• 대한간호학회지
• /
• 제45권3호
• /
• pp.378-387
• /
• 2015

Purpose: Acute myocardial infarction (AMI) leads to death if the patient does not receive emergency treatment. Thus it is very important to recognize the symptoms in the early stage. The purpose of this study was to identify clusters of symptoms that represent AMI in Koreans. Methods: The study used a retrospective, descriptive design with secondary data analysis. Data were abstracted from 725 medical records of AMI patients admitted from June 1, 2006 to August 15, 2014 at a university hospital. Results: Analysis of the AMI symptoms revealed five symptom clusters; Cluster 1 (n=140): middle chest pain (100%), shortness of breath, and cold sweating, Cluster 2 (n=256): substernal pain (100%), cold sweating, and shortness of breath, Cluster 3 (n=47): substernal pain (95.7%), left arm pain, shortness of breath, cold sweating, left shoulder pain, right arm pain, and the lower neck pain, Cluster 4 (n=212): shortness of breath (28.3%), left chest pain, and upper abdominal pain, and Cluster 5 (n=70): cold sweating (100%), left chest pain, shortness of breath, left shoulder pain, and upper abdominal pain. Length of hospital stay and mortality rate were significantly different according to symptom clusters (F=2.52, p =.040; F=3.62, p =.006, respectively). Conclusion: Symptom clusters of AMI from this study can be used for AMI patients in order to recognize their symptoms at an early stage. The study findings should be considered when developing educational prevention programs for Koreans with AMI.

• 대한간호학회지
• /
• 제42권6호
• /
• pp.799-809
• /
• 2012

Purpose: The purpose of this study was to examine the effects of an individualized nutritional education programs on nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy. Methods: Forty patients with colorectal cancer (19 experimental and 21 control patients) were recruited from a chemotherapy ward at S University Hospital in Seoul, Korea. The experimental group received two individualized nutritional counseling sessions and two telephone counseling sessions over 6 weeks. The control group received nutritional counseling after completion of data collection. Nutritional education included general guidelines for food intake while receiving chemotherapy, dietary guidelines for patients with colorectal cancer, daily meal schedules to overcome cancer, and dietary guideline for each chemotherapy side effect. Data were analyzed using ${\chi}^2$-test and t-test with the SPSS program 17.0. Results: Two group comparison revealed that the experimental group had significantly improved calorie (p=.038) and total protein intake (p=.001), and serum albumin percentage change (p=.040). Body weight did not increase but remained the same as the baseline in both groups. Conclusion: Study results indicate that this individualized nutritional education programs are effective in enhancing nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy.

• 지역사회간호학회지
• /
• 제11권1호
• /
• pp.67-79
• /
• 2000

In recent years, the recipients of the services of the health centers in Korea have been shifted from individual sick persons to families as a unit. As a result, the home visiting care records which are all filled out manually, will be increased. Since there is virtually no increase in the number of community health nurses, the CHNs are required to work more efficiently. One of the ways to make the CHNs' work more efficient is to reduce recording time by using a computer. However, a computer system that can manage the families as a unit has not yet been developed. In response to this need, we developed a database system that can be utilized in home visiting care service. The family assessment data is collected. diagnosed. and evaluated according to the family diagnosis classification. The system for family diagnosis consists of seven areas. Those areas are family structure. maintenance of the family system, interaction and interchange. support. coping and adaptation, health management. and housing environment. The areas of the family diagnosis consists of 99 items in all. We expect the following from this system. First. the CHNs will be able to identify family problems more easily. Second. the community's health level can be confirmed by the statistics the system produces. Thirdly, the CHNs' nursing services will be cost effective via reduced recording time. Finally, the family problems of the sick individuals which have been neglected under the health system oriented on individual persons can be effectively managed.

