• Title/Summary/Keyword: Special hospital

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Development and Analysis of Community Based Independent Home Care Nursing Service (지역사회중심의 독립형 가정간호 시범사업소 운영체계 개발 및 운영결과 분석)

  • Park, Jung-Ho;Kim, Mae-Ja;Hong, Kyung-Ja;Han, Kyung-Ja;Park, Sung-Ae;Yun, Soon-Nyoung;Lee, In-Sook;Cho, Hyun;Bang, Kyung-Sook
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1455-1466
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    • 2000
  • The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

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Comparison about adverse drug reaction report forms among Asian's countries using herbal medicine (한약을 사용하는 아시아권 국가의 유해사례 보고 양식에 관한 비교 연구)

  • Sun, Seung-Ho;Lee, Eun-Kyoung;Jang, Bo-Hyoung;Park, Sunju;Go, Ho-Yeon;Jeon, Chan-Yong;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.3
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    • pp.91-102
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    • 2015
  • Objective : The purpose of this study is to find out the possibility of application to herbal medicine's report form for adverse drug reaction (ADR) by reviewing and analyzing Asian countries's ADR report forms. Method : We investigated, compared, and analyzed ADR report forms (ADR-RF) of Asian countries's ADR institutions (ACAI), such as, Korea institute of drug safety & risk management and Dongguk university Ilsan oriental hospital (DUIOH) in Korea, national center for ADR monintoring (NCAM) in China, pharmaceuticals and medical devices agency (PMDA) in Japan, Ministry of Health and Welfare (MOHW) in Taiwan, and drug office, department of health, the government of the Hong Kong special administrative region (GHKSAR) in Hong Kong. Results : ADR-RF for ACAI included common contents, such as, patients information (name(initial), gender, age, weight), adverse event (AE)'s report information (Recognition and report for AE occurrence, first or follow up report, Severe AE), the detailed information of AE (the title of AE, onset & closing date of AE symptoms, the progress & results detailed test of AE), the information of AE's medicine (the types of medicine, product name, ingredient name, suspected or combination drug, single dose & frequency, dosage form, administration route, dealing for AE-suspected medicine), and AE reporter's information (reporter's information, institution's information). Taiwan had ADR-RF and the department exclusively for herbal medicine (HM), but others (except DUIOH) had not only no ADR report form but also contents for HM. Conclusion : ADR-RF for HM have to include the common contents of ACAI at least, as well as HM information related to ADR, such as the title, composition and types of HM, history related to HM's ADR, and the contents of drug-induced liver injury and so on. In addition, the main department of government for HM's ADR will be needed.

The Development and Test of Self-Efficacy Promotion Program on Self-care of Hemodialysis Patients (혈액투석환자의 자가간호를 위한 자기효능증진 프로그램 개발 및 효과)

  • Song, Mi-Ryeong
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1066-1077
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    • 2000
  • The purpose of this study is to develop self-efficacy promotion program and to test its effects on self-efficacy, self-care, physiologic index of hemodialysis patients after applying this program to them. Preliminary study was carried out to identify the levels and types of self-care, self-efficacy of hemodialysis patients. To develop self-efficacy promoting program, several discussions with nursing professors and nurse specialists on hemodialysis patients were made after in-depth literature review on the area. Through these processes, the self-efficacy promoting program including 20 minutes long videotape and other counciling documents were completed. This videotape consisted of specific self-care techniques for hemodialysis patients including management of fistula, measurement of blood presure and body weight, special diets, medications, exercise and rest, management of physical problems and social adjustment. Two group equivalent pre and post test quasai-experimental research design was used in this study. The total subjects were 34 hemodialysis patients who received hemodialysis three time per week at 1 university hospital. Seventeen experimental group subjects were matched with control group subjects in sex and age. Data were analysed with the SPSS window program. Homogeniety between experimental and control group pretest data was tested by x$^2$ and t-test. There were no significanct differences in general characteristics, illness history, specific self-efficacy and self-care between the two groups. The differences of general self-efficacy of two groups were tested with the Repeated Measure ANCOVA because of significant differences of pretest data of general self efficacy between two groups. The differences of self-efficacy and self-care of two groups were tested with Repeated Measure ANOVA and the differences of physiologic indecies including blood potassium level and blood phosphorus level and interdialytic weight gain were tested by t-test. The results were as follows: 1. There was no significant difference in general self-efficacy between the two groups over four different time, and no interaction by groups and by time. 2. There was significant difference in specific self-efficacy between the two groups over four different time, and interaction by groups and by time. 3. There was significant difference in self-care between the two groups over four different time, and interaction by groups and by time. 4. There were no significant differences of blood potassium level and blood phosphorus level, but there was significant difference of interdialytic weight gain between the two groups. From the results above, it can be concluded that the self-efficacy promotion program for hemodialysis patients was effective to improve degree of specific self-efficacy and self-care and to decrease interdialytic weight gain. Considering results, the followings are recommended: 1) Repeated studies are needed for another hemodialysis patients. 2) This program can be used for improving degree of self-efficacy and self-care of hemodialysis patients by nurse practitioner and nurse educator.

