• Title/Summary/Keyword: Patient-focused Care

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Case-based Learning through Home Care Nursing Specialists' Critical Reflection: Application with Patients Using Home Mechanical Ventilator (가정전문간호사의 비판적 성찰을 통한 사례기반 학습: 가정용 인공호흡기 적용대상자)

  • Park, Hak Young;Hwang, Moon Sook;Kim, Yeon Hee
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.25 no.3
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    • pp.153-163
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    • 2018
  • Purpose: This study is know the home care nursing specialists' copying method for life-threatening emergency situation occurred while changing the tracheotomy tube in the patient's home through case-based learning. Methods: Two cases were analyzed using structured critical reflection while changing the tracheal tube. In the first case, the patient presented with dyspnea, cyanosis, and low oxygen saturation when connected to home mechanical ventilator after replacement of the tracheotomy tube. In the second case, replacement of the tracheal tube was difficult due to a narrowed airway from proliferated granulation tissue. Results: From the case-based learning. using a critical reflection instrument, home care nursing specialists indicated that it was important to explain the possibility of danger to the client and that nurses must check the operation of the ambu-bag to prepare for an emergency when replacing a tracheotomy tube. Moreover, they stated a need for two nurses during client visits when there is the possibility of an emergency. Conclusion: Case-based learning through critical reflection provides actual practice-focused knowledge that is helpful to home care nurse specialists who face emergency situations in a restricted environment. Therefore, we hope that home care nursing specialists will use this method to strengthen their professional knowledge.

The Influences of Spiritual Care Nursing Education Towards Death and Dying (영적간호 교육이 간호학생들의 죽음에 대한 태도변화에 미치는 영향)

  • Kim Chung nam;Park Kyung min
    • Journal of Korean Public Health Nursing
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    • v.13 no.1
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    • pp.114-127
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    • 1999
  • In order to care the persons who are dying a nurse should first solve her / his own conflicts about death. and be aware of their own concepts of death and dying. In order to find out patient's spiritual needs and to give better spiritual nursing care. a nurse should know her / his own spiritual needs and be aware of their own concepts of spiritual nursing problems. To improve nurse's understanding towards death and dying and nurse's knowledge towards spiritual needs and spiritual nursing care. 14 weeks(two hours a week) spiritual nursing care education was given to 3th grade baccalaureate nursing college student. Before and after spiritual nursing care education. 30 items of prepared questionare focused on the attitudes toward death and dying was asked. Pre and post results are as follow ; 1. The dying patient's emotional and physical needs. There was no significant difference between pre and post educated groups. Both of the situations. they agreed upon$(69.64\%)$ that the dying patients have high emotional and physical needs to solve. 2. Telling the truth of dying process. There was no significant difference between pre educated group$(53.33\%)$ and post educated group$(55.95\%)$. 3. Attitudes of medical personnels. There was no significant difference between pre$(51.49\%)$ and post educated groups $(53.87\%)$. These responses indicate that nursing college student didn't have enough experiences on dying patients care. 4. General attitudes on death and dying. Number of nursing students who were thinking positively toward death and dying were Increased (pre $39.68\%$. post $45.44\%$) and who were thinking negatively toward death and dying were also decreased (pre $37.30\%$. post $33.93\%$). 5. Attitudes toward mechanical assistance for life-expanding of helpless patient. There was a significant difference between pre and post educated groups. About $34.13\%$ of them approved upon mechanical assistance for life and about $33.14\%$ of them disapproved. 6. Attitudes of family members of dying patient. There was no significant difference between pre and post educated groups. About $45.24\%$ of both groups, agreed upon that the family members feel annoyed with dying patients and about $22.42\%$ of both groups disagreed. Whether they received the spiritual nursing education or not, they were aware of that the family members feel annoyed with dying patients. 7. Special facility and educational preparation for dying patient. There was a significant difference between pre$(82.14\%)$ and post$(90.87\%)$ educated groups. These responses indicated that after they received the education, they felt more about the necessity of special facility and educational preparation for the death and dying patients. 8. Special facility and welfare system for the old. There was a significant difference between pre$(58.33\%)$ and post$70.64\%$ educated groups. There responses indicated that after they received the education, they felt more about the necessity of special facility and welfare systems for the old.

