• Title/Summary/Keyword: Physical Discomfort

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The Lived Experiences of Inpatients' Families in the Intensive Care Units (중환자실 입원환자 가족의 경험)

  • Hwang, Hye Nam;Kim, Kwuy Bun
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.175-183
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    • 2000
  • The study was done by applying a phenomenological study, which is qualitative research methods, in order to understand the meaning of the lived experiences, to confirm and describe the meaning structure, and to prepare nursing interventive strategies centering around the meanings of the inpatients' families in the intensive care units. In the study, the family members were the main important nursing providers for in the inpatients' who were admitted in the neurosurgical intensive care unit in K-university hospital and who agreed to participate in the study after being given on explanation about the purpose of the study. The data were collected from the seven participants who had feelings of trust and intimacy favorable toward the researcher as they were families of patients who had been cared for by the researcher in the ICU where the researcher has been assigned. The data were collected from April to October, 1999. The participants described their experiences as candidly as possible. The researcher described closely the lived experiences with their own words and the observations of the researcher. A tape recorder was used with the consent of the participants to prevent nursing information and communication. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi; as an unit of description, which include the participants' expressions and the researcher's observations, the analysis was used based on the data described from the expressions of the participants and the details of observations of the researcher. The conclusions of the study were as follows : The meanings of the lived experience of the inpatients' families in the ICU was confirmed by indepth interviews and observations including these of the participatants : (1) Psychological impact: confusion, impatience, surprise, insensibility; (2) Physical suffering: fatigue, discomfort, indigestion; (3) Psychological suffering: heartbreaking emotion, anxiety, annoyance, fear, compassion, grief; (4) Economical suffering: economical difficulties; (5) Psychological disagreement: escape from reality, personnel avoidance, grudge, powerlessness, carefulness, transposition of life-tract, abandonment, role-crisis, hope, lack of understanding, regret, feeling of ambivalence(progressive process, medical personnel interest); (6) Psychological dependency; self-reliance group support, family support, religious support; (7) Psychological acceptance; acquaintance, gratitude, reassurance; The study will offer better understanding of experiences therefore, based on the experiences confirmed by the study, it may facilitate more appropriate nursing interventive strategies for health maintenance and to prevent occurrence of possible problems with the inpatients' families in the ICUs.

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Development of a Tool to Measure Suffering in Patients with Cancer (암환자의 고통 측정도구 개발에 관한 연구)

  • 강경아
    • Journal of Korean Academy of Nursing
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    • v.29 no.6
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    • pp.1365-1378
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    • 1999
  • This study is a methodological research study to develop an instrument to measure in patients with cancer and to test the validity and reliability of the instrument. The research procedure was as follows : 1) The first step was to develop conceptual framework based on a comprehensive review of the literature and in-depth interviews with patients with cancer. This conceptual framework was organized in to three dimensions (the intrapersonal dimension, the significant-other and context related dimension, the transcendental dimension). Initially 59 items were adopted. 2) These items were analyzed through the index of content validity(CVI) and 53 items were selected which met more than 80% on the CVI. 3) The pretest was carried out with 87 patients with cancer. After the pretest results were analyzed by item analysis, 44 items were selected. A second test of content validity was conducted and 6 items were eliminated considering the 80% CVI. 4) To test for reliability and validity, data collection was done during the period from January 25, 1999, to February 26, 1999. The subjects for the test were 160 patients with cancer and 185 healthy persons. analysis, item analysis and multitrait-multimethod method to analyze validity. The findings are as follows : 1) The Cronbach's alpha coefficient for internal consistency was .92 for the total 38 items and .79, .82, .85, for the three dimensions in that order. 2) The item analysis was based on the corrected item to total correlation coefficient( .30 or more) and information about the alpha estimate if this item was dropped from the scale. 3) As a result of the initial factor analysis using principal component analysis and varimax rotation, one item was deleted because of factor complexity (indiscriminate factor loadings). In the secondary factor analysis, 7 factors with eigenvalue of more than 1.0 were extracted and these factors explained 56 percents of the total variance. The seven factors were labeled as 'family relationship', 'emotional condition', 'physical discomfort', 'meaning and goal of life', 'contextual stimuli', 'change of body image', 'guilt feelings'. 4) The convergence effect between this instrument and the life satisfaction scale was identified and there was significant positive correlation(r= .52, p= .00). The discriminant validity between this instrument and the depression scale(CES-D) was tested and there was significant negative correlation(r= -.50, p= .00). The instrument for accessing the suffering of patients with cancer developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for assessment in caring for patients with cancer.

