• 제목/요약/키워드: Orthopedic Nursing

검색결과 104건 처리시간 0.024초

목 통증 환자에게 목-등뼈 가동술과 치료적 운동이 근활성도, 기능장애, 머리척추각에 미치는 영향 (Effects of Cervico-Thoracic Mobilization Technique and Therapeutic Exercise on Muscle Activity, Functional Disability, Craniovertebral angle in Patient with Neck Pain)

  • 김제호;최종욱;김윤환;송현승;정용식
    • 대한정형도수물리치료학회지
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    • 제29권1호
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    • pp.11-23
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    • 2023
  • Purpose: This study aimed to determine the effects of cervico-thoracic (C-T) mobilization technique and therapeutic exercise on muscle activity, craniovertebral angle (CVA), and neck disability index (NDI) in patients with neck pain. Methods: : A total of 30 patients with neck pain were included and divided into C-T mobilization combined with Pilates group (Experimental group; EG) and thoracic mobilization and self-exercise (Control group; CG) group; each group consisted of 15 patients. The exercises were performed by patients in both groups three times a week, for four weeks. NDI was used to measure functional disability and sEMG was used to measure muscle activity. Results: The EG participants showed significant improvement in the CVA and NDI after the intervention than the CG (p<.05). While both groups presented after intervention decreased muscle activity(upper trapezius), there were no statistically significant differences between the groups (p>.05). Conclusion: The findings of this study suggest that thoracic mobilization technique combined with Pilates exercise may have beneficial effects on CVA and NDI in patients with neck pain and forward head posture.

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양.한방 협진 의료서비스 최적화를 위한 Clinical Pathway 도입과 진료패턴 분석 (Development of Clinical Pathway and Analysis of Clinical Patterns for Optimizing the Integrative Medical Service)

  • 오가은;박원숙;양형인;한상숙;유명철;박상찬;이상철
    • 대한한의진단학회지
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    • 제16권2호
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    • pp.23-32
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    • 2012
  • Objectives : The purpose of this research is to develop the clinical pathway for optimizing the integrative medical service (oriental-western integrated medical service) and to analyze the clinical pattern of the integrative patients who received the oriental-western integrated medical service. Methods : This research developed the clinical pathway by interviewing with doctors, nursing and experts at K Medical Center. To analyze the clinical patterns, this research used 860 integrative patients and 6345 non-integrative patients at K Medical Center since 2007. Results and Conclusions : 1. We developed the clinical pathway for optimizing the integrative medical service. 2. Comparing the clinical pattern of the integrative patients with the non-integrative patients, the results indicated that the interval and frequency of the integrative patients is shorter than that of the non-integrative patients. 3. Comparing the medical treatment type, the integrated patients take much more medical care and more frequently participate in medical treatment. 4. In conclusion, it is different that the clinical pathway of the integrative medical service from the non-integrative medical service and the integrative medical treatment is more effective than the non-integrative medical treatment.

만성통증환자의 통증연관 행위를 이용한 통증척도의 민감성 및 타당성 조사 (Sensitivity and Validity Test of Pain Rating Scale Using Pain Behavior of Adult Patients with Chronic Pain)

