• 제목/요약/키워드: Pre-hospital care

검색결과 345건 처리시간 0.029초

신장이식환자를 위한 능력증강교육프로그램 효과 (The Effects of an Empowerment Education Program for Kidney Transplantation Patients)

  • 김성희;유혜숙
    • 대한간호학회지
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    • 제47권4호
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    • pp.445-455
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    • 2017
  • Purpose: This study was conducted to develop an Empowerment Education Program (EEP) for kidney transplant patients and to test the program's effects on uncertainty, self-care ability, and compliance. Methods: The research was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 53 outpatients (experimental group: 25, control group: 28) who were receiving hospital treatment after kidney transplants. After the pre-test, patients in the experimental group underwent a weekly EEP for six weeks. The post-test was conducted immediately after, and four weeks after the program's completion in the same manner as the pre-test. For the control group, we conducted a post-test six and ten weeks after the pre-test, without and program intervention. A repeated measure ANOVA was performed to compare the change scores on main outcomes. Results: Uncertainty was significantly lower in the experimental group than in the control group, both immediately after (t=-3.84, p=<.001) and 4 weeks after (t=-4.51 p=<.001) the program, whereas self-care ability (t=5.81, p=<.001), (t=5.84, p=<.001) and compliance (t=5.07, p=<.001), (t=5.45, p=<.001) were significantly higher. Conclusion: Kidney transplant patients who underwent an EEP showed a decrease in uncertainty and an improvement in self-care ability and compliance. Thus, our findings confirmed that an EEP can be an independent intervention method for improving and maintaining the health of kidney transplant patients.

자기효능 증진 프로그램이 결장루 형성술 환자의 자기효능, 자가 간호 행위 및 심리사회적 적응에 미치는 효과 (Effects of Self Efficacy Promoting Programs on Self Efficacy, Self Care Behavior and Psychosocial Adaptation in Patients with a Colostomy)

  • 김경미;백은선;강남희;윤경은;배나영;차보경
    • 기본간호학회지
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    • 제14권3호
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    • pp.288-296
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    • 2007
  • Purpose: This study was conducted to investigate the effects of self-efficacy promoting program on self-efficacy, self-care behavior and psychosocial adaptation in patients with a colostomy. Method: A non-equivalent control group pre test post test design was used. The self efficacy promoting programs was composed of a CD image program based on varicaious experience, education and telephone coaching program based on verbal persuasion, and Stoma care practice, and Self care performance based on performance accomplishment. This study was carried out from July 2, 2005 to April 20, 2006 and 21 patients with a colostomy at one of 2 hospitals participated. Descriptive statistics, ${\chi}^2-test$, and Mann-whitney U test were used to analyze the data. Results: There were significantly different for specific self efficacy, self care and psychosocial adaptation between the experimental group and control group. Conclusion: The self efficacy promoting program for patients with stomas was effective in improving degree of specific self efficacy, self care and psychosocial adaptation.

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퇴원환자를 위한 간호사 주도 전환 프로그램의 내용과 효과에 관한 체계적 문헌고찰 (A Systematic Review on Nurse-Led Transitional Care Programs for Discharged Patients from Hospital to Home)

  • 이현주;김유경;오의금
    • 임상간호연구
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    • 제23권3호
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    • pp.376-387
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    • 2017
  • Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

신장이식환자에 대한 개별교육프로그램이 자가간호 지식과 자가간호수행에 미치는 영향 (The Effects of an Individual Educational Program on Self-care Knowledge and Self-care Behavior in Kidney Transplantation Patients)

  • 심미경;손선영
    • 동서간호학연구지
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    • 제18권1호
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    • pp.9-17
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    • 2012
  • Purpose: The purpose of this study was to identify the effects of an individual educational program on self-care knowledge and self-care behavior in kidney transplantation patients. Methods: The kidney transplantation patients were recruited from a transplantation center, at a university hospital located in Korea. Data were collected from June 1, 2010 to January 31, 2011. The research design was a nonequivalent one group pre-post test. Forty-two subjects were participated two times individually in an educational program given by the researcher. Results: After the intervention, the participants showed a significant increase in self-care knowledge(t=-4.10, p=.000) and self-care behavior (t=-6.07, p=.000) than before the intervention. Conclusion: This results suggest that the program developed in this study can be considered an effective nursing intervention for health promotion, prevention of complication and self-care behavior in kidney transplantation patients.

