• Title/Summary/Keyword: Patient's data

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Reducing frame rate and pulse rate for routine diagnostic cerebral angiography: ALARA principles in practice

  • Arvin R. Wali;Sarath Pathuri;Michael G. Brandel;Ryan W. Sindewald;Brian R. Hirshman;Javier A. Bravo;Jeffrey A. Steinberg;Scott E. Olson;Jeffrey S. Pannell;Alexander Khalessi;David Santiago-Dieppa
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.26 no.1
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    • pp.46-50
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    • 2024
  • Objective: Diagnostic cerebral angiograms (DCAs) are widely used in neurosurgery due to their high sensitivity and specificity to diagnose and characterize pathology using ionizing radiation. Eliminating unnecessary radiation is critical to reduce risk to patients, providers, and health care staff. We investigated if reducing pulse and frame rates during routine DCAs would decrease radiation burden without compromising image quality. Methods: We performed a retrospective review of prospectively acquired data after implementing a quality improvement protocol in which pulse rate and frame rate were reduced from 15 p/s to 7.5 p/s and 7.5 f/s to 4.0 f/s respectively. Radiation doses and exposures were calculated. Two endovascular neurosurgeons reviewed randomly selected angiograms of both doses and blindly assessed their quality. Results: A total of 40 consecutive angiograms were retrospectively analyzed, 20 prior to the protocol change and 20 after. After the intervention, radiation dose, radiation per run, total exposure, and exposure per run were all significantly decreased even after adjustment for BMI (all p<0.05). On multivariable analysis, we identified a 46% decrease in total radiation dose and 39% decrease in exposure without compromising image quality or procedure time. Conclusions: We demonstrated that for routine DCAs, pulse rate of 7.5 with a frame rate of 4.0 is sufficient to obtain diagnostic information without compromising image quality or elongating procedure time. In the interest of patient, provider, and health care staff safety, we strongly encourage all interventionalists to be cognizant of radiation usage to avoid unnecessary radiation exposure and consequential health risks.

Correlation Between Perceived Family Support and Self-Esteem of Middle Age Women with Degenerative MusculoSkeletal Diseases (퇴행성 근골격계 질환을 가진 중년여성이 지각한 가족지지의 자아존중감의 관계)

  • Kang, Kyung-Ja;Lee, Eun-Jin
    • Journal of muscle and joint health
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    • v.7 no.1
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    • pp.5-24
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    • 2000
  • Middle age for women is one of the most important stages of the whole normal life span and has unique problems concerning the psychological and physical health, specifically degenerative musculoskeletal diseases. Therefore middle age women should prepare in order to lead a healthy and fruitful life as they enter/begin old age. As the population of middle age women increase, the demands of nurses who care for this age group also continue to glow. Nurses must be interested in this middle age group of women in Korea. This study was designed to identify the extent of family support and self-esteem of the middle age women with degenerative musculoskeletal diseases and the relationship between them and nurse's contribution to middle age women's health promotion that maintain and promote qualify of her life. The population of this study was 112 women aged 40-60, attending the out patient clinic one University Hospital and one Hospital, in Pusan. The data was collected from 1st August to the 30th of September, 1998 by using 36 items questionnaire. The instrument used for measuring family support was of Chai's(1983) FSS which was modified by Kang's(1984) Family Support Scale. And that for self-esteem was Rosenberg's(1965) Self-esteem Scale. The reliability of Chai's FSS and Rosenberg's instruments were tested by Cronbach's alpha and showed that they were 0.93 and 0.89 each respectively. Data was analyzed by descriptive statistics, t-test, ANOVA, and Pearson's Correlation Coefficient using the SPSS computer program. The results of the study were summarized as follows : 1. The mean score of the perceived family support was $39.31{\pm}9.42$. 2. The mean score of the perceived self-esteem was $33.16{\pm}6.75$. 3. Statistically significant factors influencing the family support among sociodemographic variables was satisfaction of marriage(F=-3.069, p<0.003). 4. Statistically significant factors influencing the self-esteem among sociodemographic variables were age(F=3.992, p=0.000), education(F=2.260, P=0.026), housing (F=-1.987, P=0.049) and satisfaction of marriage(F=-2.305, P=0.023). 5. There was a significant correlation between family support and self-esteem (r=.621, p<.000). In conclusion, perceived the family support was important for middle age women to increase their self-esteem. Nurses should be aware of the necessity of family support in the supportive nursing of middle age women and should be able to make a plan to educate the family about supporting the wife/mother. The continuing study of the health promotion of middle age women to find out variables influencing middle age women' health must continue.

