• 기본간호학회지
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• 제6권3호
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• pp.583-596
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• 1999

The purpose of this study was to examine the effect of self-care of abdominal surgery patients in surgical intensive care unit after offering preoperative nursing information. This study worked out nonequivalant control group post test only design as suspected experimental study. This subjects of the study were 45 patients, 23 in experimental group and 22 in control group. This study was carried at a university hospital in Taegu between January 12, 1999 and March 13, 1999. The experimental group was supplied with preoperative nursing information and the control group received routine care in ICU. The measuring tools of this study were assessment of the self-care role behavior. The data were analyzed by SPSS computer program, $x^2-test$ and t-test and ANOVA were utilized for testing the difference between the experimental and the control group. The hypothesis was examined by t-test. The result of this study are summarized as follows ; 1) The hypothesis, 'The experimental group will show a higher level of self-care than the control group' was accepted(t=-8.958, p=.000). 2) We could not find any meaningful relation about general characteristics and disease associated characteristics between the experimental and the control group. 3) The self-care behavior scores according to the general characteristics and disease associated characteristics show significant statistical difference by economics status (p=.033). 4) The rate of self-care behavior scores of each questionnaire are below average in the questions that request active activity to prevent postoperative complications From the result of this study, the self-care of the experimental group was higher than those of the control group, and the nursing information can be regarded as an effective nursing intervention for preoperative patients.

• 성인간호학회지
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• 제25권4호
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• pp.473-482
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• 2013

Purpose: The purpose of this study was to investigate the effects of a structured preoperative instruction upon anxiety and postoperative self-care compliance. Methods: A randomized control group pre-post design was used. Sixty subjects undergoing cataract surgery were randomly assigned to one of two groups. The instruction consisted of cataract surgery procedure, sensory information, deep breathing, use of eye drop, and post op self-care regimen and was provided to the experimental group with control group receiving an usual treatment. State anxiety NRS, pulse, BP, and self-care compliance scale developed by Cho & Rho were used. Data were collected at two time periods: on the day of surgery in the clinic and prior to anesthesia in the operating room. The postoperative self-care compliance scores were measured at their second visits to the hospital after surgery. Data were analyzed using Kolmogorov Smirnov test, t-test, and Mann-Whitney U test. Results: There were significant differences between the two groups in the postoperative state anxiety (t=-3.57, p=.001) and the postoperative self-care compliance score (t=3.92, p<.001). There were no significant difference between the two groups in the postoperative blood pressure and pulse rate. Conclusion: The results of this study suggest that the structured preoperative instruction could be a nursing intervention for cataract surgery patients.

• 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.

• 한국의료질향상학회지
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• 제4권2호
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• pp.184-195
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• 1997

Background : The purpose of this research was to evaluate the appropriateness of preoperative hospital days in a tertiary care hospital and to examine the reasons of the inappropriateness, so as to provide basic information and policy for enhancing appropriateness of preoperative hospitalization and benefit of patients and hospital. Methods : The subjects of the research were the 344 patients who received operation among discharged patients during January, 1996 in surgical departments including general surgery, neurosurgery, orthopedic surgery, plastic surgery and ophthalmology. Their medical records were reviewed and appropriateness of hospital days was evaluated by the Appropriateness Evaluation Protocol. Result : The results of evaluating the appropriateness of preoperative hospitalization showed that inappropriate hospital days were 80.8%. The reasons of inappropriate hospital stays were the tests or preparation which could be done in outpatient basis' followed by 'possible tests or preparation on the operation day' and 'cancelation of operation'. Conclusion : In order to shorten the inappropriate preoperative length of stay, it is recommended that lengthening of laboratory running time and doing most of tests necessary for operations on the outpatient basis prior to admission should be considered. In addition, the operation at the same day of hospitalization and usage of day surgery should be encouraged. Finally there should be changes in the inpatient management system and attitudes and behaviors of surgeons to shorten unnecessary preoperative and maximize the benefit for patients and hospital.

• 가정∙방문간호학회지
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• 제21권2호
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• pp.120-126
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• 2014

Purpose: This study was carried out to investigate the effect of a decrease in indwelling catheter size and preoperative education on bladder discomfort and nursing needs. The study was conducted on patients in the recovery room after their surgery. Methods: This study is a randomized control trial. Data were collected from September 2011 to February 2012 at a university hospital in Bundang, Korea. The sample consisted of 75 patients, excluding one patient from the experimental group 2. From among the patients that were sent to the ICU, 24 were in experimental group 1, 24 were in experimental group 2, and 27 were in the control group. Data were collected and analyzed using a chi-square test, t-test, and one-way ANOVA. Results: There were significant differences between the bladder discomfort experienced by patients in experimental group 1 and the control group, and experimental group 2 and the control group. Then nursing needs of the control group were higher than those of the experimental groups 1 and 2. Conclusion: The decrease in indwelling catheter size and preoperative nursing education is an effective nursing intervention in perioperative care.

• Journal of Gastric Cancer
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• 제19권1호
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• pp.72-82
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• 2019

Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. Materials and Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. Results: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. Conclusions: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.

