• 제목/요약/키워드: Spinal health

검색결과 380건 처리시간 0.024초

간호기기 개발수요 조사연구 (A Study on the Demand for Equipent Development in Nursing)

  • 장순복;김의숙;황애란;강규숙;서미혜
    • 대한간호
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    • 제35권2호
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    • pp.71-91
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    • 1996
  • The objectives of thes study were to identify the need for equipment development in nursing, and to determine the priorities for that development. The study was descriptive study done between March 2 and May 30, 1995, in which the subjects, including 421 patients, 223 family members, and 198 nurses from neurosurgery, orthopedic, rehabilitation medicine, internal medicine and intensive care units of nine general hospitals in Seoul, completed a questionnarie developed by the research team. The questionnaire consisted of 35 open and closed questions. Data was analyzed using frequencies and percentages. The results ware summarized as follows: 1) The average age of the nurses was 27.9 years, 48% of the patients were between 20 and 40 years of age, and 17% were over 60. The average lingth of experience for the nurse subjects was four years five months with 36.9%. having over five years experience. The most frequent diagnoses of patients were spinal disc(35.9%), internal medicine disease(26.0%), cerebral vascular accident(16.6%) and spinal cord injury(10%) 2) Many of the nurses(96.4%) reported deficiencies with existing equipment and 96.5% of the nurses, but only 79.8% of the patients, nurses' time. Further, 82.3% of the nurses and 75.8% of the patients felt that the development of new equipment would lead to a decrease in the cost of nursing care. 3) Nurses felt that the greatest areas of inconvenience were patient feeding(71.7%), hygiene(71.2%), caring for a patient confined to bed(70.7%), patient clothing(67.2%), mobility transfers(63.5%) and urinary elimination(52.0%). However, patients and family members listed the following as being the most inconvenient: urinary elimination(58.7%), Hygiene(50.5), feeding(48.4%), mobility transfers(47.1%) and bed care(45.2%). 4) Generally the nurses listed more inconveniences and patients and family members listed more demands for the development of equipment. These included utensils with large handles, and regulators for tube feedings; mattresses that provide for automatic position change and massage, which have patient controlled levers and a place for bed pan insertion; automatic lifts or transfer from bed to wheelchair; equipment to facilitate washing and oral hygiene as well as equipment that will allow patients with spinal cord injuries easy access to showers; a bed pan/urinal for women that is comfortable and effective from which urine can be measured and disposed of easily; disposable dressing sets and tracheostomy care sets and a convenient way of measuring changes in wound size; a safe delivery system for oxygen, a variety of mask sizes and better control of humidity, tracheal material than at present, as well as a communication system for patients with tracheostomies; clothing that will allow access to various parts of the body for treament or assessment without patients having to remove all of their clothing; and finally a system that will allow the patient to control lighting, telephones and pagers. Priority areas for equipment development reported by the nurses were, urinary elimination(58. 7%), hygiene(50.5%), feeding(48.4%), mobility transfers(47..1%), bowel elimination(40.8%). Those reported by the patients family members were feeding(71.7%), hygiene(70.0%), bedcare(70.7%), clothing(67.2%), mobility transfers(63.6%), urinary elimination(52.9%) and bowel elimination(50.5%) Altogether, nurses, patients and family members listed the following as priorities; clothing (178), bed care(144), urinary elimination(92), environment(81), hygiene(70). Further, a health professional forum listed urinary elimination, oxygen delivery, medication delivery, mobility transfers, bed care and hygiene in that order as priority areas. From this study it can be concluded that the first need is to develop equipment that will address the problems of urinary elimination. To do (l)This nurses who are interested in equipment development should organize an equipment development team to provide a forum for discussion and production of equipment for nursing.

