• 디지털융복합연구
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• 제20권5호
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• pp.885-890
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• 2022

본 연구의 목적은 마비환자의 효율적인 이동을 돕기 위하여 환자를 돌보는 보호자에게 자체 교육 프로그램을 적용 후, 보호자가 환자를 이동시키는 상황에서 느끼는 안위감의 효과를 알아보기 위함이다. 본 연구 결과, 병실 침대에서 휠체어로의 이동은 교육 전 5.06점에서 7.02점으로, 휠체어에서 병실 침대로의 이동 5.20점에서 7.04점으로, 휠체어에서 치료실 매트로의 이동 6.00점에서 7.20점으로, 침대에서 침대로의 이동 7.14점에서 7.86점으로, 휠체어에서 샤워의자의 이동에서의 위험도는 5.92점에서 7.20점으로 안위감이 높아진 것으로 나타났다. 본 연구를 기초로 한 반복연구를 통해 마비환자의 올바른 이동 방법 프로그램 개발이 이루어 질 것을 제언한다.

• Journal of Chest Surgery
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• 제57권3호
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• pp.315-318
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• 2024

The HeartWare Ventricular Assist Device (HVAD) was widely used for mechanical circulatory support in patients with end-stage heart failure. However, there have been reports of a critical issue with HVAD pumps failing to restart, or experiencing delays in restarting, after being stopped. This case report describes 2 instances of HVAD failure-to-restart during heart transplantation surgery and routine outpatient care. Despite multiple attempts to restart the pump using various controllers and extensions, the HVAD failed to restart, triggering a hazard alarm for pump stoppage. In one case, the patient survived after receiving a heart transplantation, while in the other, the patient died immediately following the controller exchange. These cases highlight the rare but life-threatening complication of HVAD failure-to-restart, underscoring the importance of awareness among clinicians, patients, and caregivers, and adherence to the manufacturer's guidelines and recommendations for HVAD management.

• 한국병원경영학회지
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• 제17권4호
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• pp.133-166
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• 2012

Hospitals tend to provide uniformed service to patients despite their various demands stemming from the severity of disease stages or the uncertainties in information of treatment stages. To identify service factors and provide effective contextually aware service models that patients demand depending on their evolving circumstances, the study conducted a survey on service quality based on importance and satisfaction of cancer patients. The study surveyed 286 patients and caregivers on importance and satisfaction through a questionnaire comprising of 17 questions at the outpatient clinic of cancer centers of university hospitals in 5 cities. Based on the risks of the disease and uncertainties in information of treatment stages, the cancer patients were grouped into diagnosis stage; low-risk treatment stage; high-risk treatment stage; stabilization stage. Depending on the patient's situation, the importance and satisfaction of service factors were ranked. These factors were categorized into 4 groups from a managerial perspective into 'keep it up area', 'focus here area', 'low priority area', 'overdone area'. This study provides an effective medical service model that can accommodate patients based on management areas of cancer patients.

• Clinical and Experimental Pediatrics
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• 제59권8호
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• pp.319-327
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• 2016

Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and food allergy, are most common chronic, noncommunicable diseases in childhood. In the past few decades, the prevalence has increased abruptly worldwide. There are 2 possible explanations for the rising prevalence of allergic diseases worldwide, that an increased disease-awareness of physician, patient, or caregivers, and an abrupt exposure to unknown hazards. Unfortunately, the underlying mechanisms remain largely unknown. Despite the continuing efforts worldwide, the etiologies and rising prevalence remain unclear. Thus, it is important to identify and control risk factors in the susceptible individual for the best prevention and management. Genetic susceptibility or environments may be a potential background for the development of allergic disease, however they alone cannot explain the rising prevalence worldwide. There is growing evidence that epigenetic change depends on the gene, environment, and their interactions, may induce a long-lasting altered gene expression and the consequent development of allergic diseases. In epigenetic mechanisms, environmental tobacco smoke (ETS) exposure during critical period (i.e., during pregnancy and early life) are considered as a potential cause of the development of childhood allergic diseases. However, the causal relationship is still unclear. This review aimed to highlight the impact of ETS exposure during the perinatal period on the development of childhood allergic diseases and to propose a future research direction.

