• 제목/요약/키워드: Hospitalized medical patient

검색결과 326건 처리시간 0.032초

고엽제 노출이 폐렴의 치료 결과에 미치는 영향 (The Effects of Agent Orange in Patient with Pneumonia)

  • 김동성;이정엽;계유찬;정의기;정기영
    • 대한임상독성학회지
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    • 제18권1호
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    • pp.26-33
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    • 2020
  • Purpose: Agent Orange (AO) is a herbicide and defoliant used by the United States and its military allies during the Vietnam War. Pneumonia is a common cause of death among Vietnam veterans in our hospital. There have been no previous studies researching any association between AO exposure and the prognosis for pneumonia. The primary objective of this study was to investigate associations between AO exposure and 30-day mortality due to pneumonia. The secondary objective was to examine the clinical factors associated with therapeutic outcomes in veterans with pneumonia, and to assess the prevalence of combined diseases in AO-exposed veterans. Methods: This study retrospectively included veteran patients diagnosed with pneumonia in the emergency department and hospitalized between February 2014 and March 2018. The enrolled patients were grouped according to their defoliant exposure history, and the clinical information of defoliant-exposed and non-defoliant-exposed groups were compared. Patients were divided according to 30-day mortality, and significant factors influencing mortality were evaluated by using univariate analysis and multivariate analysis. The final multivariate model revealed the effect of AO exposure on therapeutic outcomes of pneumonia. Results: A total of 1006 patients were analyzed. Of these, 276 patients had a history of AO exposure, whereas 730 patients had not been exposed. Factors positively associated with 30-day mortality were malignancy, respiratory rate, blood urea nitrogen, and albumin which was negatively associated with mortality. Conclusion: Exposure to defoliant is not associated with 30-day mortality in patients with pneumonia. However, veterans with defoliant exposure are associated with a high prevalence of diabetes mellitus, hypertension, cerebrovascular accident, malignancy, and chronic kidney disease.

Changes of Plasma Tumor Necrosis Factor α and C-Reactive Protein Levels in Patients with Hypertension Accompanied by Impaired Glucose Tolerance and their Clinical Significance

  • Xiao, Qiang;Wang, Lan-Ping;Ran, Zhang-Shen;Zhang, Xin-Huan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권8호
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    • pp.3389-3393
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    • 2015
  • Background: Chronic inflammation could affect the occurrence and development of malignant tumors. To explore the levels of tumor necrosis factor ${\alpha}$ (TNF-${\alpha}$) and C-reactive protein (CRP) in patients accompanied by impaired glucose tolerance (IGT) and their clinical significance. Materials and Methods: A total of 210 patients hospitalized in Affiliated Hospital of Taishan Medical University from Jun., 2013 to Dec., 2014 were selected, in which 92 cases were accompanied by IGT. Meanwhile, 80 randomly-selected healthy people by physical examination were as the control. The levels of routine biochemical indexes, plasma TNF-${\alpha}$ and CRP in all subjects were measured. Results: Both systolic and diastolic pressures in hypertension group and hypertension plus IGT group were significantly higher than in control group (p<0.01), but there was no statistical significance between these two groups (p>0.05). The levels of fasting plasma glucose (FPG) and blood glucose 2 h after taking glucose in hypertension plus IGT group were markedly higher than other groups (p<0.01). Homeostasis model assessment-insulin resistance (HOMA-IR), TNF-${\alpha}$ and CRP contents were on the progressive increase in control, hypertension and hypertension plus IGT groups, but significant differences were presented among each group (P<0.01). Hypertension accompanied by IGT had a significantly-positive association with CRP, TNF-${\alpha}$, FPG and blood glucose 2h after taking glucose. Conclusions: The levels of plasma TNF-${\alpha}$ and CPR in patients with hypertension accompanied by IGT increase significantly, indicating that inflammatory reaction in these patient increases, thus suggesting that these patients should be focused regarding cancer prevention.

환자 및 간호사가 지각하는 치료적인 병실분위기 조성의 저해요인에 대한 조사 연구 (A Study on the Disturbing Factors which Work against Therapeutic Atmosphere & Environment on Hospital Wards as Perceived by Patients and Nurses)