Central Venous Catheterization before Versus after Computed Tomography in Hemodynamically Unstable Patients with Major Blunt Trauma: Clinical Characteristics and Factors for Decision Making

  • Kim, Ji Hun;Ha, Sang Ook;Park, Young Sun;Yi, Jeong Hyeon;Hur, Sun Beom;Lee, Ki Ho
    • Journal of Trauma and Injury
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    • 제31권3호
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    • pp.135-142
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    • 2018
  • Purpose: When hemodynamically unstable patients with blunt major trauma arrive at the emergency department (ED), the safety of performing early whole-body computed tomography (WBCT) is concerning. Some clinicians perform central venous catheterization (CVC) before WBCT (pre-computed tomography [CT] group) for hemodynamic stabilization. However, as no study has reported the factors affecting this decision, we compared clinical characteristics and outcomes of the pre- and post-CT groups and determined factors affecting this decision. Methods: This retrospective study included 70 hemodynamically unstable patients with chest or/and abdominal blunt injury who underwent WBCT and CVC between March 2013 and November 2017. Results: Univariate analysis revealed that the injury severity score, intubation, pulse pressure, focused assessment with sonography in trauma positivity score, and pH were different between the pre-CT (34 patients, 48.6%) and post-CT (all, p<0.05) groups. Multivariate analysis revealed that injury severity score (ISS) and intubation were factors affecting the decision to perform CVC before CT (p=0.003 and p=0.043). Regarding clinical outcomes, the interval from ED arrival to CT (p=0.011) and definite bleeding control (p=0.038), and hospital and intensive care unit lengths of stay (p=0.018 and p=0.053) were longer in the pre-CT group than in the post-CT group. Although not significant, the pre-CT group had lower survival rates at 24 hours and 28 days than the post-CT group (p=0.168 and p=0.226). Conclusions: Clinicians have a tendency to perform CVC before CT in patients with blunt major trauma and high ISS and intubation.

성인과 노인 관상동맥증후군 초발 환자의 임상적 특성 및 치료추구행위 비교 (Comparison of Clinical Manifestations and Treatment-Seeking Behavior in Younger and Older Patients with First-time Acute Coronary Syndrome)

  • 황선영
    • 대한간호학회지
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    • 제39권6호
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    • pp.888-898
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    • 2009
  • Purpose: This study was conducted to examine and compare clinical manifestations and predicting factors for treatment-seeking delay among patients <65 and ${\geq}65\;yr$ with first-time acute coronary syndrome (ACS). Methods: A total of 288 patients who were diagnosed with ACS were individually interviewed at C university hospital in G-city from November 2007 to December 2008. Results: Median pre-hospital delays for younger and older patients were 5 and 12 hr, respectively. Younger patients were more likely to be current smokers, heavy drinkers, obese, stressed, and have an unhealthy diet and family history, and to complain of chest pain, left shoulder and arm pain, perspiration, and nausea. Older patients were more likely to have hypertension and diabetes, and to complain syncope and dyspnea. Logistic regression analyses showed that after adjustment for age, gender and education, progressive onset of symptom and no attribution to cardiac problem significantly predicted pre-hospital delay >3 hr in both younger and older patients. Low perceived health status was a significant independent predictor in older patients only. Conclusion: Health care providers should be concerned with different manifestations between younger and older adults, and educate people at risk for heart attack about symptoms and actions to get immediate help.

Benefits and Risks of Preprepared Parenteral Nutrition for Early Amino Acid Administration in Premature Infants with Very Low Birth Weight

  • Pin-Chun Chen;Hsin-Chung Huang;Mei-Jy Jeng;Feng-Shiang Cheng
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제27권4호
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    • pp.246-257
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    • 2024
  • Purpose: Administering early parenteral amino acids to very low birth weight (VLBW) premature infants (birth body weight [BBW]<1,500 g) is challenging due to factors such as holidays, cost, and access to sterile compounding facilities. Using advance-prepared parenteral nutrition (PN) may address this issue and should be evaluated for its safety and potential benefits. Methods: We extracted data from medical records collected between July 2015 and August 2019. VLBW infants received PN for at least seven days and were split into two groups: the traditional group (n=30), which initially received a glucose solution and then PN on workdays, and the pre-preparation group (n=16), which received advance-prepared PN immediately upon admission to the neonatal intensive care unit. Results: The median BBWs of the traditional and pre-preparation groups were 1,180.0 vs. 1,210.0 g. In the initial two days, the pre-preparation group had a significantly higher amino acid intake (2.23 and 2.24 g/kg/d) than the traditional group (0 and 1.78 g/kg/d). The pre-preparation group exhibited greater head circumference growth ratio relative to birth (7th day: 1.21% vs. -3.57%, p=0.014; 21st day: 7.71% vs. 3.31%, p=0.017). No significant differences in metabolic tolerance were observed. Conclusion: Advanced preparation of PN can be safely implemented in VLBW preterm infants, offering advantages such as early, higher amino acid intake and improved head circumference growth within the first 21 days post-birth. This strategy may serve as a viable alternative in settings where immediate provision of sterile compounding facilities is challenging.