• 성인간호학회지
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• 제18권3호
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• pp.488-499
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• 2006

Purpose: Behavioral symptoms in dementia (BSD) are one of the most disturbing behaviors to caregivers and a major reason for nursing home placement. Behavioral symptoms are often treated with psychotropic drugs (PD), however, the effect of such drugs for the frail elderly dementia patient is not certain because of their critical adverse effects. Theoretical model applicable to nursing practice for BSD in nursing homes, which is essential in guiding and evaluating such interventions, is absent. This article presents the process of developing a theoretical model of BSD in nursing homes. Method: Using Walker and Avants' theory synthesis method, three behavior models and two system models were incorporated into the proposed model to provide the theoretical and analytical explanation of the relationships between PD usage, its determinants, and BSD. Results: Resident variables and nursing home variables related to the two focal concepts (i.e., PD usage and BSD) were identified. Resident variables include demographical characteristics such as age and gender, and dementia-compromised functions such as cognitive and functional impairment. Nursing home variables include facility characteristics such as ownership type and size, and physical and psychosocial environment. Conclusion: The proposed model suggests that fulfillment of resident unmet needs through improvement of physical and psychosocial environment may produce better health outcomes of nursing home residents with BSD. Assessment and intervening environmental triggers of such behaviors are also suggested to be prior to the PD usage.

• 대한간호학회지
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• 제29권3호
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• pp.518-529
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• 1999

The purpose of this research was to develop a nursing intervention list for family caregivers. The specific steps were as follows : 1. Analyze the concept, Soobal, based on literature review and case observation. 2. Generate an initial list of defining activities for ‘Caregiver Support : Soobal’. 3. Validate the defining activities. 4. Complete the final list of defining activities. A two-round Delphi questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of intervention, Caregiver Support : Soobal. The definition of ‘Caregiver Support : Soobal’ was provision of the necessary information, advocacy, and support to facilitate primary patient care by someone other than a health care professional in Korean traditional manners. Ten nurse experts participated in Round I and II of this study. They were asked to rate activities that examplified the interventions on a scale of 1 (activity is not at all characteristic) to 5 (activity is very characteristic). Round I contained 15 ‘critical’ activities and 10 ‘supporting’ activities, while round II contained 16 ‘critical’ activities and 6 ‘supporting’ activities. No activities were considered to be ‘nonsupporting’ in both round I and II. Finally, the definition and 25 defining activities were developed. Intervention, Caregiver Support : Soobal, attained an ICV score of .82. This study provides a protocol model to develop Korean nursing interventions.

• 간호행정학회지
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• 제21권5호
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• pp.469-479
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• 2015

Purpose: The purpose of this study was to compare hospitalized patients in comprehensive nursing care units and general care units as to satisfaction with nursing care and factors influencing their intent to revisit the hospital. Methods: A cross-sectional study was conducted with 178 patients who had been hospitalized in a comprehensive nursing care unit and a general care unit in one hospital. Participants completed self-report questionnaires. Data were analyzed using SPSS 21.0. Results: There was a significant difference between the comprehensive nursing care unit and general care unit for intent to revisit the hospital (p=.036). Factors influencing intent to revisit the hospital for patients in the comprehensive nursing care unit were 'satisfaction with nursing care' (p<.001) and 'use of additional costs for comprehensive nursing care' (p=.041). The factor influencing intent to revisit hospital for patients in the general care unit was 'satisfaction with nursing care' (p<.001). Conclusion: Findings indicate that comprehensive nursing care service in which all care is provided by nursing staff only, without family or private caregivers, increases intent to revisit the hospital. These results can be used as the foundation of reviewing the operation and expansion of comprehensive nursing care service.

• 국제물리치료학회지
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• 제11권1호
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• pp.1940-1949
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• 2020

Background: Self-checked monitoring home exercises are recommended for preventing falls among people with Parkinson's disease. However, as these home exercises are performed autonomously by patients without professional management, their accuracy and efficiency can be compromised. Objective: To investigate the effects of providing regular training sessions to patients and caregivers and of patient self-monitoring of exercise performance following the implementation of a self-checked monitoring exercise program for people with Parkinson's disease. Design: Randomized Pretest-Posttest Control Group Design. Methods: We provided regular self-checked monitoring home exercise and general home exercise programs to 30 participants for 12 weeks. Once a month at the first, fifth, and ninth-week sessions, a rehabilitation team attended the Parkinson's group education. In addition to the subject in the experimental group perform the home exercises program to provide feedback regarding the home exercises program and to carry out a self-monitoring checklist performance for 12 weeks. Results: The 10 m walk test, functional reach test, and sit to stand test and the modified Barthel index significantly improved in the self-checked monitoring home exercise group. Conclusion: These results suggest that self-checked home exercise programs, which facilitate safety and consistent performance of exercises at home, are beneficial for people with Parkinson's disease.

• Archives of Plastic Surgery
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• 제46권1호
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• pp.75-78
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• 2019

It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.

• 임상간호연구
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• 제29권1호
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• pp.12-23
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• 2023

Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.