• Korean Journal of Adult Nursing
• /
• v.25 no.4
• /
• pp.444-453
• /
• 2013

Purpose: The purpose of this study was to describe the differences between early and delayed enteral nutrition on nutritional intake. Methods: A pilot cohort study was conducted with 45 critically ill adult patients who had a primary medical diagnosis. Energy prescribed and received were collected during the four days after initiation of enteral nutrition. Adequate feeding was defined as the energy intake more than 90% of required energy. Results: A total of 23 patients (52%) were received early enteral nutrition (within 48 hours of admission). Energy intake of early enteral nutrition was less than intake of delayed enteral nutrition during the four days of the study. Although the difference on day one was significantly greater than the differences on day two, the differences on day two were not different from days three or four. No statistical differences in the adequacy of nutritional intake were found between patients in the early and the delayed group. Conclusion: In critically ill patients receiving early enteral nutrition, more aggressive administration from the beginning will improve the nutritional intake. Additional studies including a large multi-centre, randomized clinical trial are recommended.

• Journal of Korean Academy of Nursing
• /
• v.38 no.4
• /
• pp.629-638
• /
• 2008

Purpose: This was a methodological research to develop an instrument to assess the emotional response of family members of physically restrained patients. Methods: A primary instrument with 68 questions was developed based on literature review and semi-structured interviews with family members. A group of experts revised individual questions and removed 4 irrelevant questions. This secondary instrument, then, was tested with 199 family members of physically restrained patients in intensive care units of a university hospital. The validity and reliability of the instrument were tested by factor analysis. Results: After item analysis, 3 questions with a correlation coefficient under .30 were discarded and the questions with a factor loading under .45 on Varimax Rotation were also removed. After factor analysis on the final 37 questions, 7 factors were identified; avoidance, shock, helplessness, grudge, depression, anxiousness, and acceptance. The total variance explained was 55.63%. The reliability of this instrument was 0.93 of Cronbach's alpha. Conclusion: This instrument was statistically reliable and valid to measure family's emotional response to physical restraints of the patients. This instrument can be useful in assessing the effects of nursing interventions for family members of restrained patients.

• Journal of Korean Critical Care Nursing
• /
• v.8 no.1
• /
• pp.50-61
• /
• 2015

Purpose: The purpose of this study was to develop a valid tool for measuring the work environment of Korean nurses and test the validity and reliability of the instrument. Methods: This is a methodological study for developing and testing a measurement tool. The conceptual framework for the tool was formed through a literature review and in-depth interviews with clinical nurses. 260 meaningful statements were derived through this process, and 59 of the primary items were generated out of these statements. On the basis of the content validity test, 41 items were selected for the preliminary tool. A total of 350 nurses from 7 hospitals responded to the preliminary questionnaire in October 2011. Results: After the item analysis and the principal component analysis using varimax rotation methods, 11 items were deleted. Considering the conceptual framework and the scree plot, we extracted 4 factors from the final 30 items. These factors were organizational support, head nurse's leadership, support system, and relationship with coworkers, and their total variance was 54.4%. The value of Cronbach's ${\alpha}$ of the final tool was 0.92. Conclusion: The above findings revealed that the Korean Nursing Work Environment Scale (K-NWES) is an appropriate, valid, and reliable tool for evaluating the work environment of Korean nurses. Further research to perform a criterion validity test of the K-NWES is needed.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.9 no.2
• /
• pp.111-117
• /
• 2013

Some odontogenic infections erode into fascial spaces directly and spread toward lymphatic tissues and blood streams. The principal maxillary primary spaces are the canine, buccal, and infratemporal space, the next secondary spaces are the masseteric, temporal and pharygeal space. As a result of the infection, trismus and orocutaneous fistula may be occurred. Trismus is owing to conditions not associated with temporomandibular joint itself and may be of myogenic, neurogenic, or psychogenic nature. Muscular trismus is due to infection adjacent to the elevator muscles of the jaw. The four principles of treatment of infection are as follows: (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including rest, nutrition and physiotherapy. Jaw physiotherapy is necessary to increase the amount of mouth opening and regain normal muscle tone. If proper care of odontogenic infection could be attained, the orocutaneous fistula will heal and close spontaneously by wound contraction mechanism of natural homeostatic response. This is a case report of the care of trismus and orocutaneous fistula due to fascial space abscess by advanced odontogenic infection in a physically disabled patient.