  • 이은옥;이선옥;임난영;최순희;김달숙;김순자;한윤복;김주희;김광주
    • 대한간호학회지
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    • 제22권1호
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    • pp.5-16
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    • 1992
  • The purposes of this study were : 1) to evaluate validity of a pain rating scale using the level of correlation between the Korean Pain Rating Scale(KPRS), Short -Form KPRS(SKPRS) and the Graphic Rating Scale(GRS). 2) to identify sensitivity of the scale using pain behavior of patients with chronic pain. Of the 2025 patients with chronic pain who visited the orthopedic and neurosurgical out - patients departments of 11 university hospitals in various districts of Korea, 520 subjects were selected through convenient sampling and responded to the questionnaires by mail. The results of the study can be summarized as follows : 1. The mean pain score measured by the KPRS was 444,85 : the mean sensory score was 209.47, the mean affective score, 147.63 and the mean miscellaneus score. 87.75. The mean pain score measured by the GRS was 20.11 : the mean sensory intensity score, 10.54. and the mean distress score, 9.57. 2. The average number of hours of rest during the day was 3.3, the average score of discomfort in carrying out ADL was 99, the average frequency of pain relieving practices was 3.0, the average number of pain sites was 3.6. 3. The most sensitive scale to differentiate each group was the GRS, the KPRS and SKPRS were less sensitive than the GRS. 4. The intercorrelation between the KPRS total score and the GRS score(.500) as well as that of the SKPRS score were highly correlated(.652), but intercorrelation between the SKPRS score and the GRS score(.172) was not high. Based on the above results, it was found that the SKPRS must be studied further to obtain validity.

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산재보험지정의원 요양급여적정성 종합관리지표 산출 및 적용방안 (The Comprehensive Management Indexes and Their Application Strategies for Appropriate Medical Care in Primary Care Clinics Under Workers' Compensation Insurance)

  • 방은주;최은숙;고영
    • 한국직업건강간호학회지
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    • 제17권1호
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    • pp.86-95
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    • 2008
  • Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.

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입원환자에게 나타나는 섬망 아형별 위험요인과 증상 및 중재 분석 (Risk Factors, Symptoms, and Intervention Analysis of Delirium Subtypes in Hospitalized Patients)

  • 류아현;강영옥;송라윤
    • 한국융합학회논문지
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    • 제12권10호
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    • pp.353-363
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    • 2021
  • 본 연구는 입원환자 섬망의 아형별 위험요인, 증상 및 중재를 조사하기 위해 시행되었다. 상급종합병원에 입원한 뒤 섬망을 진단받은 환자 108명의 전자의무기록을 SPSS WIN 26.0 프로그램을 이용해 분석하였다. 분석결과, 대상자는 고령, 남성, 정형외과, 골절이나 절단 환자의 비율이 높았다. 섬망의 아형은 과활동형 51.9%, 저활동형 6.5%, 혼재형 41.7%이었다. 위험요인 중 우울과 향정신성 약물 복용은 저활동형 섬망군에게 더 많이 선행되었다. 섬망의 중재 중 행동문제 관리와 공격적 행동 중재는 과활동형, 혼재형 섬망군에게 주로 시행되었고 정서적 지지는 저활동형, 혼재형 섬망군에게 주로 시행되었다. 공격적 행동을 동반할 경우 즉각적으로 중재를 제공받을 가능성이 높았다. 따라서, 추후 입원환자의 섬망을 조기발견하고 중재할 수 있도록 중재전략과 프로토콜을 개발하기 위한 연구가 요구된다.

Effects of elevation on shoulder joint motion: comparison of dynamic and static conditions

  • Takaki Imai;Takashi Nagamatsu;Junichi Kawakami;Masaki Karasuyama;Nobuya Harada;Yu Kudo;Kazuya Madokoro
    • Clinics in Shoulder and Elbow
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    • 제26권2호
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    • pp.148-155
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    • 2023
  • Background: Although visual examination and palpation are used to assess shoulder motion in clinical practice, there is no consensus on shoulder motion under dynamic and static conditions. This study aimed to compare shoulder joint motion under dynamic and static conditions. Methods: The dominant arm of 14 healthy adult males was investigated. Electromagnetic sensors attached to the scapular, thorax, and humerus were used to measure three-dimensional shoulder joint motion under dynamic and static elevation conditions and compare scapular upward rotation and glenohumeral joint elevation in different elevation planes and angles. Results: At 120° of elevation in the scapular and coronal planes, the scapular upward rotation angle was higher in the static condition and the glenohumeral joint elevation angle was higher in the dynamic condition (P<0.05). In scapular plane and coronal plane elevation 90°-120°, the angular change in scapular upward rotation was higher in the static condition and the angular change in scapulohumeral joint elevation was higher in the dynamic condition (P<0.05). No differences were found in shoulder joint motion in the sagittal plane elevation between the dynamic and static conditions. No interaction effects were found between elevation condition and elevation angle in all elevation planes. Conclusions: Differences in shoulder joint motion should be noted when assessing shoulder joint motion in different dynamic and static conditions.