  • 김영혜;한명은
    • 대한간호학회지
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    • 제27권1호
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    • pp.178-188
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    • 1997
  • As a descriptive survey, this study was attempted to get basic data necessary to recognize the factors that disturb the therapeutic atmosphere of hospital wards as perceived by nurses and hospitalized patients, to identify differences between the perceptions of the nurses and of patients. The subjects, 159 patients in Pusan National Hospital and 68 nurses working there were sampled between March 18 and April 13, 1996. The tool used to measure the disturbing factors was an amended form of the one developed by Kim, Mae Ja(1983). The differences between each subject's score for each factor were analyzed using means & SD. and the highest 3 items above the mean score for each factor were collected and compared. The results are described below : 1. Subject's perception of main disturbing factors : patients reported that the main factors were 'loss of role & economic trouble', 'the prognosis of disease', 'the change of daily life' but nurses replied that the main factors were' the prognosis of disease', 'the communication trouble with the medical team & interpersonal relationships'. 'The change of daily life' was not a perceved factor by nurses, but ranked third by the patients. 2. Subject's perception degree of each disturbing factor : (1) among the items related to interpersonal relationship. the patient group reported that the worst disturbance was dur to severely ill patients in the same room' but the nurse group regarded 'greed to monopolize wheelchairs or other supplies' as the worst disturbance. (2) among the items related to physical factors. the patient group regarded 'limitations to wash their body, physical pain and limitations in physical activity' as the worst disturbance, but the nurse group regarded' physical pain', and 'limitations to activity or change of appearance' as the worst disturbance. (3) among the items related to the change of daily activity, the patient group regarded 'the boredom of hospitalization or infavorable diet' as the worst disturbance, but the nurse group regarded 'too much noise or unclean room' as the worst disturbance. (4) among the items related to the communication trouble with medical team, the patient group regarded 'the ignorance of their disease due to poor information. the inability to understand the language of the medical team or the difficulty in seeing physician in time' as the worst disturbance, but the nurse group regarded 'the inability to trust physicians and physician's poor attention to patients' as the worst disturbance.

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간호사와 입원 환자가 지각한 임종기 치료선호도 (Comparing the Preference for Terminal Care in Nurses and Patients)

  • 김동순;소애영;이경숙;최정숙
    • 근관절건강학회지
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    • 제20권3호
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    • pp.214-224
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    • 2013
  • Purpose: The purpose of this study was to identify the differences in preference for terminal care between hospitalized patients and nurses. Methods: A cross-sectional descriptive design was used in 79 patients and 107 nurses. The data were collected from August to October 2011, using the Preference for Care near the End of life Scale - Korean Version (PCEOL-K) with 5-point scale of 26 items. The reliability of the tool was Cronbach's ${\alpha}=.74$. Results: The mean score (SD) of PCEOL-K's sub-dimensions in nurses' priority was: (a) pain $3.70{\pm}0.63$, (b) spirituality $3.63{\pm}0.61$, (c) family $3.40{\pm}0.70$, (d) autonomous decision making $2.30{\pm}0.66$, and (e) decision making by healthcare professionals $2.14{\pm}0.64$. In patients' priority, the $M{\pm}SD$ score of each sub-dimension was: (a) pain $3.86{\pm}0.65$, (b) family $3.83{\pm}0.57$, (c) decision making by healthcare professionals $3.37{\pm}0.85$, (d) spirituality $3.01{\pm}0.80$, and (e) autonomous decision making $2.43{\pm}0.63$. Results indicated significant differences between nurses and patients regarding decision making by healthcare professionals (t=-11.28, p<.001), family (t=-4.66, p<.001), and spirituality (t=5.71, p<.001). Conclusion: The PCEOL-K of patients was higher than nurses'. A terminal care program for hospitalized patients at the end of life should be planned according to the results of PCEOL-K in nurses and patients.

진폐환자의 우울에 영향을 미치는 요인 (The Factors Affecting the Depression in Pneumoconiosis Patients)

  • 박주현;임현우;채정미;조현주;정혜선;조선진;이원철
    • 한국직업건강간호학회지
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    • 제16권1호
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    • pp.28-36
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    • 2007
  • Objectives: The objective of this study was to analyze factors affecting depression in pneumoconiosis patients. Methods: The subjects were 200 pneumoconiosis patients hospitalized in Pneumoconiosis Hospitals in An-san and Tae-beck. Collected 114 surveys were used in this study among 200 surveys since 86 surveys offered insufficient data. SAS for Windows 8.01 was used to analyse the data Results: Percentage of normal and mild depression is 2.6%, Percentage of moderate depression is 14.9%, Percentage of severe depression is 79.8%. In order to analyze the factors affecting depression rate, the factors with p-values less than 0.1, such as age, education, religion, work department, hospitalized period, physical pain existence, daily living ability, family supports and internal locus of control, were selected as independent factors and analyzed using a stepwise multiple regression. As results, the factor that affected the rate of depression were of the age, education, ADL(Activities of Daily Living), the internal locus of control, family support. Conclusion: It is necessary to develop health program which can improve the patient's ADL(Activities of Daily Living), enforce internal locus of control to minimize the depression rate in pneumoconiosis patients.