• Research in Community and Public Health Nursing
• /
• v.9 no.1
• /
• pp.89-103
• /
• 1998

The elderly population will increase from 5.8% in 1996 to 12.5% in 2020. The related problems of health will also become a very important issue in the future. Therefore it is important to address the problems of geriatric nursing and geriatric health. 87.6% of the aged were ill with chronic degenerative diseases in 1994. In 1995, hospital admission rates (86.8) for those aged 60 or older were higher than that (56.3) of the total age group. Such high medical utilization will increase national health costs. For the development of geriatric nursing, active nursing intervention in various settings combined with education and research should be developed. Considering the health and welfare of the aged and the present status and views in Korea, I suggest the following: First, the health needs of the elderly in the institution, must be met by a plan that fosters geriatric nurses and programmed service development. Second, health service for the residential elderly must be provided in day care centers, short stays, nursing homes and geriatric hospitals. Geriatric nursing services should be provided in home residential areas, public health centers, public health subcenters as well as having, community health practitioners in primary health care posts and home health nurses. Third, geriatric nursing curriculum must be developed adjust to situations and culture of Korea and be included in the nursing curriculum. And gerontological nurse practitioner or geriatric specialist must be fosteraged to provide the professional care for the aged. Geriatric nursing research should be also achived for geriatric nursing improvements.

• Journal of Home Health Care Nursing
• /
• v.22 no.2
• /
• pp.206-215
• /
• 2015

Purpose: This study aimed to provide basic data to enhance self-nursing ability by investigating the symptoms of autonomic neuropathy and self-management activities in patients with diabetes accompanying hypertension. Methods: Subjects were 113 type-2 diabetic patients who were diagnosed as hypertensive in two primary medical institutions and taking anti-hypertensive treatments. The existence of postural hypotension was evaluated by blood pressure and pulse rate, and the subjective symptoms of autonomic neuropathy and self-management activities were checked by structured questionnaires. The collected data were analyzed by chi-square test, Fisher's exact test, t-test, Wilcoxon rank sum test and analysis of covariance. Results: Postural hypotension occurred in 4.4% of the subjects. Urinary frequency and dizziness during postural changes were the most frequent symptoms of autonomic neuropathy, and 57.5% of the subjects complained of symptoms in two or more domains. The group with autonomic neuropathy symptoms showed higher age, higher living stress, and fewer self-management activities in the diet and foot management domains as compared to the group without autonomic neuropathy symptoms. Conclusion: From these results, we learned that strengthening education on self-management for diet and foot management and customized interventions considering age and living stress are required through early identification of the symptoms of autonomic neuropathy in patients with diabetes accompanying hypertension.

• Biomolecules & Therapeutics
• /
• v.24 no.1
• /
• pp.19-24
• /
• 2016

Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide. The exploration of new biomarkers with high sensitivity and specificity for early diagnosis of AMI therefore becomes one of the primary task. In the current study, we aim to detect whether there is any heart specific long noncoding RNA (lncRNA) releasing into the circulation during AMI, and explore its function in the neonatal rat cardiac myocytes injury induced by $H_2O_2$. Our results revealed that the cardiac-specific lncRNA MHRT (Myosin Heavy Chain Associated RNA Transcripts) was significantly elevated in the blood from AMI patients compared with the healthy control ($^*p<0.05$). Using an in vitro neonatal rat cardiac myocytes injury model, we demonstrated that lncRNA MHRT was upregulated in the cardiac myocytes after treatment with hydrogen peroxide ($H_2O_2$) via real-time RT-PCR (qRT-PCR). Furthermore, we knockdowned the MHRT gene by siRNA to confirm its roles in the $H_2O_2$-induced cardiac cell apoptosis, and found that knockdown of MHRT led to significant more apoptotic cells than the non-target control ($^{**}p<0.01$), indicating that the lncRNA MHRT is a protective factor for cardiomyocyte and the plasma concentration of MHRT may serve as a biomarker for myocardial infarction diagnosis in humans AMI.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.11 no.2
• /
• pp.53-57
• /
• 2015

