 박경숙;송미승;김경희
    • 성인간호학회지
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    • 제13권1호
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    • pp.123-135
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    • 2001
  • The purpose of this study is to analyze the structural pattern of nurses' pain management with patients who experience pain. As a research method, the Q methodology, which is useful for an objective view of a highly abstract concept, was applied. The data collecting activity of this study was from August, 21st, 2000 to November, 24th 2000. The Q-population, the previous thesis and a literature review were done. Questions about pain management by the nurse on the patients, caregivers, nursing students, doctors, nurses, and others were asked in documentary work and in-depth interviews. In all, 223 units of the Q-population were formed, and the last 35 units of the Q-population were extracted. The data on the P-sample was collected from 41 nurses who worked in the medical and surgical units of a hospital that belonges to C university in Seoul. The research results were constituted in 3 types. Type I was the 'pattern of judging by objectivity'. The statement on which most of the people highly agreed for those patterns was shown by 'If patients said that they are suffering from pain, we sufficiently performed an assessment about the etiology, location, duration and degree'. For type I, the same pain was found in different locations according to the patients, so the etiology of the pain should be identified first place. Since ways of coping are different according to pain etiology, it was thought that it is important to assess sufficiently the pain etiology, location, duration, and degree. Therefore, when patients complain of pain, the pain etiology should be identified and assessed; according to the result, pain management should be performed systematically. Type II was the 'pattern of accepting by subjectivity'. The statement on which most of the people highly agreed for those patterns was shown as 'If patients said that they are suffering from pain, the medical treatment should be performed rapidly and speedily.' For type II, when the patient complains of pain, treatment should be performed quickly in order to prevent the condition getting worse, and it is thought that activity is a reasonable duty. Further, by trying to show empathy after pain is admitted and by understanding and coping rapidly with the pain of patients, an attitude which matched the altruistic morals of nurses is being shown. Type III was the 'pattern of worrying about', and the statement on which most of the people highly agreed for those patterns was shown is 'When there is a pain, to help patients to tolerate the pain to the highest degree.' In type III, the pain is a subjective expression, so there is a difference according to every individual. Therefore, actually if there is no measurement of pain, it could be exaggerated so nurses should help patients to tolerate it to the utmost. Even if there is a way to remove pain without an analgesic drug, nurses were reluctant to perform pain management as they possibly could. Through these research results, pain management of nurses was classified in 3 types, and structural characteristics in each type were discovered. Based upon the characteristics according to the type, an individualized pain management intervention strategy should be established and the follow up work performed.

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말초신경재생을 위한 hNGF-$\beta$ recombinant Adenovirus의 제작 및 수종세포주에서 신경성장인자의 발현 (CONSTRUCTION OF HNGF-$\beta$ RECOMBINANT ADENOVIRUS & SCREENING OF ITS EXPRESSION AFTER TRANSFECTION INTO VARIOUS CELL LINES)

  • 고은봉;정헌종;안강민;김윤태;박희정;성미애;김남열;유상배;명훈;황순정;김명진;김성민;장정원;이종호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권5호
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    • pp.446-456
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    • 2005
  • Nerve growth factor(NGF) has a critical role in peripheral nerve regeneration. The aim of this study is to construct a well-functioning hNGF-$\beta$ recombinat adenovirus for the ultimate development of improved method to promote peripheral nerve regeneration with adenovirus mediated hNGF-$\beta$ gene transfection into Schwann cells. First PCR associated cloning of GFP-tagged hNGF-$\beta$ which was ligated into E1/E3 deleted adenoviral vector was performed and tranfected into E. coli to construct hNGF-$\beta$ recombinant adenovirus. After production of recombinat adenovirus in a large scale, its transfection efficiency, expression, and function were evaluated using cell lines or primarily cultured cells of HEK293 cells, Schwann cells, fibroblast(NIH3T3) and myocyte(CRH cells). GFP expression was observed in 90% of infected cells compared to uninfected cells. Total mRNA isolated from hNGF-$\beta$ recombinat adenoviru infected cells showed strong RT-PCR band, however, LacZ recombinant adenovirus infected or uninfected cells did not. NGF quantification by ELISA showed a maximal release of 18.865 +/- 0.31ng/mL at 4th day. PC-12 cells exposed to media with hNGF-$\beta$ recombinant adenovirus infected Schwann cell demonstrated higher levels of differentiation compared with controls. We generated hNGF-$\beta$ recombinant adenovirus and induced over expression of NGF successfully in nonneuronal and neuronal cells. Following these result, it is expected to develop an improved treatment strategy peripheral nerve regeneration using the hNGF-$\beta$ gene transfected cells.