• 성인간호학회지
• /
• 제23권4호
• /
• pp.321-331
• /
• 2011

Purpose: This study was designed to identify the incidence risk of cardicerebrovascular disease (CVD) among male bus drivers, and to examine and compare the predictors of their health behavior according to the level of CVD incidence risk. Methods: The convenience sample of 222 male bus drivers were recruited from a bus company located in Jeonnam province. Data were collected from self-reported questionnaires and annual medical examination records from 2010. The CVD incidence risk was calculated based on the risk criteria for industrial workers. Results: The 26.6% and 26.1% of the participants were in the moderate and high risk group, respectively. The 72% of the participants were in the precontemplation stage and reported no intention to change their unhealthy lifestyles. Stepwise multiple regression analyses showed that current smoking, excessive alcohol drinking, physical inactivity and lack of knowledge were negative predictors of good health behavior in the normal/low risk group (Adj $R^2$=.443). Heavy alcohol drinking, current smoking, physical inactivity and dyslipidemia were reported by the moderate/high risk group (Adj $R^2$=.427). Conclusion: This study suggested that targeted education and counseling are needed to modify unhealthy lifestyles such as alcohol consumption, smoking and exercise among middle aged male drivers. Especially, dyslipidemia should be managed among those who are at risk for CVD.

• 한국의료질향상학회지
• /
• 제9권1호
• /
• pp.74-89
• /
• 2002

Background : The purpose of this study was to investigate the incidence of unplanned endotracheal extubation and to identify the influencing factor of unplanned extubation in ICUs for providing baseline data in developing prevention strategies and administrative standards. the medical records and hospital information system. In order to analyze factors related to unplanned extubation, the subjects of this study were divided by unplanned extubation group and planned extubation group and were matched by its sex, age, and disease groups in a ratio of one to two. The data were analyzed by descriptive statistics, ${\chi}^2$- test, t-test, Fisher's exact test, and logistic regression analysis with SPSSWIN 10.0 program. Result : 1) Forty-seven(4.99%) of 942 intubated patients experienced unplanned extubation 65 times during the twelve-month period. Thirtyfour( 72.34%) of 47 unplanned extubated patients required reintubation, whereas thirteen patients(27.66%) did not. 2) About half of unplanned extubation(46.8%) occurred during the night shift. 3) As for the nursing activity, respiratory nursing activity score(P=.0.06) and total nursing activity score(P=.011) showed statistically significant differences between unplanned extubation group and planned extubation group. 4) As for the patient status, unplanned extubation group showed more lower consciousness level(P=.000), more irritable or agitated behavior(P=.000), and had more applied physical restraints(P=.000) than planned extubation group. 5) As for the intubation related variables, unplanned extubation group revealed more intubated with respiratory failure(P=.000), more dependent on mechanical ventilation(P=.015) than planned extubation group. 6) Factors affecting unplanned extubations in intensive care unit patients were irritable or agitated behavior(odds ratio=13.757), night shift(odds ratio=7.166), and mechanical ventilation(odds ratio=6.257) from conditional logistic regression analysis. Conclusion : The most affecting factor of unplanned extubation was agitated or irritable behavior. Therefore the results of this study could be helpful to ICU nurses for meticulous care, decision making, timely intervention, and development of intervention strategies for preventing unplanned extubation.

• 성인간호학회지
• /
• 제24권4호
• /
• pp.348-357
• /
• 2012

Purpose: This retrospective chart review study was carried out in order to examine the frequency of delirium, and to identify the risk factors associated with the development of delirium in elderly patients with arthroplasty. Methods: Data were collected from medical records of patients who received arthroplasty during one and half year in a hospital. Three hundred sixty five patients were selected for the study. The onset of delirium was reviewed based on the result of psychological doctor's consultation or nurse's assessment with Confusion Assessment Method and delirium onset risk factors were examined. Data were analyzed with descriptive statistics, t-test, $x_2$-test, Fisher's exact test and logistic regression analysis. Results: Delirium occurred with 31 patients (8.5%) out of 365 patients who underwent arthroplasty. There were statistically significant differences between incidence of delirium and gender ($x_2$=6.11, p=.025), age ($x_2$=32.81, p<.001), hearing difficulty ($x_2$=8.08, p=.012), albumin level of preoperational day (t=-3.43, p<.001), albumin (t=-2.20, p=.028) and hemoglobin level (t=-2.83, p=.005) of operational day. Age and gender were the most significant predictive factors with regard to the incidence of delirium. Conclusion: Through understanding of these results, nurses will be able to identify those patients who may be at risk for developing delirium in early stages.