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Oral health belief and satisfaction after scaling experience with comprehensive dental hygiene care (포괄치위생관리(CDHC) 과정 적용에 따른 스케일링 경험 대상자의 구강건강신념과 만족도)

  • Kim, Mi-Hye;Moon, Sang-Eun;Kim, Yun-Jeong;Kim, Seon-Yeong;Cho, Hye-Eun;Kang, Hyun-Joo
    • Journal of Korean society of Dental Hygiene
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    • v.22 no.1
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    • pp.1-9
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    • 2022
  • Objectives: This study was conducted to find scaling patients' oral health belief and satisfaction by applying Comprehensive Dental Hygiene Care (CDHC) process. Methods: From July 1 to September 20, 2020, the data about 182 patients who had scaling in dental clinics and hospitals had been collected and analyzed. For data analysis, SPSS Statistics 22.0 was applied to conduct frequency analysis, chi-square, t-test, One way ANOVA and Pearson's correlation analysis. Results: Regarding oral health behavior, in the CDHC group 92.4% used oral care products (p<0.001), and 67.4% regularly visited dental clinics for oral care (p<0.001). Regarding the oral health belief according to general characteristics, in the CDHC group, persons aged '50-65' scored 2.4 (the highest), and were significantly different from those aged '20-29' as the result of post-hoc analysis (p<0.001). Regarding the oral health belief of the CDHC group according to oral health behavior, the scaling cycle '3 months' scored the highest (p<0.05). The patients' satisfaction had high correlations with benefit (p<0.01) and Importance (p<0.05) as the sub factors of the oral health belief of the CDHC group. Conclusions: CDHC positively influenced scaling patients' oral health belief and satisfaction. Therefore, it is necessary to expand CDHC, as the medium to improve oral health belief and satisfaction, to clinical settings.

Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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An External Surfaces Modeling of Inlay/onlay Using Geometric Techniques (기하학 기술을 이용한 인레이/온레이의 외면 모델링)

  • Yoo kwal-Hee;Ha Jong-Sung
    • The KIPS Transactions:PartA
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    • v.12A no.6 s.96
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    • pp.515-522
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    • 2005
  • This paper presents a method for effectively modeling inlay/onlay prostheses restoring a tooth that are partially destroyed. An inlay/onlay is composed of internal surface adhering to an abutment, and external surface revealed to the outside sight. Internal surfaces are modeled using Minkowski sum expanding the grinded surface parts of abutments so that the internal surfaces can adhere to the abutments with closer contact. In modeling external surfaces, we exploit 3D mesh deformation techniques: DMFFD(direct manipulation free-form deformation)[19] and MWD(multiple wires deformation)[17] with three kinds of informations: standard teeth models, mesh data obtained by scanning a plaster cast of a patient's tooth, FGP(functionally guided plane) measuring the occlusion of the patients's teeth. The standard teeth models are used for building up the basic shapes of external surfaces, while the plaster fast and FGP data are used for reflecting the unique properties of adjacent md occlusal surfaces of the patients's teeth, which are slightly different to each other but very important for correct functioning. With these informations as input data, the adjacent and occlusal surfaces are automatically generated as mesh data using the techniques of DMFFD and m, respectively. Our method was implemented so that inlay/onlay prostheses fan be designed more accurately by visualizing the generated mesh models with requirements by dentists.