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The Influence of Inpatient's Experience on Hospital Recommendation Intention - Focusing on the Moderating Effects of Health Condition - (입원 환자경험이 병원 추천의도에 미치는 영향 - 건강상태의 조절 효과를 중심으로 -)

  • Lee, Kyoungsook;Kim, Jeoungae;Lee, WangJun
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.133-143
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    • 2017
  • Purpose : This study is to analyze the inpatients's experience of medical services provided by hospital including medications, treatments, and environment. Based on the results of surveys conducted as part of the inpatient experience evaluation in A hospital in Goyang, Gyeonggi province. Methodology : A sample of 300 adults aged 19 years or older who had more than one day of hospitalization was selected. The questionnaire was conducted from April 3rd to June 21st, 2017 by telephone. Findings : It is found that recommendation intention influenced by medical services, hospital environment, medication treatment process. but it turns out that there is no moderate effects of health condition between patient's experience and recommendation. Practical Implication : In order to improve the inpatient experience, there should be a way to improve experience in providing patient-centered services in the hospital s environment, medication and treatment.

Single Case Report of a Stage IV Geriatric Gallbladder Cancer Patient treated with Korean Medicine Who Could Not Receive Conventional Therapies (항암 치료가 불가한 고령의 4기 담낭암 환자 한방치험 1례)

  • Ryu, Han Sung;Oh, Hye Kyung;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.21 no.1
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    • pp.27-33
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    • 2016
  • Background : This case is to report a gallbladder cancer patient treated with Korean Medicine who could not receive conventional cancer therapies such as operation and chemotherapy due to her underlying diseases, old age and poor performance. Method and Results : An eighty-year-old female patient was diagnosed with stage IV gallbladder cancer on Feb. 2014 and she already had hypertension, diabetes and Parkinsonism. Comprehensive Korean Medicine (KM) treatments instead of operation and chemotherapy were administrated due to her poor condition and old age. KM treatments were done focused on improving symptoms and quality of life combined with best supportive care. During KM treatments her abdominal pain was generally managed and she survived for 22 months. Conclusion : Further studies should be performed in the future to clarify the survival benefit and symptom management of comprehensive KM treatments.

A Comparison of Hospital Nursing Practice in Korea and the U.S. as Experienced by Korean Nurses (재미 한국 간호사들이 경험한 한국과 미국 병원의 간호실무의 차이)

  • 이명선
    • Journal of Korean Academy of Nursing
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    • v.28 no.1
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    • pp.60-69
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    • 1998
  • Since the introduction of Western concept of nursing to Korea in late 1880s, Korean nursing practice has evolved into Korean culture. The purpose of this study was to explore and identify similarities and differences in hospital nursing practice between Korea and the United States using the grounded theory method. The data were gathered from 15 Korean nurses working in U.S. hospitals using semi-structured, in-depth interview method. Major similarities in nursing practice between Korea and U.S. existed in the 7 domains that Benner indicated in 1984. The nursing administration system was also similar in both countries. On the other hand, differences existed in how nurses execute these domains of nursing practice. These are the roles of nurses. nurse aides and family members. and the interpersonal relationships, and problem presentation and problem-solving strategies. American family members rarely participated in the patient's bedside nursing care, while Korean family members actively participated. American nurse aide participated in direct patient care, while Korean nurse aides did not. Also Korean nurses were participated more in administering and managiang the patient's diagnostic and treatment modalities, while American nurses foucused on the needs and demands of the patient. In terms of interpersonal relationships, American patients were more self-centered and demanding than Korean. American nurses focused more on the right of individuals while Korean nurses were more oriented to harmony with the coworkers. With inferiors and superiors, American members were more egalitarian, while Koreans tended to be hierachical. In ways of suggesting problems, American nurses tended to pick out the problems more frequently than Korean nurses did.. As to ways to solve the problems, American nurses relied heavily on explicit verbal explanations, while Korean nurses relied more on bodily action and behaviors. The results of this comparative study contribute to nursing by adding knowledge on the theory of culture care by describing the similarities and differences in nursing practice between Korea and the United States.

