• 제목/요약/키워드: Patient emotional care

검색결과 161건 처리시간 0.031초

척추마취 수술환자의 간호요구 (A Study on Needs of the Spinal anesthesia Patients)

  • 남성미;김명희
    • 성인간호학회지
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    • 제12권4호
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    • pp.666-677
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    • 2000
  • The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.

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가족면회가 심장 중환자실 환자와 가족의 스트레스 반응에 미치는 효과 (The Effect of Family Visits on Stress Responses of Patients and Their Families in the Cardiac Intensive Care Unit)

  • 박찬금;김혜순;이명희
    • 중환자간호학회지
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    • 제3권1호
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    • pp.41-51
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    • 2010
  • Purpose: The purpose of this study was to identify the effects of family visits upon the stress response of patients and their families, Methods: This study was the interrupted time series design, The subjects consisted of 197 patients and 197 family members in the cardiac intensive care unit of S Hospital in Bucheon. Physiological stress responses such as blood pressure, heart rates, respiration rates, and oxygen saturation were measured using HP monitors. VAS was used to measure the emotional stress. Collected data was analyzed using repeated measure ANOVA, t-test by SPSS 17.0 statistical program. Results: The family visits did not change patients' blood pressure, pulse rate, respiration rate and oxygen saturation, However the anxiety level of patients and their family members were decreased significantly during family visits. Furthermore, 30-minute family visit reduced more effectively patient's anxiety than 15-minute family visit. Conclusion: Family visits need to be used as a means of nursing intervention to ease the emotional stress of patients and their families. In addition, increasing of visiting time should be considered.

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치매전문요양병원의 병동 몇 병실 유니트에 관한 건축계획적 연구 (A Study on the Architectural Planning of the Ward and Patient Room Unit of the Health Care Facilities for the People with Dementia)

  • 강지원;박재승
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제4권6호
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    • pp.37-47
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    • 1998
  • In Korea, it is urgently required to develop the health care facilities and services for People with dementia. The progression of dementia is associated with a gradual decline in functional, cognitive, emotional, and social abilities. Therefore, architectural design for People elderly with dementia should be focused to maintain and preserve this abilities. This study aims to derive the design guidelines of the ward and patient roon unit planning to maintain this abilities in the health care facilities for People with dementia. For this, investigation and analysis through the case studies of domestic and foreign facilities and P.O.E of domestic facilities were performed.

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뇌.척추질환 노인 환자 주 가족수발자의 부담감에 영향을 미치는 요인 (Factors Influencing the Burden Felt by Main Family Caregivers of Elderly Patients with Brain and Spinal Diseases)

  • 박희경;박경민
    • 지역사회간호학회지
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    • 제22권4호
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    • pp.389-398
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    • 2011
  • Purpose: This study of this study was to identify factors influencing the burden of main family caregivers who take care of elderly patients with brain and spinal diseases. Methods: This was conducted as descriptive research and data were collected from 255 main family caregivers who were taking care of elderly patients with brain and spinal diseases from 4 hospitals in Daegu and Gyeongbuk Province. Stepwise-multiple regression was used to identify the influencing factors of burden felt. Results: As the score of burden felt by the main family, economic, social, physical, interdependent and emotional burdens were high in order. Factors influencing burden felt by main family care givers taking care of elderly patients with brain and spinal diseases were changed relation with patient after hospitalization, daily life ability, marital status, education and family caregiver's personality (explanatory power of 24.6%). Family caregivers felt a heavier burden when their relation with the patient was changed negatively or when the patient's activity of daily living was low. Conclusion: Based on these results, we need to develop coping measures and interventional programs for reducing the burden felt by the main family caregivers of elderly patients with brain and spinal diseases.