Fat Embolism Syndrome - Three Case Reports and Review of the Literature

  • Grigorakos, Leonidas;Nikolopoulos, Ioannis;Stratouli, Stamatina;Alexopoulou, Anastasia;Nikolaidis, Eleftherios;Fotiou, Eleftherios;Lazarescu, Daria;Alamanos, Ioannis
    • Journal of Trauma and Injury
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    • 제30권3호
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    • pp.107-111
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    • 2017
  • The fat embolism syndrome (FES) represents a condition, usually with traumatic etiology, which may pose challenges to diagnosis while its treatment usually requires supportive measures in the intensive care units (ICUs). The clinical criteria, including respiratory and cerebral dysfunction and a petechial rash, along with imaging studies help in diagnosis. Here we present three case reports of young male who developed FES and were admitted to our ICUs after long bones fractures emerging after vehicle crashes and we briefly review FES literature. All patients' treatment was directed towards: 1) the restoration of circulating volume with fresh blood and/or plasma; 2) the correction of acidosis; and 3) immobilization of the affected part. All patients recovered and were released to the orthopedic wards. The incidence of cases of patients with FES admitted in our ICUs records a significant decrease. This may be explained in terms effective infrastructure reforms in Greece which brought about significant improvement in early prevention and management.

뇌졸중환자 가족간병원의 스트레스에 관한 연구 (A Study on the Stress of the Family Caregivers for Patients with Stroke)

  • 권원안;김한수
    • The Journal of Korean Physical Therapy
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    • 제20권2호
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    • pp.25-32
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    • 2008
  • Purpose: The purpose of this study was to provide the basic data to decrease the stress of the family caregivers. Methods: The questionnaire was administrated to the family caregivers of 156 patients with stroke who consented to be interviewed. Among 156 caregivers, we analyzed 120 caregivers. We evaluated on the stress of the family caregivers. Results: First, the general characteristics of patient with CVA were high at 82.55% in male, 55.83% in infarction, 53.33% in the left hemiplegia, 47.50% in sixties, 80.83% in 1 recurrence rate, 27.50% in 1-2 years of disease period. Second, the general characteristics of family caregivers were high in above sixties, female in gender, existence in religion, married in marital status, high school in educational level, below 1 million-won in monthly income, spouse in relationship with patient, below 1 years in total caring period. Third, it showed that stress of family caregivers above 3.0 score has 8 items. Forth, the patient's characteristic that have the influence on the stress was significant in the period of disease(p<0.05). Finally, the characteristics of family caregivers that have the influence on the stress were the monthly income, caring period(p<0.05). Conclusion: These findings indicated that the stress of the family caregivers was correlated with the time in hospital, the income and nursing period.

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환자중심 스마트병원의 개요와 전망 (Overview and Prospects of Patient Centered-Smart Hospitals)

  • 박현영;조용진
    • 디지털융복합연구
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    • 제19권7호
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    • pp.419-426
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    • 2021
  • 정보통신기술이 발달함에 따라 스마트병원은 헬스케어 산업에서 새로운 트렌드가 되고 있다. 본 논문에서는 문헌고찰을 통해 스마트병원의 개념, 주요 기술, 적용분야, 직면과제 및 사용자 중심의 스마트병원 구축 전략에 대해 살펴본다. 스마트병원에서는 상호연결된 디지털 네트워크 안에서 임상가들이 환자중심의 통합적 의료서비스를 효율적으로 제공하도록 함으로써 보다 나은 환자결과에 도달할 수 있게 될 것이다. 그러나 향후 보다 성공적인 환자중심 스마트병원을 위해서는 비용이나 기술, 보안, 표준 등과 관련된 여러 장애요소들이 극복되어야 하며, 디지털 솔루션의 최종 사용자인 환자와 의료인의 참여가 요구된다.