남자 간호학생의 분만실 실습 체험 (Male nursing students' Practicum Experiences on Delivery Room)

  • 김경아;원미화;신선화;고기연;최준경
    • 한국산학기술학회논문지
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    • 제17권2호
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    • pp.458-469
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    • 2016
  • 본 연구는 간호학과 남학생을 대상으로 분만실 실습 체험의 의미를 파악하고자 수행하였다. 2012년 7월 20일부터 12월 28일까지 분만실 실습을 마친 후 한 달 이내의 4년제 간호대학 3학년 남학생 대상으로 자료가 포화될 때까지 진행하였다. 수집된 8명의 질적 자료는 Colaizzi의 현상학적 연구방법을 적용하여 6단계로 분석하였다. 분석결과 30개의 주제(themes), 9개의 주제묶음(clusters) 및 3가지 범주(categories)를 도출하였다. 도출된 범주는 '여성 프라이버시가 중시되는 실습환경이기 때문에 위축됨', '남자이기 때문에 불평등함', '분만간호를 볼 수 있는 단 한 번의 기회임'으로 구조화되었다. 이를 통해 볼 때 연구 참여자들은 성 역할에 대한 사회적 인식에서 여성 간호 분야의 학습에 제한을 받으면서도 전문직 간호사의 태도를 가지고 실습에 임하고자 하였다. 따라서 성 역할에 대한 사회적 인식이 개선될 수 있도록 전문직 간호의 이미지를 신장시키는 전략과, 전문직 간호사의 역할 정립을 위하여 간호교육현장에서 성 차별적인 교육방법을 개선하기 위한 다각적인 연구의 시행이 필요하다.

관상동맥우회술 후 1년 개존성에 관한 연구 (One-year Graft Patency after Coronary Artery Bypass Surgery)

  • 김기봉;김현조;성기익
    • Journal of Chest Surgery
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    • 제30권12호
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    • pp.1190-1196
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    • 1997
  • 1994년 7월부터 1995년 8월까지 서울대학교병원 흉부외과에서 시행한 관상동맥 우회술 78례 중 49례 (62,8%)에서 수술 1년 후 관상동맥 조영술을 시행하여 이식 혈관의 개존성을 조사하였으며, 수술 전,후 및 수술과 관련된 여러 위험 요소들이 개존성에 미치는 영향에 대하여 분석하였다. 관상동맥 우회술 후 평균 13.4$\pm$2.1개월 째에 관상동맥 조영술을 시행하였다. 내유동맥으로 문함을 시행한 60개소 중 3개소에서 string sign을 보였으나, 폐쇄 없이 전례에서 개존성이 유지되었으며, 요골동맥으로 문합을 시행한 4개소는 모두 개존성이 유지되었다. 복제정맥으로 문합을 시행한 81개소 중 69개소(85.2%)에서 개존성이 유지되었으며, 12개 소(14.8%)에서 폐쇄되었다. 개존성에 미치는 위험요소로 수술 전,수술 중 그리고 합병증 등의 수술 후 요소로 나누어 일원적 및 다원적으로 분석하였으며, 내유동맥의 협착 과 복재정맥의 개존성, 폐쇄에 미치는 요소들을 분석하였다. 내유동맥은 환자의 연령(60세 이상),수술 후 대동맥 내 풍선펌프의 삽입,수술 후 출혈, 및 급성신부전 등 합병증이 이식 혈관의 협착과 관련된 위험 인자였으며, 복제정맥은 우회술을 시\ulcorner 받은 관상동맥의 직경이 1.5mm 이하인 경우가 이식 혈관의 폐쇄 위험성과 관련된 위험 인자로 분석되었다(p<0.05). 관상동맥 우회술 1년 후 이식 혈관의 개존성은 내유동맥이 복재정맥보다 우수함을 보였으며 환자 연령 수술 후 대동맥 내 풍선펌프의 삽입여부, 출혈, 급성 신부전 등의 합병증 및 문합된 관상 동맥의 직경 등이 개존에 관련된 요소로 분석되었다. 이러한 결과를 토대로 수술 후 이식혈관의 폐쇄 여부에 대한 11측과 수술 방법이나 수술 후 환자의 추적 관찰에 도움을 줄 수 있으리라 생각된다.