A Study of Effect on Quality of Life of Cancer Patient's Caregiver : Focusing on the Mediating Effect of Feeling of Burden and Growth (사회적 지지와 암환자 가족의 삶의 질의 관계에서 돌봄부담감과 내적성장의 매개효과)

  • Rhee, Young-Sun
    • Korean Journal of Social Welfare
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    • v.61 no.2
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    • pp.325-348
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    • 2009
  • This study intends to investigate the main and mediating effects which caregiving appraisal and positive reappraisal exert on quality of life (QOL) of primary family caregivers of cancer patient considering the relationship with social support. The processes of this study areas follows. First, the variables which research model were chosen on the basis of stress-appraisal-coping theory through reviews of the previous studies. Second, a survey was conducted upon 295 primary caregiver of patient with cancer at National Cancer Center. Collected data were analyzed by SPSS 12.0 and SEM (Structural Equation Modeling) method using AMOS 5.0. The summary of the result is as follows. First, the entire model including measurement and structural model shows sufficient fit index of CFI(.951), TLI(.940) and RMSEA(.062). Second, the results of analysis of direct effects among variables are as follows. The 'Social support' has statistically significant direct effect on the 'feeling of burden' and 'growth'. The 'feeling of burden' has statistically significant direct effect on the 'growth' and 'QOL-mental and physical'. The 'growth' has statistically significant direct effect on the 'QOL-mental'. Third, the results of analysis of mediating effects of the 'social support and QOL' and 'feeling of burden and QOL' are as follows. The effects of 'social support' on 'QOL-mental' are significantly mediated by the 'feeling of burden' and 'growth'. The effects of 'social support' on 'QOL-physical' are significantly mediated by the 'feeling of burden'. The effects of 'feeling of burden' on 'QOL-mental' are significantly mediated by 'growth'. Through this research, these implications in social work study and practice are found: (1) this study extended the scope of study in the caregiver's health area from negative sides into positive ones by using growth variables as positive reappraisalof caregiving in research model, which has not been tried on the Korean family caregivers of the cancer patient. (2) The effects of positive reappraisal on QOL-mental can provide a foundational necessity for social workers to help family caregivers find positive meaning in their caregiving experience. This approach of social work practice will improve QOL of family caregivers. (3) This study present a framework including social support, negative appraisal, positive reappraisal, and QOL variables available to social work practice and explaining affective relationships among these variables in various aspects.

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Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center (응급의료센터 내원환자 진료시 소요시간과 관련된 요인)

  • Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.138-155
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    • 2000
  • Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

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The Analysis of Outpatient Anesthesia for Dental Treatment in Handicapped Patients with Behavior Disorder (행동조절장애 환자에서 치과치료를 위한 외래마취의 분석)

  • Ban, Min-Hee;Chung, Sung-Su
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.1
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    • pp.57-62
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    • 2014
  • Background: The aim of this study was to analyze outpatient anesthesia for dental treatment in handicapped patients with behavior disorder in order to use data for carrying out better and safe anesthetic management. Methods: The data were drawn from the 100 patients with behavior disorder who visited CNUDH dental clinic for disabled based on anesthesia record to investigate patient's systemic condition, cooperative level, anesthesia method according to patients cooperation, and side effects after recovery time. Results: Mental retardation (58%) is the most reason to choose general anesthesia. The methods of induction according to cooperative level are intravenous propofol injection in 22 cases and inhalation of sevoflurane in 78 cases. Induction time of anesthesia were within 10 seconds in cases of propofol induction and average $48.8{\pm}18.5$ seconds in cases of inhalation induction. The time spent on dental treatment was average $3.2{\pm}1.1$ hours. After the end of treatment, average time to move from unit chair to recovery bed, to recliner, and to discharge from hospital are $10.4{\pm}5.1$, $36.9{\pm}17.1$ and $72.4{\pm}16.0$ minutes, respectively. During recovery, there are nausea with 9%, vomiting with 4%, dizziness with 2%, finger injury with 1%. Conclusions: This study showed our successful anesthetic outcomes without any severe side effects or complications. Through this study, it will be used for safe anesthetic management as useful reference data.