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디지털 적외선 체열진단기를 이용한 추간판탈출증 환자의 ROI 온도측정 (Measurement of ROI Temperature in Herniation of Intervertebral Disc Patients Using DITI)

  • 박정규;박종삼;권순무
    • 한국방사선학회논문지
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    • 제11권4호
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    • pp.273-278
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    • 2017
  • 적외선 체열검사를 시행한 $L_4-L_5$ 추간판 탈출증 환자의 45명 중 여자가 더 많았으며, 연령은 50대가 가장 많았다. 피절 분포표에 따라 측정한 결과, ${\chi}^2-test$에서는 성별과 나이에 따라서 유의한 차이를 보이지 않았다(p>0.05). $L_4-L_5$ 추간판 탈출증 환자의 ROI 온도를 측정한 부위는 후면 오른쪽 정강이뼈 뒤쪽의 온도가 가장 높았으며, 후면 왼쪽 정강이뼈 뒤쪽-전면 오른 무릎아래-전면 왼 무릎아래의 순이었다. 측정부위에 따라 유의한 차이를 보였다(p<0.05). 나이에 따라서는 ${\chi}^2-test$에서는 나이에 따라 0.030을 유의한 결과를 보였다(p<0.05). 정상인의 평균 ROI 온도는 $31.20{\pm}0.58$, 환자의 평균 ROI온도는 $30.30{\pm}0.50$으로 온도 차이는 $0.66{\pm}0.59$로 나타났다. 환자의 ROI온도가 정상인과 차이가 나는 지 알아보기 위한 일 표본 t-검정결과, 유의확률이 0.03으로 0.05보다 작으므로 환자의 ROI온도는 $31.20{\pm}0.58$보다 낮게 나타났다(p<0.05). 앞으로의 과제는 온열환경에 따른 보정 테이타의 처리기술과 그것을 이용한 새로운 온열 인덱스의 개발이 필요하다고 사료된다. 따라서 데이타의 보정을 줄이기 위해서는 적외선 체열 진단 시 전처치가 무엇보다 중요하며, 이를 검사하는 방사선사는 환자를 측정 시 주의 깊은 관찰과 배려가 요구된다.

119구급대의 간호사 배치여부에 따른 응급처치 실태 (Emergency Care Conditions where the Nurse is posted in the 119 Relief Squad)

  • 김영임;정혜선;이창현;김금숙;박정영
    • 지역사회간호학회지
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    • 제11권2호
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    • pp.411-422
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    • 2000
  • The purpose of this study is to identify the difference of emergency care conditions where the nurse is posted in the 119 relief squard or not. The data composed a total of 777 cases of emergency activity of one police stand in Seoul during March, June. September and December in 1998. The results of this study were as follows: 1. The age of the subjects was 20-60 age 54.3%, over 60 age 35.4% with an average age of 50.2. Among them men were 55.0%, the unemployed were 60.8%. The place of the occurrence of an accident was the house, 49.7% and the cause as illness was 59.6%. 2. The main symtom was pain the 36.2% the main consciousness state was alert 76.9%: The state of the patients as chronic was 59.6%. 3. The consulting hospital of the 119 relief squad as a third medical center was 79.9%. The distance to the medical center as less than 5 km was 77.2%, and an average transfer distance was 5.38 km. The cases of doctor guided emergency care was 0.9%, the cases that had posted nurses in 119 relief squads was 48.6%. 4. The case of the best emergency care operation was difficulty in breathing, 62.1% and the second was unconsciousness, 46.1 %. The more serious the consciousness state, the higher the rate of emergency care operation. There wasn't any difference in emergency care operation concerning transfer distance. 5. The cases that had the posted nurses was 19.1%, the cases of no nurse was 11.7% among the cases of emergency care operation during transfering; the cases that had posted nurses had the higher emergency care operation. (p<0.05). Airway maintenance was 14.8% in cases that had the posted nurses, while in the cases of no nurse, 10.9%; and oxygen inspiration was 16.0% in cases that had the posted nurses while in the cases of no nurse 7.6% (p<0.01); spinal fixation was 6.6% in cases that had the posted nurses while in the cases of no nurse 4.6%(p<0.05). With these results, we can conclude that the cases that had the posted nurse showed higher emergency care operation.