고관절 전치환술 환자의 Critical pathway적용효과 (Effects of Critical Pathway(CP) on the patients with Primary Total hip replacement(THR))

  • 이미경;도복늠
    • 간호행정학회지
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    • 제8권2호
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    • pp.295-308
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    • 2002
  • Purpose: The purpose of this quasi-experimental research is to develop the CP for primary THR patients and verify its effectiveness. Method: The CP is designed for both patients and medical employees to meet the 14-day-long hospitalization with an expert and clinical validity test, and the standardized orders are also created. 21 eligible subjects for the control group(with common care plan) and 27 subjects for the experimental group(with CP service) were assigned. Data were collected from questionnaires to evaluate patients' satisfaction level of nursing care and CP, investigation of physical complications, inspection of LOS(length of hospital stay) and hospital charges from April 2000 to February 2001 at K-hospital in Daegu. The collected data were analyzed by using the SAS program. Results: After implementation of CP, there was a statistically significant reduction in mean length of stay. The hospital charges have no considerable difference between two groups. Frequency of physical complications is reduced considerably. The experimental group scored much higher than the control group on the satisfaction level toward nursing care. And in the analysis of CP satisfaction questionnaires, many subjects have high satisfaction in items of 'I see the treatment process and hospital life', 'I feel that I am participating in my treatment process with health care staff'. The analysis of variances which cause a prolonged LOS supports that it's necessary to strengthen an evaluation of pre-operative outpatients' condition and link the home nursing care system in discharge for more shortening of LOS. Conclusion: The above results show that CP can have a positive impact on satisfaction level of inpatients with primary THR and the hospital.

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Transitional care for high-risk elderly patients pre/post discharge by collaboration between general hospital and community pharmacy: a pilot study

  • Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
    • 한국임상약학회지
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    • 제32권1호
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    • pp.27-36
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    • 2022
  • Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

초산모를 위한 산후간호 교육의 효과 (Effects of Education on Primiparas' Postpartial care)

  • 신혜숙;김숭희;권숙희
    • 여성건강간호학회지
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    • 제6권1호
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    • pp.34-45
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    • 2000
  • The study was to find whether the educational program contributed to increase of knowledge and self-efficacy of the postpartal primiparas. This study aimed at improvement of the educational effect for postpartal primiparas. The Subjects were 34 primiparas who were admitted to the obstetric ward in a University hospital from November 15th to December 9th, 1999. The Subjects were those who had no labor pain at the admission time, had no complications during labor and delivery and, gave birth to a healthy baby. They were tested on knowledge and self-efficacy two times, one at the admission time and prior to discharge. After the first test nurses in a maternity ward taught them on postpartal care. Two tools were developed by authors based on literature review. The test tool fr knowledge of postpartal car consisted of 23 items. The test tool for self-efficacy of postpartal care consisted of 16 items. Analysis of demographic data were analyzed with calculation of percentage. Score differences between the first test and the second test were analyzed with paired t-test. The Spss (Win 8.0) program was used for data analysis. The results are as follows. 1. There were not significant influencing general characteristics of primiparous to pre-educational knowledge. There were significant influencing general characteristics of primiparous to post-educational knowledge : occupation(t=13.04, p=0.00), postpartal education(t=5.51, p=0.02). 2. There were not significant influencing general characteristics of primiparous to pre-educational self-efficacy. There were significant influencing general characteristics of primiparous to post-educational self-efficacy : antenatal education(t=5.53, p=0.02) 3. Primiparas' knowledge of postpartal care increased significantly after education(t=13.04, p=0.00). 4. Primiparas' self-efficacy of postpartal care increased significantly after education(t=5.51, p=0.02). 5. Correlation between knowledge and self-efficacy was r=.360(p=0.03). We suggest follow-up studies to find whether primiparas' self-efficacy will last after discharge or not.

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