• 성인간호학회지
• /
• 제13권4호
• /
• pp.529-538
• /
• 2001

Purpose: This study purposed to examine the disease-related knowledge level and compliance with good health behavior in patients with myocardial infarction according to the atherosclerotic risk factors. Method: The subjects consisted of 72 patients with myocardial infarction and the data were collected by interviewing the subjects with questionnaires and reviewing their medical records from September, 15, 1999 to July 31, 2000. Data were analyzed using the SAS program. Results: 1) With regard to atherosclerotic risk factors: of the subjects, 91.7% lacked regular exercise, followed by smoking (61.1%). 2) The average knowledge score of the patients was 19.7 and the average compliance score was 53.9. 3) There were no significant differences in the total knowledge scores according to the patients' atherosclerotic risk factors. 4) Non-diabetics were significantly higher in knowledge scores on domain of risk factors than the diabetics. 5) The overweight patients were significantly higher in knowledge score on domain of nature of disease than the normalweight patients. 6) The total compliance scores of the non-smokers were significantly higher than those of the smokers. 7) The total compliance scores of the patients who do regular exercise were significantly higher than those of the patients who forgo regular exercise. 8) The non-smokers were significantly higher in compliance scores on domain of diet than the smokers. 9) The diabetic patients were significantly higher in compliance scores on domain of smoking cessation than the non-diabetics. 10) Patients who do regular exercise were significantly higher in compliance scores on other domains than the patients who forgo regular exercise. Conclusion: According to the above findings, it can be concluded that intensive nursing care and education should be provided to patients who have atherosclerotic risk factors such as smoking, hypertension, diabetes mellitus, lack of exercise, over weight, or hypercholesterolemia to increase disease related knowledge level and to improve compliance with good health behavior.

• 성인간호학회지
• /
• 제20권1호
• /
• pp.163-175
• /
• 2008

Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

• 대한간호학회지
• /
• 제41권1호
• /
• pp.92-100
• /
• 2011

Purpose: Mortality Provability Model (MPM) II is a model for predicting mortality probability of patients admitted to ICU. This study was done to test the validity of MPM II for critically ill neurological patients and to determine applicability of MPM II in predicting mortality of neurological ICU patients. Methods: Data were collected from medical records of 187 neurological patients over 18 yr of age who were admitted to the ICU of C University Hospital during the period from January 2008 to May 2009. Collected data were analyzed through $X^2$ test, t-test, Mann-Whiteny test, goodness of fit test, and ROC curve. Results: As to mortality according to patients' general and clinically related characteristics, mortality was statistically significantly different for ICU stay, hospital stay, APACHE III score, APACHE predicted death rate, GCS, endotracheal intubation, and central venous catheter. Results of Hosmer-Lemeshow goodness-of-fit test were MPM $II_0$ ($X^2$=0.02, p=.989), MPM $II_24$ ($X^2$=0.99 p=.805), MPM $II_48$ ($X^2$=0.91, p=.822), and MPM $II_72$ ($X^2$=1.57, p=.457), and results of the discrimination test using the ROC curve were MPM $II_0$, .726 (p<.001), MPM $II_24$, .764 (p<.001), MPM $II_48$, .762 (p<.001), and MPM $II_72$, .809 (p<.001). Conclusion: MPM II was found to be a valid mortality prediction model for neurological ICU patients.

• 대한간호학회지
• /
• 제42권2호
• /
• pp.181-189
• /
• 2012

Purpose: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm ($34{\leq}GA<37$) and preterm infants (GA<34). Methods: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. Results: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. Conclusion: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.