A Study on Perceived Discomfort in Patients Following Cardiac Catheterization (심도자 검사 환자의 불편감에 관한 연구)

  • 이은자
    • Journal of Korean Academy of Nursing
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    • v.25 no.1
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    • pp.124-140
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    • 1995
  • Cardiac cathererization has become a routine diagnostic procedure indicated for evaluation of a wide varity of cardiac conditions. Patients are admitted to the coronary care unit after cardiac catheterization. These conscious patients report feeling uncomfortable in the CCU, but no studies have been done on the effects of bed rest, sand bags on the femoral puncture site and restricted mobility for 4 to 12 hours or longer postprocedure. The main objective of this thesis is to provide basic data to nursing on interventions which de-crease the uncomfortableness experienced by patients in the CCU following cardiac catheterization. In this phenomenological study, the various discomforts felt by the patients were collected and classified. The study subjects were a convenience sample of 29 patients who were admitted to the CCU of a general hospital in Inchon following cardiac catheterization. They were conscious, so they were able to communicate without difficulty. The data were collected over an U days period from July 21, to October 14, 1994. The subjects were interviewed using unstructured open questions and the interviews were tape recorded with the patient's permission The data were analyzed using the Van Kaams phenomenological method. Reliability and validity were exammed by two professor of nursing science, one head nurse, one staff nurse and one cardiologist. The results of the study are summarized as follows ; 1. The 129 descriptive statements by the postcardiac catheterization patients of discomfort were organized into 19 themes. 2. The 19 themes were divided into 3 categories ; physical, psychological, and environmental aspects. 3. The problems concerning the physical aspect were the discomfort of restriction of movement, dysuria, medical devices, pain in the puncture site, symptom is related to the procedure of cardiac catheterization, headache and dizziness, leg painand tingling sensation, and chest pain. The problems concerning the psychological aspect were regret resulting from dependency, economic burden, dissatisfaction with medical personnel, dissatisfaction with medical service system, anxiety about the result of the procedure, concern about the prognosis, loneliness, and concern over treatment procedure. The problems concerning the environmental aspect were influence from neighboring patients, noise, and maladaptation to environmental change. The necessity for holistic care which satisfies physical, psychological, and environmental need must be emphasized in order to solve these discomforts.

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Nutritional Status of Hospitalized Geriatric Patients Using by the Mini Nutritional Assessment (MNA를 이용한 노인 환자의 영양 상태 판정)

  • Chung Su-Hyun;Sohn Cheong-Min
    • Korean Journal of Community Nutrition
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    • v.10 no.5
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    • pp.645-653
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    • 2005
  • The prevalence of undernutrition in hospital populations is known to be high. The presence of malnutrition is associated with depression, infections, sarcopaenia, falls, fractures, reduced autonomy and increased mortality. This study specifically examined the prevalence of malnutrition in patients aged 65 or older at the time of admission as determined by the Mini Nutritional Assessment (MNA) which has been a frequently used nutritional risk screening tools in detecting undernutrition in old people. This study was done for one hundred eight hospitalized geriatric patients in Seoul National University Bundang Hospital, Seoul, Korea. On admission baseline history, anthropometrics measurements, laboratory data and nutritional status by MNA were assessed. Length of hospital stay was obtained by reviewing medical charts. We used one-way analysis of variance to compare the differences in variables. Spearman's rank correlation coefficients were calculated for associations between MNA and variables. On admission, $22.3\%$ of patients were malnourished and $40.7\%$ were at risk of malnutrition according to the MNA. Percent of ideal body weight, anthropometrics data, albumin, and hemoglobin were lower in the malnourished patients (p<0.05). The malnourished patients stayed in the hospital 7.3 days longer, as compared with well nourished patients (p<0.05). Percent of ideal body weight, albumin, hemoglobin and total cholesterol were correlated inversely with nutritional status according to MNA (p<0.05). MNA can be used for nutritional assessment in Korean old people, because MNA significantly correlated with other nutritional assessment parameters, such as, anthropometric and laboratory data in hospitalized geriatric patients. The high prevalence of malnutrition in the elderly was observed and the presence of malnutrition on admission predicted a significant increase in the length of hospital stay in this study. Therefore further studies are needed to determine whether nutritional interventions in old people with low MNA scores can improve clinical outcomes during the hospital course.