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병원환경의 안전관리를 위한 기초조사 -청결도를 중심으로- (A Survey on Environmental Safety Focussed on Cleanliness for Hospitalized Patients)

  • 박점희
    • 대한간호학회지
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    • 제7권1호
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    • pp.99-111
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    • 1977
  • One of the fundamental provisions that a hospital requires is the environmental safety through cleanliness s. The effective management of atmospheric conditions, i. e. air purity, cleanliness of facilities furnitures and bed- linen instruments are direct- environment of hospitalized patients. Meeting physical cleanliness needs of patients, application of aseptic teaching while carrying out nursing measures and the cleanliness of hospital personnel are another categories of concern. This study was carried out, from March through April 1976, to investigate the degree of satisfaction on cleanliness that patients perceived, and to compare with that of nurses on their nursing performances. 44 questionaries categorized into 6 major concern were used. For the survey, 269 patients and 191 nurses of 3 general hospitals in Taegu: kyung-puk University Hospital, Presbyterian Mission Hospital, and Catholic Patima Hospital and 116 senior nursing students from Kyung-Puk University and Presbyterian School of Nursing were randomly sampled. Results are as follows : 1. Mean satisfaction score on cleanliness revealed to be average on patients, on nursing performance for cleanliness revealed to be average in nursing students and relatively high in graduate nurses. 2. Mean score of patients revealed to be significantly lower in comparison with that of nursing. 3. Mean score of nurses revealed to be significantly higher in comparison with that of nursing students. 4. Mean score of patients revealed to be significantly lower in comparison with nursing students. 5. Mean satisfaction score of patient3 in all categories revealed to be the lowest in the rank order . 6. The lowest categorial mean score revealed to be the linen and instrument in all three groups. Recommendations 1. A more satisfactory mean of cleaning (medical asperses of mouth thermometers needs to be developed. 2. Further investigation to clarify the difference between patients and nurses on hospital cleanliness is recommended.

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일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정 (Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital)

  • 김경운
    • 간호행정학회지
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    • 제6권3호
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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허혈성 뇌졸중 환자의 재원적절성 평가 (Appropriateness Evaluation of Hospitalization for the Cerebral Ischemia Patients)

  • 염효영;김순례
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.80-92
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    • 1999
  • The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

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구조화된 환자교육이 뇌졸중 환자의 조기재활에 관한 지식과 활동수행에 미치는 영향 (The Effect of the Structured Education on the Early Rehabilitation Knowledge and Activity Performance of the C.V.A. Patients)

  • 이혜진;이향련
    • 대한간호학회지
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    • 제27권1호
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    • pp.109-119
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    • 1997
  • This study has been attempted to set up the strategies of the nursing which can promote the activity performance for early rehabilitation for the patients by examining the effect of the structured patient education on the early rehabilitation knowledge and activity performance of the C.V.A patients. The study method has been done by investigating the experiment group and control group in advance through the question papers and interview and observation on 65 patients who had been hospitalized at oriental medicine hospital of K Medical Center from July 1st 1995 to the end of Sep, 1995. The analysis of the collected material had been done for the homogeneity test in which general characters of experiment group and control group had been tested by X²and the homogeneity test of ADL by t-test. To test the hypothesis the t-test had been given for the difference of the early rehabilitation knowledge and activity performance between the two groups and the correlation between early rehabilitation knowledge and activity performance had been tested by Pearson's Correlation Coefficient. The result of the test of the hypothesis is as the below. 1 The 1st hypothesis “The experiment group which had received the structured education should be higher in the early rehabilitation knowledge than the control group” was supported(t=4.45. p=.000). 2. The 2nd hypothesis “The experiment group which received the structured education should be higher in the early rehabilitation activity performance than the control group”was supported(t=2.11, p=.036). 3. The 3rd hypothesis “The higher the early rehabilitation knowledge of the patient the higher the activity performance degree” was rejected (r=.1546, p=.219). In conclusion, the patients who received the structured education showed the increase in the degree of early rehabilitation knowledge and activity performance, so it has been judged that education has been prerequisite in increasing the knowledge and activity performance of early rehabilitation.

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감두탕가미(甘豆湯加味)를 이용한 파라콰트 중독 환자 치험 1례 (Case Report of Treatment for Paraquat Poisoning with Gamdutanggami)

  • 박형진;김유경;이재원;이상민;이진구;송봉근;심하나
    • 동의생리병리학회지
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    • 제19권6호
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    • pp.1694-1700
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    • 2005
  • Paraquat is a nonselective contact herbicide that may induced damage to many organs poisoned with it. But there is no effective treatment modality. This report is about one case of treatment for paraquat poisoning. The patient was hospitalized of Wonkwang university Gwangju Oriental Medical Hospital at the department of Internal Medicine. For 26 days of hospitalization period, the authors supplied gamdutanggami(甘豆湯加味), which consists of Radix glycyrrhizae(甘草), Semen Glycine(黑豆), burned powder of Rhizoma rhei(大黃沙炭末), Succus phyllostachyos(竹瀝) and chinese ink(墨汁), decoction of Galla chinensis(五倍子) and Radix glycyrrhizae(甘草), and fluid. And then he showed improvement of condition and returned to a daily life. This report has a limitation for proof of oriental medicine remedial value. Because this is the only one case of a small quantity of paraquat poisoning patient less than 20cc. Actually there are a few paper regarding the Oriental medicine remedial value in paraquat poisoning patient, so we hope luther study and report ensue.