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Evaluation of Factors Affecting Glomerular Filtration Rate by Contrast Media in Patients with Coronary Angiography (심혈관 조영술 시행 환자의 조영제 사용 시 사구체여과율 변화에 영향을 미치는 인자들 평가)

  • Kim, Eun-Young;Lee, Ok-Sang;Lim, Sung-Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.103-112
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    • 2012
  • Performance of coronary angiography for exact diagnosis and treatments of cardiovascular disease have been increased recently and it also brings increase of the contrast-induced nephropathy (CIN) referred from increasing use of radiological contrast agents. The variation of estimated glomerular filtration rate (eGFR) is an indicator of CIN, which is known to increase when renal function is decreased. Therefore, this study was to evaluate the affecting factors including concomitant drug on variation of eGFR of patients who underwent coronary angiography according to the conditions of renal function. Medical records of 66 patients were evaluated retrospectively and the patients underwent coronary angiography or angioplasty with nonionic and isotonic contrast media (iodixanol) at Chungnam national university hospital from 1 Jan 2008 to 30 Jul 2010. Patients group was divided into 2 groups; the patients in stages 3-4 chronic kidney disease (CKD) and the patients in stage 2 CKD. Each group was researched about the effect of concomitant drug and clinical characteristics on eGFR variation. The change of eGFR was compared among baseline and 2 or 3 day after coronary angiography. In results, the eGFR variation in group over age 75 was significantly decreased after radiological contrast agents exposure (p $$\leq_-$$ 0.05). The eGFR variation in anemia was significantly decreased after radiological contrast agents exposure in stage 2 CKD (p > 0.05). The eGFR variation in group under $HbA_{1c}$ 6.5% was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, angiotensin converting enzyme inhibitors, calcium channel blockers and nitroglycerin was increased after radiological contrast agents exposure in stage 2 CKD (p $$\leq_-$$ 0.05). The eGFR variation by using of diuretics was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, nitroglylcerin was increased after radiological contrast agents exposure in stages 3-4 CKD(p > 0.05). The eGFR variation in group over contrast dosage 150 ml was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). Therefore, when undergoing coronary angiography, contrast dosage should be minimized less than 150 ml, and diuretics should be restricted as possible in stages 3-4 CKD. Patients over age 75 require special attention to prevent CIN, and if patients undergo coronary angiography in stages 3-4 CKD, $HbA_{1c}$ is also requried to maintain below 6.5% to prevent CIN.

A clinical pilot study of jawbone mineral density measured by the newly developed dual-energy cone-beam computed tomography method compared to calibrated multislice computed tomography

  • Kim, Hyun Jeong;Kim, Ji Eun;Choo, Jiyeon;Min, Jeonghee;Chang, Sungho;Lee, Sang Chul;Pyun, Woong Beom;Seo, Kwang-Suk;Karm, Myong-Hwan;Koo, Ki-Tae;Rhyu, In-Chul;Myoung, Hoon;Heo, Min-Suk
    • Imaging Science in Dentistry
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    • v.49 no.4
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    • pp.295-299
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    • 2019
  • Purpose: This clinical pilot study was performed to determine the effectiveness of dual-energy cone-beam computed tomography (DE-CBCT) in measuring bone mineral density (BMD). Materials and Methods: The BMD values obtained using DE-CBCT were compared to those obtained using calibrated multislice computed tomography (MSCT). After BMD calibration with specially designed phantoms, both DE-CBCT and MSCT scanning were performed in 15 adult dental patients. Three-dimensional (3D) Digital Imaging and Communications in Medicine data were imported into a dental software program, and the defined regions of interest (ROIs) on the 3-dimensional surface-rendered images were identified. The automatically-measured BMD values of the ROIs (g/㎤), the differences in the measured BMD values of the matched ROIs obtained by DE-CBCT and MSCT 3D images, and the correlation between the BMD values obtained by the 2 devices were statistically analyzed. Results: The mean BMD values of the ROIs for the 15 patients as assessed using DE-CBCT and MSCT were 1.09±0.07 g/㎤ and 1.13±0.08 g/㎤, respectively. The mean of the differences between the BMD values of the matched ROIs as assessed using DE-CBCT and calibrated MSCT images was 0.04±0.02 g/㎤. The Pearson correlation coefficient between the BMD values of DE-CBCT and MSCT images was 0.982 (r=0.982, P<0.001). Conclusion: The newly developed DE-CBCT technique could be used to measure jaw BMD in dentistry and may soon replace MSCT, which is expensive and requires special facilities.