가상현실과 포톤 네트워크를 이용한 고령 환자용 여행체험 콘텐츠의 구현 (Implementation of Traveling Contents for Elderly Patients using Virtual Reality and Photon Network)

  • 임수빈;조면균
    • 융합정보논문지
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    • 제8권6호
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    • pp.123-128
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    • 2018
  • 최근 고령인구 증가와 장기요양 보험의 도입으로 요양기관에 입주하는 고령 환자의 수가 빠른 속도로 증가하고 있다. 이러한 장기요양 환자들은 만성질환과 치매 등의 질환을 앓고 있어 거동이 불편하거나 인지력이 떨어지는 어려움을 겪을 뿐 아니라, 가족과 떨어져서 우울증에 시달리므로 심리 및 정서적인 지원이 절실하다. 그리하여, 본 논문에서는 거동이 불편한 고령 환자를 위하여 VR과 포톤네트워크를 이용하여 물리적으로 떨어져 있는 가족들과 함께 평소에 가보지 못했던 해외여행 체험을 가상으로 제공하고자 한다. 기존 VR을 이용한 여행체험 서비스는 혼자 체험하는 반면, 제안하는 콘텐츠는 포톤 네트워크를 통해 가족 및 친구들이 네트워크로 참여함으로써 여행 체험 시 대화는 물론 지인들의 옆모습을 보며 함께 경치를 즐길 수 있다. 이를 통하여 고령의 장기 요양환자로 하여금 심리적 안정감을 회복하고 치유의 의지를 높여서 투병생활에서 삶의 질을 높이는데 도움을 줄 것이라 기대한다.

환자호소에 대한 해결시간 단축을 위한 기초조사연구 (An analysis of in-patient complaints and subsequent intervention)

  • 김용순;박지원;박연옥
    • 한국의료질향상학회지
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    • 제4권1호
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    • pp.64-80
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    • 1997
  • Background : An important issue in health care today is in trying to center service around the hospitalized patient. There is a "Kindness Movement" developing now, where in the focus of Health Care is being changed from simply treating the basic physical needs of the patient with sophisticated technology, to keeping emotional well being healthy with more humane and attentive treatment. In our attempt to reach the goal of a completely satisfied patient, we undertook a study of the common complaints of patients, and the subsequent nature of the interventions. Method : The study was carried out in two stages, first the patients made known their complaints by filling out questionnaires, then we collected data on the attempts to alleviate the complaints. The questionnaire provided 19 different complaints, which were then analysed for such variables as content, source of complaint, persons treating the complaint, and length of time and method used to solve the complaint. Results : 1. The Chief complaints made by patients(99.1%) were of physical discomfort, such as pain, nausea, vomiting, indigestion, diarrhea and constipation. 2. The complaints were voiced primarily by either of the patient's family, or by the patients themselves(78.4). 3. The complaints were intervened by nurses alone(53.5%), physicians alone(25.5%), or by nurses and physicians together(19.25%). 4, The method by which the complaints were resolved included the utilization of prescriptions(55.7%), further explanation and education(25. 5%) and notification after treatment(13.2%). 5. Most complaints were voiced during the dayshift(42.6%, 7:00-15:00), followed by the evening shift(36.0% 15:00~22:00), and then the nightshift(21.3 %, 22:00-07:00). 6. The time required for successful resolution of the patient's problems varied from 10~88.9min, according to the nature of the complaint. Conclusion : Hopefully by knowing beforehand the nature of both complaint and intervention, we can anticipate problems and shorten reaction time, in order to provide for a more satisfied patient.

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일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정 (Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital)

  • 김경운
    • 간호행정학회지
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    • 제6권3호
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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중환자실 환자의 물리적 억제대 적용 여부에 따른 신체손상, 정서반응, 우발적 치료기구 자가 제거 발생 비교 (Comparison of Physical Injury, Emotional Response and Unplanned Self-Removal of Medical Devices According to Use of Physical Restraint in Intensive Care Unit Patients)

  • 이미미;김금순
    • 임상간호연구
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    • 제18권2호
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    • pp.296-306
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    • 2012
  • Purpose: This study was done to compare the physical injury, emotional response and unplanned self-removal of medical devices in patients with physical restraints and patients not restrained. Methods: Eighty patients admitted to the intensive care unit (ICU) of a university hospital in Seoul participated in this study. Forty patients made up each group and the group not restrained was matched with the restraint group for age and history of smoking and alcohol consumption. Data on occurrence of physical injury, intensity of anxiety, stage of agitation and unplanned self-removal of medical devices were collected by observation and medical chart review using a structured instrument. Statistical processing of collected data was done with the SPSS WIN 17.0 program. Results: The physically restrained group experienced more physical injuries and recorded significantly higher levels of anxiety and agitation than the unrestrained group. However, there were no significant differences between the groups in occurrence of unplanned self-removal of medical devices. Conclusion: Results indicate a need for critical care nurses to carefully monitor physical injuries and emotional responses of physically restrained patients and to develop nursing interventions to prevent adverse effects associated with restraint use. There is also a need to develop patient safety guidelines when using physical restraints.

