• Title/Summary/Keyword: Patient consultation

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Development of Nursing Intervention Protocol for Childhood Cancer at Early Diagnosis Stage (소아암 환자의 초기 진단단계의 간호중재 프로토콜 개발)

  • Choi Ja-Yun;Yoo Il-Young
    • Child Health Nursing Research
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    • v.8 no.1
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    • pp.44-54
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    • 2002
  • The main purpose of this methodological study was to develop an assessment tool and intervention protocol for child and family with childhood cancer at early diagnosis stage. The assessment tool and intervention protocol was developed by extensive literature review and consultation with experts. Review of nine domestic and sixty-six international journal articles were done to identify stress, interventions, coping strategies and adjustment of children with cancer and their family. Results were as follows; First, assessment at the early diagnosis stage need to include information on patient, family, and patient/family attitude toward diagnosis and treatment. Second, intervention protocol for children with cancer includes control physical symptoms, manage the side effects of chemotherapy and diagnostic or therapeutic procedures, control emotional responses, provide support and information, assist decision-making and adjust to environment. Third, intervention protocol for family includes controlling emotional responses, provision of informations, inducing family support to patient, improving family cohesion, supporting siblings and supporting spiritual growth. In conclusion, the early diagnosis stage in cancer treatment is important for child and family since this stage greatly affects the overall adjustment of child and family to live with cancer. Therefore, pediatric nurses need to be sensitive to the need of patient/family and systematically manage their needs at this stage.

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A Case of Panic Disorder of Soeumin Concurrently Treated with Psychotherapy Based on Sasang Constitutional Medicine (사상의학적으로 접근한 정신요법을 병행한 소음인 공황장애 치험 1례)

  • Lee, Yong-jae;Lee, Seul;Park, Jieun;Kim, So-hyung;Lee, Jeongyun;CHAE, Han
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.2
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    • pp.61-70
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    • 2020
  • Objectives The purpose of this case study was to report that a patient with Panic Disorder concurrently treated with psychotherapy based on Sasang Constitutional Medicine was able to discontinue the drugs. Methods The patient was diagnosed as Soeumin and consulted according to her Sasang constitution while being administered with herbal medicines. The psychotherapy applied in the consultation was to reduce excessive expectations towards her family members or situations. Results and Conclusions Anxiety of the patient was alleviated and the patient was able to discontinue the drugs during the treatment period. And no panic attack or adverse effect of the discontinuation of the drugs was observed during the rest of the time of 7 months and 4 months later after the termination of the treatment.

Changes of Clinical Practice in Gastrointestinal Perforation with the Increasing Use of Computed Tomography

  • Park, Ji-Min;Yoon, Young-Hoon;Horeczko, Timothy;Kaji, Amy Hideko;Lewis, Roger J
    • Journal of Trauma and Injury
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    • v.30 no.2
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    • pp.25-32
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    • 2017
  • Purpose: The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED). Methods: We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003-2004 and 2013-2014. Results: In patients with gastrointestinal perforation, time from ED arrival to CT was shorter ($111.4{\pm}66.2min$ vs. $199.0{\pm}97.5min$, p=0.001) but time to surgical consultation was longer ($135.1{\pm}78.8$ vs. $77.9{\pm}123.7$, p=0.006) in 2013-2014 than in 2003-2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups. Conclusion: With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.

A Study on the Present Status of Clinical Nurses with Expanded Role (진료협력간호사의 운영현황에 관한 연구)

  • Kwon, Young Dae;Sung, Young Hee;Kwon, In Gak;Hwang, Moon Sook
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.99-115
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    • 2008
  • Purpose: The purpose for this study was to identify the present state of Clinical Nurses with Expanded Role (CNERs) and provide basic data to refine the roles of CNERs. In this study, CNREs refers to nurses who perform techniques traditionally done by doctors and use titles such as clinical nursing specialist, educator with consultation, research assistant, coordinator, physician assistant and special examiner. Method: This study was conducted from September 1 to November 12, 2007. Data from 684 nurses from 38 hospitals who responded to the questionnaire were analyzed with descriptive statistics using the SPSS 14.0 program. Results: The mean percentage of time spent was, for direct practice, 41.1%, for education and counseling, 22.8%, for consultation and coordination, 10.4%, for research, 6.8%, for administration, 8.9% and for other activities, 10.0%. The most frequently implemented CNERs, activities included consultation and education for patients and their families, counseling by telephone, history taking, physical examination, reading examination results, psychosocial assessment, managing treatment, input of prescriptions, and writing up patient records, Although not frequently performed, nurses in some fields carried out invasive procedures and prescribed medication and laboratory tests. Conclusion: Although the number of hospital CNERs are rapidly increasing, there is still confusion about the title and framework as well as standards. Furthermore, because some nurses are prescribing medication and laboratory tests as well as performing techniques not traditionally done by nurses, there is an absolute need for a legalized system and systematic education system for the safety of patients who are being cared by all CNERs.