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Carotid sparing intensity modulated radiotherapy on early glottic cancer: preliminary study

  • Choi, Hoon Sik;Jeong, Bae Kwon;Jeong, Hojin;Song, Jin Ho;Kim, Jin Pyeong;Park, Jung Je;Woo, Seung Hoon;Kang, Ki Mun
    • Radiation Oncology Journal
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    • 제34권1호
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    • pp.26-33
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    • 2016
  • Purpose: To compare the dose distribution between carotid sparing intensity modulated radiotherapy (IMRT) and opposed lateral field technique (LAFT), and to determine the effects of carotid sparing IMRT in early glottic cancer patients who have risk factors for atherosclerosis. Materials and Methods: Ten early glottic cancer patients were treated with carotid sparing IMRT. For each patient, the conventional LAFT plan was developed for comparison. IMRT and LAFT plans were compared in terms of planning target volume (PTV) coverage, conformity index, homogeneity index, and the doses to planning organ at risk volume (PRV) for carotid arteries, spinal cord and pharyngeal constrictor muscle. Results: Recurrence was not observed in any patients during the follow-up period. $V_{95%}$ for PTV showed no significant difference between IMRT and LAFT plans, while $V_{100%}$ was significantly higher in the IMRT plan (95.5% vs. 94.6%, p = 0.005). The homogeneity index (11.6%) and conformity index (1.4) in the IMRT plan were significantly better than those in the LAFT plans (8.5% and 5.1, respectively) (p = 0.005). The median $V_{5Gy}$ (90.0%), $V_{25Gy}$ (13.5%), and $V_{50Gy}$ (0%) for carotid artery PRV in the IMRT plan were significantly lower than those in the LAFT plan (99.1%, 89.0%, and 77.3%, respectively) (p = 0.005). Conclusion: Our study suggests that carotid sparing IMRT can significantly decrease the dose to carotid arteries compared to LAFT, and it would be considered for early glottic cancer patient with high risk of atherosclerosis.

단일조사 whole spine Lateral 검사에서 3D 프린터로 제작한 구리 필터 유용성 연구 (A Study on the Usefulness of Copper Filter in Single X-ray Whole Spine Lateral using 3D Printer)

  • 권경태;윤다연;신래운;한봉주;윤명성
    • 한국방사선학회논문지
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    • 제14권7호
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    • pp.899-906
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    • 2020
  • WSS 측면 검사는 척추의 질환을 진단하기 위해 매우 중요한 검사이다. 최근 대면적의 Long Length Detector가 보급되고 있어 피폭선량과 검사 시간을 효율적으로 줄일 수 있으며, 낙상 고위험군 환자 및 소아, 청소년기 환자의 검사에 매우 효율적으로 적용할 수 있다. 하지만 1회 조사로 영상을 얻기 때문에 기하학적인 척추의 해부학적 구조상 허리뼈 보다 목뼈 부근이 상대적으로 체적이 적어 목뼈 부위의 영상 품질은 진단 가치가 매우 하락한다는 단점이 있다. 이에 본 연구는 WSS 측면 검사에서 균일한 영상품질을 얻기 위해 3D 프린팅 기술과 구리 필라멘트를 이용하여 부가 필터를 제작하고 결과를 분석하고자 한다. 3D 프린팅 기술은 원하는 모양을 손쉽게 출력할 수 있는 장점이 있어 산업 분야 전반에 광범위하게 사용되고 있으며, 최근 구리 소재의 필라멘트가 개발되어 부가 필터로서의 가능성을 확인하였다. WSS 측면 검사에서 부가 필터 적용시 CNR과 SNR이 우수하게 측정되어 부가필터의 사용 가능성을 확인 하였다.