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흑인삼엽의 제조 및 항산화 활성 평가 (Preparation of Black Panax ginseng Leaf and Evaluation of its Antioxidative Effect)

  • 김상겸;김의검;이지현;조수현;신귀남;김룡국;오정민;명창선;오한진;김동희;윤미영;윤재돈;노성수;박용진;서영배;송규용
    • 동의생리병리학회지
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    • 제22권2호
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    • pp.397-402
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    • 2008
  • The purpose of this study is to prepare black Panax ginseng leaf (PGL) and evaluate its antioxidative effect. In order to make black PGL, the raw PGL was successiely steamed at $95^{\circ}C$ for 3 hr nine times. The antioxidant activities of total saponins (Sa) from PGL and black PGL against peroxyl radicals and peroxynitrites were determined by the total oxy-radical scavenging capacity (TOSC) assay. Specific TOSC values for black PGL-Sa against peroxyl radicals and peroxynitrites were 2.3-fold and 2.1-fold of PGL-Sa, respectively, and 2.2-fold and 5.2-fold of glutathione, a positive control antioxidant, respectively. The black PGL-Sa exhibited stronger antioxidative effect than PGL-Sa. The main ginsenosides of black PGL were $Rg_3,\;Rk_1\;and\;Rg_5$. Among the saponins in black PGL, the amount of ginsenoside $Rg_3$ was examined by HPLC. 22.12 mg of ginsenoside $Rg_3$ was obtained from 1g of dried black PGL.

반구형 시준기를 가진 감마나이프에 대한 렉셀감마플랜 결과물의 독립적인 검증방법들의 비교 (A Comparison of the Independent Verification Methods for the Results of Leksell GammaPlan for Gamma Knife Predecessor with the Hemispherical Collimators)

  • 허병익
    • 한국방사선학회논문지
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    • 제10권7호
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    • pp.521-529
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    • 2016
  • 감마나이프 방사선수술은 일회에 고방사선량을 조사하는 치료 전략에 기초하기 때문에 렉셀감마플랜의 결과물에 대한 독립적인 검증은 환자의 안전성을 보장하고 치료 오류의 위험을 최소화하는데 중요한 절차 중 하나이다. 기존에 개발된 여러 검증 방법들의 구현을 통해 통계적으로 검토하고 치료에 시도했다. 이 연구의 목적은 감마나이프 치료에 대해 제안된 여러 검증방법의 정확도를 적용하고 평가하는 것이었다. 본 연구에서 감마나이프방사선 수술에 의해 치료된 두개 내 병변을 가진 10명의 환자가 포함되었다. 우리는 최대 선량, 임의의 점에서의 선량, 등선량중심점에서의 치료시간에 관하여 제안된 알고리즘과 렉셀감마플랜으로 획득한 데이터를 비교 하였다. 모든 데이터는 두 개의 상이한 측정 기법을 비교하기 위해 사용되는 통계적 방법인 대응표본 t 검정에 의해 분석되었다. 10가지 사례에서 최대 선량의 통계적 유의성은 제안된 검증방법과 렉셀감마플랜 사이에 관찰되지 않았다. 평균 최대 선량의 차이는 -0.53 Gy에서 3.71 Gy범위내였다. 제안된 검증방법과 렉셀감마플랜에 의해 계산된 임의의 점에서의 선량 또한 통계적으로 유의하지 않았다. 그러나 우리는 등선량중심점에서의 치료시간에 대한 조직최대비율 알고리즘과 렉셀감마플랜사이에 p=0.021인 통계적인 차이가 발견되었다. 통계적 분석에 의하면 제안된 검증방법은 감마나이프 방사선수술의 최상의 치료계획을 위해 최대 선량과 임의의 점에서의 선량을 고려할 때 렉셀감마플랜과 상당히 일치한다고 볼 수 있다. 제안된 검증방법들은 과다선량 조사 가능성을 최소화하기 위한 통상적인 정도관리 절차의 일부분으로 통합될 수 있다고 여겨진다.