• Journal of Korean Neurosurgical Society
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• 제41권2호
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• pp.100-104
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• 2007

Objective : Despite the widespread use of preoperative ventriculostomy in aneurysmal subarachnoid hemorrhage [SAH], there is no general consensus regarding the risk of bleeding associated with its use before aneurysm repair. This study was conducted to define the efficacy and rebleeding risk of ventriculostomy in aneurysmal SAH. Methods : The authors reviewed 339 consecutive patients with aneurysmal SAH who were treated at our hospital between January 1998 and December 2004. Results : Preoperative ventriculostomy was performed on 73 patients for acute hydrocephalus after aneurysmal SAH. The Hunt-Hess[H-H] grades of patients who underwent ventriculostomy were higher. Out of the 73 patients who underwent preoperative ventriculostomy, 58 [79%] demonstrated immediate clinical improvement after ventriculostomy. Of those same 73 patients 22 [30%] suffered aneurysmal rebleeding, whereas only 11 [4%] of the 266 patients who did not undergo ventriculostomy showed preoperative aneurysm rebleeding. The causes of rebleeding in the 22 patients who underwent ventriculostomy before surgery were related to the ventriculostomy procedure itself, subsequent cerebrospinal fluid [CSF] drainage, angiography and patient care procedures, such as endotracheal suction and nursing care. The mean time interval between SAH and surgery in the patients who underwent ventriculostomy was not statistically different from those who did not receive preoperative ventriculostomies [44.66 compared with 42.13 hours; p=0.73]. Conclusion : The preoperative ventriculostomy improved patients' clinical condition but increased the risk of rebleeding after aneurysmal SAH. When necessary, however, rapid change in transmural pressure during ventriculostomy must be avoided, careful management during ventricular drainage is needed, and surgery should be performed as soon as possible to prevent or reduce the incidence of rebleeding.

• Journal of Korean Biological Nursing Science
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• 제21권4호
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• pp.292-299
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• 2019

Purpose: The purpose of this study was to determine whether poor preoperative nutritional status in elderly patients exhibited a negative influence on postoperative clinical outcomes. Methods: The medical records of 645 elderly patients were examined retrospectively. The patients had undergone major surgery between January 2017 and January 2018. Their nutritional status was measured using the Nutritional Risk Screening 2002. The data were analyzed using the chi-squared test, the Mann-Whitney U test, logistic regression, linear regression, Cox proportional hazards regression, and the Kaplan-Meier analysis. Results: Preoperative malnutrition was found in 73 patients (11.3%). Poor preoperative nutritional status was significantly associated with pressure ulcers, length of hospitalization, discharge to patient care facilities rather than home, and mortality rate at three months. Conclusion: Preoperative malnutrition in elderly patients was associated with negative postoperative clinical outcomes. These results indicate that an effective nutritional program before surgery can lead to a more rapid postoperative recovery.

• Journal of Chest Surgery
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• 제49권5호
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• pp.337-343
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• 2016

Background: Recent developments in surgical techniques and hospital care have led to improved outcomes following total anomalous pulmonary venous return (TAPVR) repair. However, the surgical repair of TAPVR remains associated with a high risk of mortality and need for reoperation. We conducted this retrospective study to evaluate mid-term outcomes following in situ TAPVR repair without total circulatory arrest (TCA), and to identify the risk factors associated with surgical outcomes. Methods: We retrospectively reviewed 29 cases of surgical intervention for TAPVR conducted between April 2000 and July 2015. All patients were newborns or infants who underwent in situ TAPVR repair without TCA. Results: Four anatomic subtypes of TAPVR were included in this study: supracardiac (20 cases, 69.0%), cardiac (4 cases, 13.8%), infracardiac (4 cases, 13.8%), and mixed (1 case, 3.4%). The median follow-up period for all patients was 42.9 months. Two (6.9%) early mortalities occurred, as well as 2 (6.9%) cases of postoperative pulmonary venous obstruction (PVO). Preoperative ventilator care (p=0.027) and preoperative PVO (p=0.002) were found to be independent risk factors for mortality. Conclusion: In situ repair of TAPVR without TCA was associated with encouraging mid-term outcomes. Preoperative ventilator care and preoperative PVO were found to be independent risk factors for mortality associated with TAPVR repair.

• 대한간호학회지
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• 제4권2호
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• pp.44-56
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• 1974

Very few studies regarding the effects of preoperative nursing intervention on children's welfare after surgery have been conducted. The purpose of this study was 1) to evaluate the effects of preoperative nursing instructions on children's physical recovery and emotional state after surgery and 2) to analyse the relationship between the effects of preoperative nursing instructions and the age and general anxiety of child. The study was conducted flow: August 15th to October 30th at Severance Hospital, Seoul, Korea. A total of 41 Pediatric surgical Patients, between the age of 4 to 14, participated in the study. Twenty patients, randomly selected, were visited by the experimenter in the evening before, surgery and received specific preoperative nursing instructions. These instructions were designed to alleviate emotional stress and were adopted to the age of child. The postoperative recovery of these patients were then compared with a randomly selected control group of 21 patients who received only the routine preoperative care by the staff in the hospital Dependent variable were vomiting, pain medication, ability to void, elevation of temperature, infection, the between surgery and hospital discharge and postoperative emotional stress which was measured by the vital signs. Because of the limitation of the sample size it was difficult to obtain valid statistical results. However, the analysis of the raw data indicates that: 1) the preoperative nursing instructions appears to promote physical recovery and it seems especially effective in preventing elevation of temperature and shortening the length of the hospital stay, 2) the preoperative nursing instruction also seems to be effective in relieving the child's emotional stress(situational anxiety) after surgery, 3) the patient's general anxiety level preparatively seems to be a predictor of postoperative problems, 4) the preoperative nursing instructions were an effective means of promoting physical recovery in every age group as long as the child understood the instructions. The above data would seem to indicate that all preoperative pediatric patients four years of age or older, if they can understand, should have preoperative nursing instruction in order to alleviate postoperative stress and enhance physical recovery. The level of general anxiety preparatively deserves special attention since the amount of nursing instruction needed seems to vary with tile level of anxiety.