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An Analysis of the Role of Nurse Specialists in the General Hospital (일 종합전문병원의 전문간호사 업무 분석)

  • Park, Kwang-Ok;Kim, Jong-Kyung;Jeong, Jae-Sim
    • The Journal of Korean Academic Society of Nursing Education
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    • v.13 no.2
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    • pp.246-256
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    • 2007
  • Purpose: The purpose of this study was to explore the role of nurse specialist in the general hospital, and to provide basic data for the role management of nurse specialist. Method: The subjects were 38 staff nurses who worked in a medical, surgical, or other department in one general hospital. Survey tools were developed with criteria for a clinical nurse specialist by American Nurses Association(1986), Korean Nurses Association(2001), Kim(2005)'s research, and the nurse specialists' self job description. Validity of the tool was examined by 5 clinical nursing experts and nurse specialists. Data analysis was done by using SPSS Win 12.0 program. Result: The results of domains for the job of nurse specialists were 61.6% for direct clinical practice, 21.7% for education, 5.7% for consultation, 5.2% for management, 5.2% for research, and 1.1% for other domains. The results for the large classifications in nurse specialists domains were 57.6% for direct nursing practice in direct clinical practice domain, 89.1% for patient education in education domain, 57.5% for medical consultation in consultation domain, 57.5% for medical research in research domain, and 39.2% for documentation in management domain. Conclusion: This research revealed that direct clinical practice domain was higher than the other domains of research, education, and management. Discussion and development about the nurse specialist's various roles needs to be addressed on a continual basis.

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Obtaining Informed Consent Using Patient Specific 3D Printing Cerebral Aneurysm Model

  • Kim, Pil Soo;Choi, Chang Hwa;Han, In Ho;Lee, Jung Hwan;Choi, Hyuk Jin;Lee, Jae Il
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.398-404
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    • 2019
  • Objective : Recently, three-dimensional (3D) printed models of the intracranial vascular have served as useful tools in simulation and training for cerebral aneurysm clipping surgery. Precise and realistic 3D printed aneurysm models may improve patients' understanding of the 3D cerebral aneurysm structure. Therefore, we created patient-specific 3D printed aneurysm models as an educational and clinical tool for patients undergoing aneurysm clipping surgery. Herein, we describe how these 3D models can be created and the effects of applying them for patient education purpose. Methods : Twenty patients with unruptured intracranial aneurysm were randomly divided into two groups. We explained and received informed consent from patients in whom 3D printed models-(group I) or computed tomography angiography-(group II) was used to explain aneurysm clipping surgery. The 3D printed intracranial aneurysm models were created based on time-of-flight magnetic resonance angiography using a 3D printer with acrylonitrile-butadiene-styrene resin as the model material. After describing the model to the patients, they completed a questionnaire about their understanding and satisfaction with aneurysm clipping surgery. Results : The 3D printed models were successfully made, and they precisely replicated the actual intracranial aneurysm structure of the corresponding patients. The use of the 3D model was associated with a higher understanding and satisfaction of preoperative patient education and consultation. On a 5-point Likert scale, the average level of understanding was scored as 4.7 (range, 3.0-5.0) in group I. In group II, the average response was 2.5 (range, 2.0-3.0). Conclusion : The 3D printed models were accurate and useful for understanding the intracranial aneurysm structure. In this study, 3D printed intracranial aneurysm models were proven to be helpful in preoperative patient consultation.

Severe Recurrent Gingival Bleeding and Toothache Control in a Patient with Liver Cirrhosis and Oral Metastatic Hepatoma: Report of a Case (간경화증과 구강전이 간암환자에서 과도한 재발성 치은출혈과 치통조절: 증례보고)

  • Lee, Chun-Ui;Mo, Dong-Yub;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Jong-Bae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.6
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    • pp.592-596
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    • 2010
  • The common local causes of active gingival bleeding are the vessel engorgement and erosion by severe inflammation and injury to hypervascularity lesion. Abnormal gingival bleeding is also associated with systemic bleeding disorders (liver disease, leukemia etc.). There are many conventional methods for gingival bleeding control, such as, direct pressure, packing, electrocoagulation, tight suture and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the all local application methods, the medical consultation should be obtained for systemic condition care and the major feeding arterial embolization. This is a case report of severe gingival bleeding and periodontitis control in a patient with liver cirrhosis and oral metastatic lesion of hepatocellular carcinoma. The bleeding lesion was placed in left buccal mucosa and gingiva of the left mandibular molars. The control methods were dental crown removal, primary endodontic drainage, gingival sulcus drainage and maxillary arterial embolization with medical consultation.