Most special health care needs (SHCN) people suffer from oral health problems due to high incidence and severity of oral disease. The aim of the present study was to investigate the characteristics of dental treatment provided in this patient population. The study population comprised 485 SHCN patients who visited Kyung Hee University Dental Hospital from 2006 to 2014. Based on the medical record, the date were evaluated according to age, gender, type of disorder, reason for visit, type of behavior management, and type of dental treatment. The most common age group was 7-12 year olds (26%). The chief compliant was dental caries (39%), as followed by oral exam (12%) and trauma (12%). Approximately half of SHCN patients (45.9%) was treated under behavior management. Restorative treatment was the most common procedure with the average of 2.9 teeth treated per patient. The results of the present study may be valuable for establishing the data of SHCN patients for primary dental care.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.2
• /
• pp.195-201
• /
• 2022

Background: The aim of this study was to evaluate the long-term (5-year) clinical outcomes of patients who received intensive care unit (ICU) treatment using Korean nationwide data. Methods: All patients aged >18 years with ICU admission according to Korean claims data from January 2008 to December 2010 were enrolled. These enrolled patients were followed up until December 2015. The primary outcome was ICU mortality. Results: Among all critically ill patients admitted to the ICU (n=323,765), patients with cancer showed higher ICU mortality (18.6%) than those without cancer (13.2%, p<0.001). However, there was no significant difference in ICU mortality at day 28 among patients without cancer (14.5%) and those with cancer (lung cancer or hematologic malignancies) (14.3%). Compared to patients without cancer, hazard ratios of those with cancer for ICU mortality at 5 years were: 1.90 (1.87-1.94) for lung cancer; 1.44 (1.43-1.46) for other solid cancers; and 3.05 (2.95-3.16) for hematologic malignancies. Conclusion: This study showed that the long-term survival rate of patients with cancer was significantly worse than that of general critically ill patients. However, short term outcomes of critically ill patients with cancer were not significantly different from those of general patients, except for those with lung cancer or hematologic malignancies.

• Journal of Trauma and Injury
• /
• v.35 no.1
• /
• pp.25-33
• /
• 2022

Purpose: The scoring system for traumatic liver injury (SSTLI) was developed in 2015 to predict mortality in patients with polytraumatic liver injury. This study aimed to validate the SSTLI as a prognostic factor in patients with polytrauma and liver injury through a generalized estimating equation analysis. Methods: The medical records of 521 patients with traumatic liver injury from January 2015 to December 2019 were reviewed. The primary outcome variable was in-hospital mortality. All the risk factors were analyzed using multivariate logistic regression analysis. The SSTLI has five clinical measures (age, Injury Severity Score, serum total bilirubin level, prothrombin time, and creatinine level) chosen based on their predictive power. Each measure is scored as 0-1 (age and Injury Severity Score) or 0-3 (serum total bilirubin level, prothrombin time, and creatinine level). The SSTLI score corresponds to the total points for each item (0-11 points). Results: The areas under the curve of the SSTLI to predict mortality on post-traumatic days 0, 1, 3, and 5 were 0.736, 0.783, 0.830, and 0.824, respectively. A very good to excellent positive correlation was observed between the probability of mortality and the SSTLI score (γ=0.997, P<0.001). A value of 5 points was used as the threshold to distinguish low-risk (<5) from high-risk (≥5) patients. Multivariate analysis using the generalized estimating equation in the logistic regression model indicated that the SSTLI score was an independent predictor of mortality (odds ratio, 1.027; 95% confidence interval, 1.018-1.036; P<0.001). Conclusions: The SSTLI was verified to predict mortality in patients with polytrauma and liver injury. A score of ≥5 on the SSTLI indicated a high-risk of post-traumatic mortality.