HIDDEN CARIES: CASE REPORT (Hidden caries의 치험례)

  • Yoon, Hye-Jeong;Kim, Seong-Oh;Son, Heung-Kyu;Choi, Byung-Jai;Lee, Jae-Ho;Song, Je-Seon;Choi, Hyung-Jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.4
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    • pp.532-536
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    • 2010
  • Hidden caries is a subtype of the occlusal pit and fissure caries type and is defined as a dentinal caries lesion near the occlusal surface of the tooth seen on a radiograph. In visual examination, the occlusal enamel is seen intact or is minimally perforated. Covert caries, Occlult caries or Fluoride syndrome are used as synonym. The percentage of occlusal dentin lesions that are clinically undetected ranges from 1.4-50%. Little is known about the mechanisms involved in the development of hidden caries. But it is thought that extensive use of topical fluoride or the special bacteriological profile has been a major factor. This case report is about detection and treatment of hidden caries of two children who visited the department of pediatric dentistry, Yonsei University Dental Hospital. The color of caries dentin found in hidden caries lesion is lighter than cavity forming caries, which makes it more difficult to detect caries by visual examination. Therefore diagnosis of hidden caries is often accomplished after clinical sign is recognized by patients. The use of advanced caries detection aids such as Diagnodent.. with periodic radiographic examination is seemed to be helpful for early detection of hidden caries.

The Suitability of the CDC Field Triage for Korean Trauma Care

  • Choi, Kang Kook;Jang, Myung Jin;Lee, Min A;Lee, Gil Jae;Yoo, Byungchul;Park, Youngeun;Lee, Jung Nam
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.13-17
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    • 2020
  • Purpose: Accurate and appropriate prehospital field triage is essential for a trauma system. The Korean trauma system (established in 2014) uses the trauma field triage algorithm of the United States Centers for Disease Control and Prevention (CDC). This study evaluated the suitability of the CDC field triage criteria for major trauma cases (injury severity score >15) in Korea. Methods: This retrospective cohort study evaluated trauma patients who presented at the authors' regional trauma center from January 1 to May 7, 2017. The undertriage and overtriage rates of each CDC field triage step were calculated. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was evaluated for each step. Results: Among the 1,009 enrolled patients, 168 (16.7%) had major trauma. The undertriage/overtriage rates of each step (steps I, II, III, and IV) of CDC field triage were 9.2%/47.4%, 6.3%/50.8%, 4.5%/59.4%, and 5.3%/78.9%, respectively. The AUC values of each CDC triage step were 0.722, 0.783, 0.791, and 0.615, respectively. The AUC values of the separate components of each step (physiologic criteria, anatomic criteria, mechanism-of-injury criteria, and special considerations) were 0.722, 0.648, 0.647, and 0.456, respectively. Conclusions: The CDC field triage system is acceptable, but not ideal, for Korean trauma care. If we follow the protocol, it would be preferable to omit step IV. The Korean Triage and Acuity Scale may be a good indicator for in-hospital triage. However, a new triage protocol that is simple to estimate on-scene while having good performance should be developed.

Simultaneous Reduction of Contralateral Malar Complex in Cases of Unilateral Zygoma Bone Fracture (편측 관골 골절에서 동시 반대측 관골 축소술)