간호기기 개발수요 조사연구 (A Study on the Demand for Equipent Development in Nursing)

  • 장순복;김의숙;황애란;강규숙;서미혜
    • 대한간호
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    • 제35권2호
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    • pp.71-91
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    • 1996
  • The objectives of thes study were to identify the need for equipment development in nursing, and to determine the priorities for that development. The study was descriptive study done between March 2 and May 30, 1995, in which the subjects, including 421 patients, 223 family members, and 198 nurses from neurosurgery, orthopedic, rehabilitation medicine, internal medicine and intensive care units of nine general hospitals in Seoul, completed a questionnarie developed by the research team. The questionnaire consisted of 35 open and closed questions. Data was analyzed using frequencies and percentages. The results ware summarized as follows: 1) The average age of the nurses was 27.9 years, 48% of the patients were between 20 and 40 years of age, and 17% were over 60. The average lingth of experience for the nurse subjects was four years five months with 36.9%. having over five years experience. The most frequent diagnoses of patients were spinal disc(35.9%), internal medicine disease(26.0%), cerebral vascular accident(16.6%) and spinal cord injury(10%) 2) Many of the nurses(96.4%) reported deficiencies with existing equipment and 96.5% of the nurses, but only 79.8% of the patients, nurses' time. Further, 82.3% of the nurses and 75.8% of the patients felt that the development of new equipment would lead to a decrease in the cost of nursing care. 3) Nurses felt that the greatest areas of inconvenience were patient feeding(71.7%), hygiene(71.2%), caring for a patient confined to bed(70.7%), patient clothing(67.2%), mobility transfers(63.5%) and urinary elimination(52.0%). However, patients and family members listed the following as being the most inconvenient: urinary elimination(58.7%), Hygiene(50.5), feeding(48.4%), mobility transfers(47.1%) and bed care(45.2%). 4) Generally the nurses listed more inconveniences and patients and family members listed more demands for the development of equipment. These included utensils with large handles, and regulators for tube feedings; mattresses that provide for automatic position change and massage, which have patient controlled levers and a place for bed pan insertion; automatic lifts or transfer from bed to wheelchair; equipment to facilitate washing and oral hygiene as well as equipment that will allow patients with spinal cord injuries easy access to showers; a bed pan/urinal for women that is comfortable and effective from which urine can be measured and disposed of easily; disposable dressing sets and tracheostomy care sets and a convenient way of measuring changes in wound size; a safe delivery system for oxygen, a variety of mask sizes and better control of humidity, tracheal material than at present, as well as a communication system for patients with tracheostomies; clothing that will allow access to various parts of the body for treament or assessment without patients having to remove all of their clothing; and finally a system that will allow the patient to control lighting, telephones and pagers. Priority areas for equipment development reported by the nurses were, urinary elimination(58. 7%), hygiene(50.5%), feeding(48.4%), mobility transfers(47..1%), bowel elimination(40.8%). Those reported by the patients family members were feeding(71.7%), hygiene(70.0%), bedcare(70.7%), clothing(67.2%), mobility transfers(63.6%), urinary elimination(52.9%) and bowel elimination(50.5%) Altogether, nurses, patients and family members listed the following as priorities; clothing (178), bed care(144), urinary elimination(92), environment(81), hygiene(70). Further, a health professional forum listed urinary elimination, oxygen delivery, medication delivery, mobility transfers, bed care and hygiene in that order as priority areas. From this study it can be concluded that the first need is to develop equipment that will address the problems of urinary elimination. To do (l)This nurses who are interested in equipment development should organize an equipment development team to provide a forum for discussion and production of equipment for nursing.

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