New Directions in Communicating Better Nutrition to Older Adults

  • Guldan, Georgia-Sue;Wendy Wai-Hing Hui
    • Journal of Community Nutrition
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    • 제2권1호
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    • pp.62-70
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    • 2000
  • Nutrition education should be an important component of ongoing health promotion for older adults and their caregivers. This is because prevention through sound nutrition and food hygiene practices and regular excercise is the most cost-effective way to reduce risks for and deal with their major health problems. nutritions education services should effectively promote optimum intake and successful self-care. Unfortunately, however relative to other vulnerable groups, nutrition education for older adults has not been systematically developed or evaluated. Usually oder adults care a lot about their health, so this should be a relatively easy group to teach - but their increasing numbers, longevity and great diversity with respect to health, physical, and economic status and educational level present challenges. Some older adults may not perceive they would benefit from nutrition education, so interesting and motivating them is a challenge. The food and nutrition knowledge of older people has been acquired through a lifetime of experience. For most older adults in the Asian region, their sources are restricted by their restricted education, so that their major sources of information have been informal sources, such as television, radio, friends, family, and perhaps newspapers and magazines if they are literature. Nonetheless, dietary advice for older people should build on their existing knowledge and ingrained values. It should provide information useful in daily food selection, and focus on food, not nutrients - the same foods and groups considered appropriate for younger people, with consistent messages as given throughout the population. Attention must also be paid to discovering learning styles in older people. When we teach in schools, the young students are a captive audience resigned to their learning role. Learning by an older adult, however, reflects an effort to meet his or her perceived needs. Therefore, nutrition education should be a positive experience in a non-threatening environment, relaxed and non-competitive, and perhaps even social environment. The messages also need to be practical and achievable. A needs assessment is essential, because our ability to provide the most effective nutrition education will depend on our success in matching the needs, both perceived and unperceived. of this vulnerable group. Therefore, go to the potential older learners to assess their interest and preferences. Nutrition education activities for older adults are widespread, but few have been evaluated. Evaluation is therefore also recommended, particularly when new methods are used. Tips from other countries for giving successful nutrition education will be given, including some examples of applications as attempted in Hong Kong. Research needs will also be described. In conclusion, successful nutrition education for older adults depends on positive needs-based messages. This is may be hard to do, as few good examples are available to illustrate these principles.

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3대의 ADVIA 2120 System 평행시험에 대한 연구 (A Study of Parallel Test Among Three ADVIA 2120 System)

  • 장상우;조은해;김남용;추경복;이숙정;홍성노;오종도
    • 대한임상검사과학회지
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    • 제38권1호
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    • pp.16-21
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    • 2006
  • Parallel testing means ordering a number of tests at the same time so abnormalities in any of the tests can be found quickly and used in making the diagnosis. This is a good medical strategy to eliminate diseases and it is relatively inexpensive if all the tests are potential sources of information and performed on the same analyzer. In regression, the equation for the straight line is recast as y = bx + a. This change in terminology leads to confusion. Here a is the y-intercept or constant and b is the coefficient or slope of the line. A few more words of caution about regression - as in all of statistics there are certain assumptions: the x value is a true measure, both X and Y distributions are normal, and homoscedasticity, i.e., the variance of y is the same for each value of x. In this study the linearity classification made by different scientists were always in agreement. Typical examples of curves that were considered linear are presented in Fig. 1-5. Because these automated procedures values were usually within five percent of each other the curvature could be easily detected. The plot of the WBC, RBC, hemoglobin, hematocrit and platelet concentrations from approximately 74.4 to $0{\times}10^3/{\mu}L$ and $80.4-0{\times}10^3/{\mu}L$, $5.6-0{\times}10^6/{\mu}L$ and $6.1-0{\times}1106/{\mu}L$, 18.3-0 g/dL and 19.0-0 g/dL, 54.1-0% and 56.8-0% and 642.0 to $0.03{\times}10^3{\mu}L$ and $754.0-0{\times}10^3/{\mu}L$ on the ADVIA 2120 C Versus and A and B typical of an acceptable linear study as shown in Fig. 1-5. The grand mean of R2, intercept and slope is 0.99898, 0.99459 and 1.54626.