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Epidural Ketamine for postoperative Analgesia -Comparison with Epidural Morphine- (경막외케타민 주입을 이용한 술후 통증관리 -경막외몰핀과의 비교-)

  • Kim, Han-Soo;Baik, Seong-Wan;Kim, Inn-Se;Chung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.192-198
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    • 1988
  • Sixty patients, of ASA physical status class I for elective operations in the lower abdomen, perineum, or lower extremities, were studied in a comparative prospective trial to evaluate the efficacy of epidural morphine and ketamine for postoperative analgesia. They were divided into two groups: an epidural morphine sulfate group (EMS group; 30 patients), and an epidural ketamine hydrochloride group (EKH group; 30 patients). Indwelling epidural catheters were placed in the patients' lumber areas (L3-4) and then all patients were anesthetized with thiopental, nitrous oxide, and halothane. After the patients had fully recovered from the anesthesia, the analgesic agents were administered epidurally via the catheter when the patients complained of pain in the postoperative period. The groups were given either 0.1 mg/kg of morphine sulfate or 0.5 mg/kg of ketamine hydrochloride administered in a volume of 10 ml of normal saline. Patients were observed for the onset and duration of postoperative analgesia and for other effects. Total doses were $5.7{\pm}0.6\;mg$ of morphine sulfate in the EMS group and $27.9{\pm}3.3\;mg$ of ketamine hydrochloride in the EKH group. The onset of analgesia was detectable within 35 min.($23.5{\pm}6.3$ min) in 86.7% (26 cases) of the EMS group and within 10 min. ($7.8{\pm}3.7$ min.) in 76.7% (23 cases) of the EKH group. Mean duration of postoperative analgesia was $22.3{\pm}2.1\;hr$. in the EMS group. In the EKH group, the duration of analgesia was shorter and variable, the range of duration was from 2 hr. to 24 hr., Cardiopulmonary changes were statistically insignificant ih both groups. Side effects such as nausea, vomiting, urinary retention, pruritus, dizziness, and headache were observed in EMS group. In the EKH group, there was no discomfort except dizziness (3 cases) and headache (1 case). Epidural ketamine was a safe technique for postoperative analgesia, but because of the variability and relative shortness in the duration of analgesia the use of this technique will require further clinical trials.

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Clinical Investigation of Fatigue Among Outpatients (피로를 호소하는 외래환자에 대한 임상적 관찰)

  • Park, Shin-Myong;Seung, Hyun-Suk;Kim, Young-Chul;Lee, Jang-Hoon;Woo, Hong-Jung;Lee, Ji-Hyeon
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.299-307
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    • 2001
  • Objectives: Fatigue is a common symptom experienced by many people who visit Oriental medical clinics or hospital. However, there has been little study about the fatigue in the Oriental medical academic world. For this reason, we attempted to investigate the present status of fatigue of outpatients, and its relation with Health Practice Index(HPI). Methods: The subjects were 63 outpatients who visited the Tonification Clinic in Kyunghee Oriental Medical Center between January 1, 2001 and July 31, 2001. Their chief complaint was fatigue and they did not have any physical or mental problem. They were given a questionnaire which included questions reflecting general characteristics, fatigue degree and health habits. We measured degree of fatigue by Chalder scale et al. Health habits were investigated about 5 articles out of 'Breslow 7 Health habits'. Results: Among the subjects, 48 people(76.2%) were considered as 'fatigue patients' by the Chalder scale. Of this 48 fatigue patients, 27 people(56.3%) had manifested fatigue for more than 6 months. The average of scale II for all the patients was 14.05, which indicates moderate degree of fatigue. They complained fatigue, drowsiness and general weakness, dryness and discomfort of the eyes, headache, shoulder pain and neck stiffness, dizziness, heat in the upper part of the body, and poor concentration. There were no differences in degree of fatigue according to Health habits including exercise or not, smoking or not, the frequency of drinking, hours of sleeping, and body mass index. Conclusions: Many people complain fatigue symptom. Therefore doctors should have more interest in fatigue and care. This study can provide standards of prognosis of fatigue patients. Also prospective studies are needed to find relationship between health habits and fatigue degree.