수술 전 심리간호가 회복에 미치는 효과에 관한 실험적 연구 (Effects of Preoperative Psychological fare on Postoperative Recovery - An Exploratory Experiment -)

  • 김조자
    • 대한간호학회지
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    • 제2권1호
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    • pp.97-113
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    • 1971
  • The purpose of this study was to investigate the preoperative anxiety of surgical patients and to observe the effects of an experimental nursing process on the incidence of vomiting, the number of analgesics used and the voiding ability of surgical patients within a 48 hour postoperative period and also the number of postoperative days in the hospital. This study me based on a sample of 51 patients who were scheduled for abdominal surgery. They were assigned alternately to experimental and control groups. Patients assigned to the experimental group were given nursing care by the writer, using an experimental nursing process. This is a process directed toward helping the patient obtain a suitable psychological state for surgery. This process was performed by use of the following steps: 1. The nurse approached the patient with interest and concern, and observed the patient's behavior to determine the presence of anxiety. 2. The nurse explored further to find out what was causing the anxiety and what was needed too relieve it. 3. The nurse listened carefully lo the patient. 4. The nurse gave an opportunity for expression of individuality. 5. The nurse showed friendliness and reassured the patient 6. The nurse gave instruction about deep berating, turing and coughing and gave an explanation of routine preoperative preparation which decreased the unknown and so decreased the patient's anxiety- The findings of this study are as follows: 7. The investigation of preoperative anxiety through observing and interviewing revealed patients were concerned about the following: a. Length of stay in the hospital 69.7% (31 cases) b. Condition unimproved o. worse 48.,8% (30 cases) c. Postoperative pain and discomfort .56.8% (29 cases) 2. The results of the study regarding the four hypothesis were as follows: a. Preoperative psychological care not reduce the number of analysis needed during the 48 hour period following surgery. b. Preoperative psychological care did not reduce the Postoperative incidence of vomiting c. Preoperative psychological care had no influence on voiding ability following surgery. d. Preoperative psychological care significantly reduced the number of postoperative days in tile hospital. The experimental nursing process proved to be successful in decreasing the length of postoperative hospitalization (improving rate of healing). This study has demonstrated further that the relief of anxiety (emotional distress) is part of the nurse's professional role. In order to be sure psychological care is given it is important to make a nursing care plan which .includes a plan for the psychological care needed by the patient. As this care is given it can be charted off by each nurse just as medication and treatments are checked after they are given.

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Delayed Presentation of Self-discovered Breast Cancer Symptoms in Iranian Women: A Qualitative Study

  • Khakbazan, Zohreh;Taghipour, Ali;Roudsari, Robab Latifnejad;Mohammadi, Eesa;Omranipour, Ramesh
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9427-9432
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    • 2014
  • Background: Delayed presentation of symptomatic breast cancer is a public health issue in Iran, making a major contribution to low survival. Despite the importance of this problem, current knowledge is insufficient to inform interventions to shorten patient delay. The aim of this study was to explore factors influencing patient delay in Iranian women with self-discovered breast cancer symptom. Materials and Methods: This qualitative study was conducted during 2012-2013. Purposeful sampling was used to recruit 20 Iranian women with self-discovered symptoms of breast cancer who attended the Cancer Institute of Tehran University of Medical Sciences, Tehran, Iran. Data were collected through semi-structured in-depth audiotaped interviews, which were transcribed and analyzed using conventional content analysis with MAXqda software version 10. Findings: Content analysis of the data revealed four main themes related to the delay in seeking medical help including: 1) attributing symptoms to the benign conditions; 2) conditional health behavior; 3) inhibiting emotional expression; and 4) barriers to access to health care systems. Conclusions: These results suggest that patient delay is influenced by complex and multiple factors. Effective intervention to reduce patient delay for breast cancer should be developed by focusing on improvement of women's medical knowledge, managing patients' emotional expression and reform of the referral system.