MRI 검사 시 금속 인공물 억제를 위한 합리적인 수신대역폭 적용 기준 (Standards for Applying Reasonable Receive Bandwidth to Suppress Metal Artifacts in MRI)

  • 유세종;전민철;안남용;권순용;김성호
    • 한국방사선학회논문지
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    • 제17권7호
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    • pp.1115-1122
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    • 2023
  • 본 연구는 MRI 검사 시 금속 인공물을 억제하기 위한 목적에서 합리적인 수신대역폭 적용 기준을 제시하고자 하였다. 이를 위해 척추 수술용 나사로 제작된 팬텀을 대상으로 고속 스핀 에코기법을 적용한 T2 대조도 영상을 획득해 금속 인공물을 재현하였다. 그리고 수신대역폭을 100 Hz/PX에서 800 Hz/PX까지 100 Hz/PX씩 증가시키며 영상을 획득하였다. 금속 인공물은 신호 감쇄 영역과 신호 누적 영역의 면적을 측정하여 합으로 정하였다. 더불어 영상 변수에 따른 금속 인공물의 양상을 분석하기 위해 Pearson 상관 분석을 시행하였다. 그 결과, 신호 누적 영역은 수신대역폭 증가에 따라 유의한 변화가 없었지만(p>0.05) 신호 소실 영역과 금속 인공물의 면적은 수신대역폭의 증가에 따라 감소하였다(p<0.05). 흥미로운 점은 금속 인공물의 면적은 수신대역폭을 100 Hz/PX에서 200 Hz/PX로 증가시킨 구간에서 최대로 감소하였는데 이는 수신대역폭 증가에 따른 에코 간격이 최대로 줄어든 구간과 일치하였다. 더불어 상관 분석 결과에서도 에코 간격은 수신대역폭과 비교하여 신호 감쇄 영역 및 금속 인공물의 면적과 더 높은 연관성이 있는 것으로 나타났다. 따라서 금속 인공물을 줄이기 위한 목적으로 수신대역폭을 증가시킬 경우, 화질 요소를 고려해 에코 간격이 최소화되는 수치를 기준으로 정하는 것이 합리적이라 생각된다.

중학교 체질검사 실태에 관한 연구 (A study on physical examination of middle school students)

  • 박성희
    • 한국학교보건학회지
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    • 제14권1호
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    • pp.131-143
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    • 2001
  • The primary aim of this dissertation is to contribute to the improvement of methods in physical examination by providing quality information for the current school system and advice for improving status. Present status, controversial points and possible remedies in physical examination were analyzed on a frequency and percentage basis. An $x^2$-test was used to verify the statistics between the results from the examination and each variable. In case of multiple categories of variables, an $x^2$ cs was adopted. Chronological data as well as both total and sampling physical examination data verified the statistics using an $x^2$-test. This thesis is based both on the data from middle school health care specialists in Gyunggi Province and on the analysis of physical examinations reported from local schools to the municipal education agency from 1997 to 1999. The results of the study are as follows: First, according to the survey, only 29.0% of the total schools had their school doctors examine all the students while most of the educational institutions failed to implement the whole process of physical examination on the list. It also turned out that the more students the schools have, the lower the rate of implementation of physical examination by school doctors(p=0.014). Second, the average time a school doctor spends for checkup turned out to be approximately 1.7 minutes per student This means that the quality of the physical examination is not guaranteed in the process. Third, 47.7% of those surveryed say that a dental examination was performed, each taking 21.24 seconds on average. In addition, it shows that some 31.5% wanted to have a task force team for dental checkups at the local health center. Given the fact that dental caries among students is progressively on the rise, the dental health centers that are now set up in some elementary schools should be expanded to cover the whole educational institution in order to raise awareness of the importance of dental care. Fourth, 48.5% of those surveyed say that a comprehensive physical examination should be adopted to promote the health of high schoolers. Since it takes a lot of public funds to implement a comprehensive method, it is essential to make sure that in-depth studies should be based on the frequency and methods of physical examination. Fifth, regarding such diseases among 3rd year middle school students in 1999, statistics shows that there was a slight difference in the prevalence rate of color blindness, and allergic diseases for male students ; and color blindness, hearing disturbance and allergic disease for female students. For those items, however, it is too little to say that there is a significant difference and accordingly it is assumed to be a problem of the measuring process. Sixth, the result of analysis on the sample physical examination and the total physical examination of the year 1999 shows as follows: For male students in the 3rd year of middle school, a slight difference appeared to those students in 11 items including eye problems and eye disease, otitis media, tonsillar hypertrophy, spinal shape, respiratory urinary allergic disease and other abnormal diseases(p<0.05). Particularly, the prevalence rate between students with and without disease was shown to be two times more in the following: eye problems, otitis media, tonsill hypertrophy, allergic diseases, etc. For female students in the 3rd year, prevalence rate showed little difference in 14 items(p<0.05). For items including eye problem, otitis media, tonsill hypertrophy, allergic disease, etc. it was shown that the rate was two times more between students with and without diseases. Physical examinations under the current school system are not producing any fundamental results for the health of the students. Methods and results are not trustworthy. Accordingly, a drastic overhaul of the current practices is needed in frequency, methods and items on the list in order to promote the health of the students. Cost-benefit studies as well as political considerations to ensure the development of efficient methods for physical examination are urgently needed at this moment.