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우리나라 노인의 신체기능 요인과 차별경험의 관련성 연구: 노인실태조사(2014, 2017) 자료 분석 (Relationship between Physical Function Factors and Discrimination Experiences of the Elderly in Korea: The 2014 and 2017 National Survey on Living Conditions and Welfare Needs of Korean Older Persons)

  • 이규희;용왕식;유창훈;이용재;정우진
    • 보건행정학회지
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    • 제29권4호
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    • pp.454-468
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    • 2019
  • Background: Supporting the elderly population is presented as a social issue, and it affects age discrimination, which forms a negative perception and avoids the elderly. Since age discrimination lowers the quality of life of the elderly and hinders social unity, it may be important to research related factors. This study examined the physical function as a factor that influences discrimination experiences and aimed to identify the relationship between physical function factors and discrimination experiences. Methods: In this study, we analyzed 20,225 elderly from the 2014 and 2017 survey of living conditions and welfare needs of Korean older persons, conducted nationwide among older than 65 years. Physical function factors are activities of daily living, instrumental activities of daily living, sight discomfort, hearing discomfort, chewing discomfort, and leg strength as factors of interest. We performed multivariable logistic regression that reflected survey characteristics, adjusting for socio-demographic factors, health related factors, and social-support factors. Results: The number of elderly who faced discrimination experiences was 1,175 (5.8%). The results showed that the odds ratio of facing a discrimination experience in the dependent group was significantly higher compared to the independent group when being transferring out of the room (4.05; 95% confidence interval [CI], 1.50-10.88) and difficulty in hearing (1.25; 95% CI, 1.05-1.49). Even with respect to chewing ability, which was significant in models 1 and 2, they face more discrimination experiences (1.30; 95% CI, 1.11-1.53). Conclusion: These research results indicate that an important strategy for preventing age discrimination is to understand the physical function conditions of the elderly and promote the physical functions of the elderly related to transferring, hearing, and chewing; it is necessary to develop a practical intervention plan that considers these aspects.

신공법에 의한 흑삼의 제조 및 항암활성 (Preparation of Black Panax Ginseng by New Methods and its Antitumor Activity)

  • 김의검;이지현;조수현;신귀남;김룡국;명창선;오한진;김동희;윤재돈;노성수;박용진;서영배;송규용
    • 대한본초학회지
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    • 제23권1호
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    • pp.85-92
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    • 2008
  • Objectives : This study was performed to efficiently make Black Panax Ginseng (BPG) and evaluate its antitumor activity. Methods : Panax ginseng was steamed at $95^{\circ}C$ for 3 h, dried and steamed again at $115^{\circ}C$ for 6 h. The main ginsenosides of BPG were $Rg_{3}$, $Rk_{1}$ and $Rg_{5}$. Results : Among the saponins in BPG, the amount of ginsenoside $Rg_{3}$ was determined by HPLC method. The 11.48 mg of ginsenoside $Rg_{3}$ was obtained from lg of dried BPG. The crude saponin fraction (CSF) of BPG was tested in vitro for its cytotoxic activities against various human cancer cell lines, such as ACHN, NCI-H23, HCT-15 and PC-3. The CSF of BPG exhibited stronger cytotoxic activity than that of red Panax ginsneng. CSF of BPG exhibited good cytotoxic activities against ACFIN, HCT-15, and PC-3 cell lines with $IC_{50}$ values of 60.3-90.8 ${\mu}g$/ml. However, CSF of BPG did not show any cytotoxic activity against NCI-H23 cell line. Conclusions : BPG produced by new manufacturing is more effective than BPG produced by existing processing in anticancer activity. And new BPG has a possibility of investigation because of high contents of Rg3, Rk1 and Rg5 that have various phisological activities.

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