  • Kim, Peter Chan-Woo;Lee, Byung-Kwon;Bae, Ji-Suk
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.851-860
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    • 2011
  • Purpose: Reduction by simply assembling bones is recognized as treatment for a zygoma fracture. However, in patients who originally had a protruding zygoma, the fractured parts look like malarplasty after the edema subsides, giving a soft impression which patients notice. Thus, we created symmetry through simultaneous contralateral malar reduction in a unilateral zygoma fracture. Methods: In this study, the patients who had surgery between July, 2008 and December, 2009 with admission were object. In 76 patients with a zygoma fracture, the patients with bilateral zygoma fractures were excluded. Among 48 patients who had a reduction only after a unilateral zygoma fracture, the patients hoping for a reduction of their rough protruding zygoma were analyzed with front cephalometry. The study progressed on 22 patients who had simultaneous contralateral malar reduction in a unilateral zygoma fracture with consent. After fixing the fracture, we did a straight zygoma osteotomy through a 1.5 cm intraoral incision. After that, we created symmetry with a special ruler and fixed the broken zygomatic arch with a screw and plate. We evaluated the facial index and satisfaction with a statistical analysis before and after the surgery. Results: In 22 patients, there was no reoperation except for 1 patient who had a zygoma fracture. None of the patients were treated for infection or hematoma. Two patients complained of paresthesia after the malar reduction operation, but this subsided in 4 months. Most of them were satisfied with the malar reduction, especially the women, and we obtained a better mid facial contour with decreased facial width ($p$ <0.05). Conclusion: Existing zygoma fracture surgery focuses on anatomical reduction. However, we need to have a cosmetic viewpoint in fractures as interests of face contour arise. Thus, contralateral malar reduction got a 4.7 (range 0~5) from patients who had malar reduction surgery in our hospital. Although adjusting to all zygoma fractures has limitations, it can be a new method in zygoma fractures when there are limited indications of protruding zygoma and careful attention is given to patients' high demands.

A Study on the Perception of the Nurses in Cancer Wards of the Complementary and Alternative Therapies (암 병동 간호사의 보완대체요법에 관한 인식 조사연구)

  • Lee, Jung-Ran
    • Asian Oncology Nursing
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    • v.4 no.2
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    • pp.124-134
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    • 2004
  • The major results of this study were as follows : 1. The percentage of nurses who know the complementary and alternative therapies was 50.1% Most of them(70.6%) acknowledged the therapies from newspapers, television and magazines. 2. The complementary and alternative therapy was perceived as effective by 64.9% of the nurses and as trusted by 60.2% of them The effective methods of the therapy are acupuncture herb medicine and massage. 3. Most of the nurses 93.4% experienced getting inquiries from patients or their guardians whether to use the therapies. 4. The complementary and alternative therapies was experienced by 38.9% of nurses and 7.1% of them use the therapies frequently 92.9% of patients and families were satisfied with the result 'Massage Therapy' was used the most with no side-effects and thus higher need of education for nurses. 5. They wanted to be trained for massage therapy finger-pressure, music therapy, acupuncture, aroma therapy in order. 6. Reliance on the complementary and alternative therapies, 75.2% of nurses completed the course trusted the therapies and the result of others uncompleted was similar as 52.2% Moreover both 79.5% of nurses completed it and 61.6% of the others said that the complementary and alternative therapy's nursing interventions is possible to develop. 7. It shows high relation to recognition having possibilities for applying and developing as the nursing intervention. if the confidence is as high as about the complementary and alternative therapies. Based of the results of this study as above this study proposes as follows. First, The nurses should understand mentality of the patients so that the nurses have to put in operation appropriate nursing intervention as accurate knowledge of the alternation therapies using to cancer patients for having on damages to patients from their rash using way. Furthermore, it is necessary to supply the special place and the professional nurses taking complete charge at them. Next politic interest and support from government are required to develop and practice systematic and resonable education programs for the complementary and alternative therapies. Moreover, it is necessary for nurses to be educated about the therapies continually. Finally, it is compulsory that the research and development for complementary and alternative therapies is needed. In addition, it has to be made standard and legal equipment for safety efficacy and theory about the therapies.

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Multiple Primary Malignant Tumor (다발성 원발성 악성종양)

  • Lee, Su-Jung;Chung, Yun-Woong;Kim, Hong-Jin;Suh, Bo-Yang;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.221-230
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    • 1988
  • Though the occurrence of multiple primary malignant tumor is a rare finding but the reported cases of it has increased in recent years. We collected multiple primary cancer of different organ, tissue and the multicentric origin of bilaterally paired organs. This paper reports 6 cases of multiple primary malignant tumors which were experienced at Yeungnam university hospital in Taegu during the past 2 years with review of journals. The results were as follows. 1. The incidence of multiple primary cancer was 0.31% for 2 years(1987-1988). 2. The ratio between male and female was 1:1 and mean age of incidence was 54.1 years. 3. The ratio between synchronous and metachronous(interval more than 6 months) was 1:1. 4. The time interval between first and second cancer was average 2.7 years in metachronous cases. 5. The most frequent involved organ was stomach, breast and colon in order of frequency. 6. The incidence of familial cancer associations was found in one out of 6 cases. 7. The test of DNCB, multi test CMI and ratio of T4 to T8 were performed in 4 cases but there was no definitive evidence of abnormality. We concluded that every effort should be made to discover the presence of synchronous malignancies in the patients who are being treated for a known tumor, and also special care should be given to detect new metachronous lesions is required.

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