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Effects of Sweet Bee Venom Pharmacopuncture Combined with Korean Medicine Treatment for Acute Low Back Pain Syndrome Patient: A Case Report (급성 요통 증후군 환자에 대해 봉독약침요법을 병행한 한의학적 치료 효과: 증례보고)

  • Bong, Sung Min;Jang, Woo Seok;Kim, Kyung Ho
    • Korean Journal of Acupuncture
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    • v.37 no.1
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    • pp.54-62
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    • 2020
  • Objectives : Acute low back pain syndrome causes pain and poor quality of life. There are various studies of SBV (Sweet bee venom) pharmacopuncture, but few have identified the therapeutic effects for patients unable to walk due to acute back pain. This case series report three cases of acute low back pain syndrome treated with SBV pharmacopuncture combined with Korean Medicine (KM) treatments. Methods : Three acute low back pain syndrome patients with no other acute abnormalities in the imaging were treated by KM treatments including SBV pharmacopuncture, acupuncture, cupping, herbal medicine and physical therapy. The improvement of symptoms was evaluated using Numerical rating scale (NRS), Oswestry disability Index (ODI), EuroQol-5 dimension index (EQ-5D) and EuroQol-visual analogue scale (EQ-VAS). Results : Patients who were unable to walk due to acute back pain were able to walk. There were significant improvements of NRS, ODI, EQ-5D and EQ-VAS after treatment. The patients experienced an average 90% decrease in low back pain after inpatient KM treatment for about 8 days. NRS decreased by an average of 78.9%, ODI decreased by an average of 49.4%, and EQ-VAS increased by an average of 92.6%. In the case 1, EQ-5D decreased in all categories, but in the case 2, it decreased in all categories except for pain/discomfort and anxiety/depression, but in the case 3, it decreased in all categories except anxiety/depression. There was no serious side effect after treatment of SBV pharmacopuncture. Conclusions : KM treatments including SBV pharmacopuncture may be effective for acute low back pain syndrome patients. However, randomized controlled trials are needed in the future to confirm the clinical effects of these interventions.

A Phenomenological Study on the Science Anxiety Experience of Science-Gifted Middle School Students (중학교 과학영재학생의 과학불안 경험에 대한 현상학적 연구)

  • Kang, Jihoon
    • Journal of The Korean Association For Science Education
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    • v.41 no.4
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    • pp.283-295
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    • 2021
  • This study attempts to explore the nature of science anxiety experienced by science-gifted middle school students based on Giorgi's phenomenological research method. Among the first-year middle school students selected by the University-affiliated Science Education Institute for the Gifted, six science-gifted students with high levels of science trait anxiety and science state anxiety experience were selected. Two interviews related to experience of science anxiety were conducted with participants. As a result of the analysis, science anxiety experienced by science-gifted students was caused by setting the ideal self-concept, lack of confidence, past experiences, difficulty in contents, and something valuable. Students complained of physical·physiological, cognitive, emotional·psychological discomfort when they felt science anxiety, and recognized it as an opportunity for growth. In addition, science-gifted students were shown to cope with various ways such as confronting uneasy situations directly or refining their minds to overcome various uncomfortable symptoms that arise when science anxiety is triggered. Some students thought that no special efforts were required to lower their level of anxiety because anxiety was relieved over time. The students had both negative and positive meanings for science anxiety. The results of this study will help teachers in-depth understanding of middle school science-gifted students who experience science anxiety and provide a theoretical basis for what kind of educational environment should be created and educational programs should be provided in relation to science anxiety.

Image Quality and Dose Assessment According to Examination Mode during Head CT Examination (두부 CT 검사 시 검사 모드에 따른 화질 및 선량평가)

  • Gang, Heon-Hyo;Choi, Woo-Jeon;Kim, Dong-Hyun
    • Journal of the Korean Society of Radiology
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    • v.15 no.4
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    • pp.437-444
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    • 2021
  • To evaluate the usefulness of Volume Axial Mode by comparing analyzing the exposure dose of the patients and the quality of each images from CT images obtained from high pitch mode using the local phantom or volume axial mode to determine the usefulness of he volume axial mode in diagnosing the head and cervical disease in adults. High Pitch Mode, Helical Mode, and Volume axial Mode as adult phantom were tested according to 70 kVp, 80 kVp, and 100 kVp tube voltages during an adult frontal CT scans. The equipment used was GE's Revolution (GE Healthcare, Wisconsin USA) model and iMED X-ray Phantom. The exposure dose of phantom was compared using the images obtained from each protocol, and the image quality was compared by calculating SNR and CNR by setting ROI on each image. When examined using Volume Axial Mode, the exposure dose of phantom was measured 17.12% lower than Helical Mode, 5.35% lower than High Pitch Mode, and both SNR and CNR were improved. Volume Axial Mode is a useful test that reduces investigation time without table movement using high speed rotary scanner, and in which exposure dose is reduced and image quality is improved by acquiring images in a short time of 0.28 seconds of phantom than using High Pitch Mode and Helical Mode. In addition, the fast testing time of Volume Axial Mode can be seen as the biggest advantage CT scans of emergency patients or patients with physical discomfort.