Analysis of Importance, Difficulty, and Frequency of Nurses' Job in Outpatient Departments (외래간호사의 직무에 대한 중요도, 난이도, 빈도 분석)

  • Yi, Yeo-Jin;Cho, Kyung-Sook;Park, Young-Sook;Lim, Nan-Young;Kim, Dong-Oak;Kwon, Sung-Bok;Lee, Eun-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.16 no.2
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    • pp.232-241
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    • 2009
  • Purpose: The purpose of this study was to analyze the importance, difficulty, and frequency of work (duties and tasks) done by nurses' in Outpatient Departments (OPD). Method: Data were collected using structured questionnaires, which included 11 duties and 92 tasks making up the OPD nurse's job. Questionnaires were completed by 286 nurses. Each duty and task was analyzed for importance, difficulty, and frequency (range 1-3). Results: The mean score for importance was $2.58{\pm}0.29$, for difficulty, $2.11{\pm}0.31$, and for frequency, $2.18{\pm}0.31$. OPD nurses recognized 'patient education and consultation' as important and difficult. However, in practice OPD nurses reported the most frequent task as 'support for medical services'. There was a significant difference in importance and difficulty of duties according to OPD nurses' university degree (F=3.693, p=.026; F=4.089, p=.018) and hospital size (F=4.274, p=.006; F=3.154, p=.025). However there were no differences in importance, difficulty, or frequency according to clinical experience in OPD. Conclusion: The findings indicate that OPD nurses must be able to do important and difficult duties and tasks, especially patient education and consultation. To have time for these uniquely nursing tasks, OPD nurses need to delegate 'preparation for medical service', and 'management of facility and environment' to nonmedical health-care workers.

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A Neuropathic Atypical Odontalgia Recognized after the Apicoectomy under Local Anesthesia on the Maxillary Lateral Incisor -A Case Report- (국소마취하 상악 측절치 치근단 절제술 후 인식된 신경병성 비정형 치통 1예 -증례 보고-)

  • Mo, Dong-Yub;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Ha-Rang;Lee, Chun-Ui;Kim, Jong-Bae
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.1
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    • pp.20-26
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    • 2010
  • This type of neuropathic pain(atypical odontalgia) is seen most often in middle-aged women or men after dentoalveolar operation. Atypical odontalgia probably is caused by deafferentation leading to intraneural changes in the medullary dorsal horn. Treatment of this problem is difficult, but some success has been reported in uncontrolled, open-labeled studies using high doses of tricyclic antidepressants. This is the management report of a patient case, that had a neuropathic atypical odontalgia recognized with the right maxillary lateral incisor. The patient was consulted to the Department of Pain Clinics, ENT & Neurology and diagnosed the adenoid cystic carcinoma on left cerebellum and right paranasal sinus with extension to the cavernous sinus. In spite of the osteoplastic craniotomy, neurosurgical mass removal and radiation therapy were done with chemotherapy, atypical odontalgia was continued. In addition to the consultation to Psychology, stress management and antidepressant medication were done and improved slowly.

A Study on the Development of Criteria for the Assessment of the Sasang Constitutional Health Level of Cancer Survivors (암생존자를 대상으로 한 사상체질에 따른 건강수준 평가기준 개발 연구)

  • Jin-Hyeok Kwon;Sung-Woon Park;Byung-Joo Park;Seung-Min Hong;A-Ri Kim;Hyunjoo Oh;Jun-Hee Lee
    • Journal of Sasang Constitutional Medicine
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    • v.35 no.4
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    • pp.23-41
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    • 2023
  • Objectives This study is aimed to develop criteria for assessing the health level of cancer survivors through patient reported outcome based on sasang constitutional symtomology. Methods As a result of the researchers' meetings and the first round of expert group consultation, the constitutional health level assessment items that would be common to all Sasang constitutions were extracted, and constitutional health level assessment items for cancer survivors were selected. A second round of expert group consultation was conducted to determine the importance and weighting of these items for each constitution. Results & Conclusions For soeumin, the importance ranking and calculated weight were as follows: 'I had sweats even when I was not hot or exercising.(1st, 4.09)', 'I had night sweats while sleeping(2nd, 3.94)', 'I lost weight.(3rd, 3. 75)', etc. For soyangin, as follows: 'I had night sweats while sleeping.(1st, 3.08)', 'I had vomiting.(2nd, 3.02)', 'I felt hot flashes in the afternoon or at night. (3rd, 2.73)', etc. For taeumin, as follows: 'I was out of breath.(1st, 3.48)', 'My heart was pounding for no reason.(2nd, 3.45)', 'My body was swollen.(3rd, 3.22)', etc. For taeyangins, as follows: 'I couldn't urinate well.(1st, 4.49)', 'I vomited(2nd, 4.44).', 'My upper abdomen were hard.(3rd, 3. 14)', etc. Based on the results, we developed a draft of a questionnaire to assess the Sasang constitutional health level of cancer survivors, weighted for each item.