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An Integrative Review of the 'QUality Of care Through patient's Eyes' (환자의 눈을 통한 간호의 질(QUOTE) 평가의 통합적 고찰)

  • Oh, Jina;Kim, Yae Young;Kim, Hyun-Kyoung;Park, Hyun-Jung;Cho, Haeryun
    • Child Health Nursing Research
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    • v.20 no.4
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    • pp.283-293
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    • 2014
  • Purpose: The patient's perspective in the assessment of quality of care has become increasingly important. The purpose of this paper was to introduce the concept of 'QUality Of care Through patient's Eyes (QUOTE)', to analyze the papers using QUOTE through an integrative review method, and to present the attributes of the QUOTE evaluation. Methods: Data were collected from electronic databases. Inclusion criteria were publication in English from 1997 to 2013, as a peer-reviewed research article, with an empirical study focused on QUOTE. Thirty two papers met the criteria and were analyzed. Results: QUOTE had been applied to various groups of patients such as those with various diseases since 1997 in the Netherlands. Four themes were retrieved from synthetic analysis of the thirty-two papers using QUOTE; 1) acceptance of individuation of the patient and family, 2) evaluation of diverse nurses' competencies, 3) evaluation of quality of nursing environments, and 4) participation of patient in the whole process of evaluation. Conclusion: The strengths of QUOTE are that it attempts to overcome the conceptual and methodological problems associated with evaluation of quality of care. Our results imply that QUOTE evaluation could be an effective strategy to improve care of patients in clinical setting.

Testing The Healing Environment Conditions for Nurses with two Independent Variables: Visibility Enhancement along with Shortening the Walking Distance of the Nurses to Patient - Focused on LogWare stop sequence and space syntax for U-Shape, L- Shape and I-Shape NS-

  • Shaikh, Javaria Manzoor;Park, Jae Seung
    • KIEAE Journal
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    • v.15 no.2
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    • pp.19-26
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    • 2015
  • Purpose: Maximizing human comfort in design of medical environments depends immensely on specialized architects particularly critical care design; the study proposes Evidence-Based Design as an apparent analog to Evidence-Based Medicine. Healthcare facility designs are substantially based on the findings of study in an effort to design environments that augment care by improving patient safety and being therapeutic. On SPSS (Statistical Package for Social Science) t-test is applied to simulate two independent variables of PDR (Pre Design-Research) and POE (Post- Occupancy Evaluation). PDR is conducted on relatively new hospital Hallym University Dongtan Sacred Heart Hospital to analyse visibility from researchers' point of view, here the ICU is arranged in I-Shape. POE is applied on Dongguk University Ilsan Hospital to simulate walking on LogWare where two NS are designed based on L- Shape and Seoul St. Mary's Hospital, The Catholic University of Korea where five NS are functional for ICU Intensive Care Unit, Surgical Intensive Care Unit (SICU), Medical Intensive Care Unit (MICU), Critical Care Unit (CCU), Korean Oriental Medical Care Unit which are mostly arranged in U-Shape, and walking pattern is recognized to be in a zigzag path. Method: T-Test is applied on two dependent communication variables: walkability and visibility, with confidence interval of 95%. This study systematically analyses the Nurse Station (NS) typo-morphology, and simulates nurse horizontal circulation, by computing round route visits to patient's bed, then estimating minimum round route on LogWare stop sequence software. The visual connectivity is measured on depth map graphs. Hence the aim is to reduce staff stress and fatigue for better patients care by minimizing staff horizontal travel time and to facilitate nurse walk path and support space distribution by increasing effectiveness in delivering care. Result: Applying visibility graph and isovist field on space syntax on I- Shape, L- Shape and U- Shape ICU (SICU, MICU and CCU) configuration, I-shape facilitated 20% more patients in linear view as they stir to rise from their beds from nurse station compared to U-shape. In conclusion, it was proved that U-Shape supply minimum walking and maximum visibility; and L shape provides just visibility as the nurse is at pivot. I shape provides panoramic view from the Nurse Station but very rigorous walking.