Assessment of Dental Noise Environment of a Pediatric Dentist (소아치과의사의 치과 소음 환경에 대한 평가)

  • Cho, Hyeonmin;Kim, Ik-Hwan;Cho, Seunghyun;Song, Je Seon;Lee, Jaeho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.2
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    • pp.209-220
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    • 2021
  • The noise is defined as unwanted sound that causes discomfort and physical changes. This study was conducted to evaluate intensity of noise in the pediatric dental clinic and to investigate noise environment of a pediatric dentist. Human ear shaped microphone and mobile noise level meter were used for recording noise and calculating intensity of noise. By recording according to the method specified by Korea Occupational Safety and Health Agency (KOSHA) of Korea Ministry of labor and employment, the following results were obtained. For 16 experimental days, 8 hour time weighted average (8hr-TWA) was 49.33 dBA (A-weighted deci-Bell) on daily average with maximum 58.54 dBA and minimum 33.97 dBA. And Dose was 0.49% on daily average with maximum 1.28%, minimum 0.04%. These values are less than criteria of KOSHA standard (85 dBA, 100%). Comparing the highest noise level for each patient, pulp therapy group and Frankel grade I group were the highest. The intensity of dental noise of pediatric dental clinic didn't meet standard of KOSHA. It is necessary to re-evaluate noise environment by establishing new standards considering environment of pediatric dental clinic.

Concert Oriented Music Therapy(COMT) Alleviates Depression: Validated on Elderly Persons with Visual Impairments (연주회 중심의 음악치료에 대한 시각장애 노인의 우울 개선 효과)

  • Hong, Geum Na;Kim, Seong Chan;Choi, Min Joo
    • Journal of Naturopathy
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    • v.9 no.2
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    • pp.46-56
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    • 2020
  • Purpose: This study proposes a concert oriented music therapy (COMT) program which takes into account the personal and social factors of depression, and its clinical effects were validated on elderly persons with visual impairments who were susceptible to depression. The experiment was conducted on 34 elderly persons with visual impairments, randomly allocated to either the experimental group (n = 15) or the control group (n = 19). The COMT program was applied 20 times in total to the experimental group for 110 minutes every other week, for a duration of 10 months. The depression level was evaluated using the Korean form of the Geriatric Depression Scale (KGDS). The experimental results showed that the average KGDS score in the experimental group decreased by 4.1 points (19.4%), from 21.0 to 16.9, whereas it increased by 1.16 points (5.8%), from 19.95 to 21.11, in the control group. The reduction in the depression level was significant for the following 4 depression factors : decreased social interest (40%), negative thinking and the unhappiness feeling (20%), emotional discomfort (16.3%), and cognitive dysfunction (7.6%), whereas it was negligible in the factors of physical weakening and decreased vitality. The COMT program reduced the KGDS scores of the experimental group regardless of their experience in musical performance. In conclusion, the proposed COMT program proved to be efficacious in alleviating depression in elderly persons with visual impairments. In particular, it proved highly effective in helping with decreased social interest, namely, the social factor of depression which is not properly considered in existing music therapy methods.

Estimation of Measure of Alarmness of Drivers in Ubiquitous Transport Based on Fuzzy Set Theory (퍼지이론에 기초한 유비쿼터스 교통시대 첨단차량 운전자의 불안감도 산정)

  • Park, Hee Je;Bae, Sang Hoon;Kim, Young Seup
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.28 no.1D
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    • pp.11-19
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    • 2008
  • Currently, existing car following models among several basic systems of advanced vehicle systems are almost developed related to the physical relation between two vehicles except for the driver's behavior or environmental factors. But the consideration of driver's character and environmental factors on driving are very essential factors for actual application. Hence, we suggested calibrating the degree of driver's discomfort on driving that is the former study to develop a new car following model of advanced vehicle to use in actuality. The degree of driver's discomfortness (Measure-of-Alarmness; MOA)is measured related to the relationship between the following vehicle and the preceding vehicle, the environmental factors and driver's characters in ubiquitous traffic. We made up questions to drivers to obtain the general and the objective measurement of driver's MOA. And the fuzzy logic model for measurement of MOA was constructed based on the results of survey. We verified the suitability of fuzzy logic model through the computation of MOA with several scenarios. And we measured the quantitative degree of driver's discomfortness on car following related to several factors which affect drivers. In accordance with this study, development of car following model applying driver's MOA will promote the actual application of advanced vehicle more effectively than the existing models. Finally, we thought the measurement of driver's MOA will be applied significantly to evaluate safety and comfort of drivers on driving.