Deducing the conventional biomedical therapy to Ayurvedic fundamentals: Illustrations from a case report

  • Rastogi, Sanjeev
    • CELLMED
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    • v.5 no.3
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    • pp.20.1-20.4
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    • 2015
  • Ayurveda is often criticized for having empirical and non-evidence based approach to treat the patients. At the same time, modern medicine is also being criticized for having a non-holistic, reductionist and mechanistic approach of treating the patients which do not help in many real clinical situations. An open minded deduction of treatment approaches in both of these systems for a common patient however makes us to rethink that ideally both systems are similar with a common objective of offering a cure although in a manner which is better understood through their own methods of learning. The differences therefore, are more superficial rather than being deeply rooted in the understanding. A more tolerant viewpoint towards the competitive medical systems may therefore be a better approach to offer optimal health care to our people through a genuine amalgamation of these two health care sciences through an integrated approach. Once this tolerance is developed, it will give us an opportunity to think for a focused selection of type of health care depending upon the type of the disease and strength of the particular system in that area.

Nurse-Patient Interaction Patterns and Patient Satisfaction in the Emergency Department (군집분석을 이용한 응급실 간호사-환자 상호작용 유형 및 환자의 상호작용 만족도)

  • Kim, Eun-Jung
    • Journal of Korean Academy of Nursing
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    • v.40 no.1
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    • pp.99-109
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    • 2010
  • Purpose: The purpose of this study was to identify effective nurse interaction patterns with patients in the emergency department. Methods: For this study, video technology was used to record complete conversations between the nurse and patient. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data were collected from November, 2002 to April, 2003. The video recordings were observed for 4 hr for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS). The data were analyzed using cluster analysis to identify the patterns of nurse-patient interaction. Results: Cluster analysis revealed 4 distinct nurse interaction patterns; 1) "closed" characterized by orientation and negative talk, 2) "positive" characterized by positive affective talk, 3) "informative and directing" characterized by task-focused behavior including data gathering, and giving information about medical condition and treatment, 4) "facilitative" characterized by balance of psychosocial and biomedical topics. Patient satisfaction was highest in the facilitative interaction pattern. Conclusion: The patient centered interaction pattern, balancing information exchange and psychosocial exchange are the most effective interactions in the emergency department, suggesting that effective interaction skill is a core clinical nursing intervention in acute care.

Korean Immigrant Women's Taekyo Practices in the United States as a Traditional Prenatal Self-care

  • Lee, Kyoung-Eun
    • Women's Health Nursing
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    • v.21 no.3
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    • pp.241-251
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    • 2015
  • Purpose: The purpose of this study was to explore preserved belief system supporting Korean immigrant women's Taekyo practices and influencing factors while they observe the tradition within US sociocultural context. Methods: Leininger's exploratory focused ethnographic approach was used. Semi-structured in-depth interviews were conducted with purposive sample of sixteen Korean immigrant women who gave birth in the US within last 6 months. Researcher's observation and reflective field notes were also integrated into the interview data. Leininger and McFarland's four phases of ethnographic analysis guided data analysis process. Results: The perceived belief system supporting Taekyo practices included Taekyo as an enculturated Korean tradition, connecting parents with fetus, and positive impacts on fetal development. And Korean immigrant women's Taekyo practices were influenced by resources of information, woman's orientation toward Taekyo, pressure from local Korean community, and child order. Conclusion: The findings from this research would serve as an important knowledge base to expand US health care providers' understanding of Korean traditional Taekyo practices observed by Korean immigrant women's as important prenatal self-care practices. The findings could also aid in providing more patient-centered and culturally-tailored prenatal care plan to Korean immigrant by including Korean traditional belief system supporting Taekyo practices.