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퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로 (A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal-)

  • 최연순;김대현;서미혜;김조자;강규숙
    • 대한간호
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    • 제31권4호
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    • pp.77-99
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    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

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방사선치료를 위한 CT 검사 시 3DCT와 4DCT에 대한 피폭선량 고찰 (Consideration on Measured Patients Dose of Three-Dimensional and Four-Dimensional Computer Tomography when CT-Simulation to Radiation Therapy)

  • 박령황;김민정;이상규;박광우;전병철;조정희;유병규;이종석
    • 대한방사선기술학회지:방사선기술과학
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    • 제34권4호
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    • pp.341-349
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    • 2011
  • 방사선치료를 위한 CT 검사 시 동일 환자에 대하여 3차원영상과, 호흡주기영상을 획득하기 위한 컴퓨터단층촬영에서 환자의 피폭선량을 측정하고자 SOMATON SENSATION OPEN(SIEMENS, GERMANY)을 이용하여 내원환자 중 폐암환자 10명, 간암환자 10명의 CT 검사 시 피폭선량을 측정했다. 환자가 받는 피폭선량은 The volume CT dose index(CTDIvol), Dose Length Product(DLP)를 이용하여 분석하였으며 각각의 장기들이 받는 피폭선량의 실측은 환자의 장기를 대상으로 할 수 없어 Rando 팬텀을 이용 흉부검사 시 폐와 심장, 척수를, 복부검사 시 간과 신장의 위치를 선택하여 in-vitro와 in-vivo 계측이 가능한 광유도발광선량계(Optically Stimulated Luminescent Dosimeter, Landauer, Inc., USA)를 이용하여 측정하였다. 폐암환자의 CT 검사 시 10명의 CTDIvol값은 5.7배, DLP값은 약 2.4배, 간암환자의 CTDIvol값은 3.8배, DLP값은 약 1.6배의 값을 나타내었고, OSLD를 이용한 실측정치 역시 폐암환자의 경우 6배, 간암환자의 경우 5.5배의 차이를 보이는 등 4DCT 검사에서 전체적인 피폭선량의 증가를 볼 수 있었다. 방사선치료 시 호흡에 의한 치료부위의 위치변화를 4DCT 검사를 이용하여 움직임을 보정하여 치료계획시 치료용적의 정확성을 높일 수 있으나 4DCT 검사로 인한 환자의 피폭선량 증가를 고려하여 검사시간과 검사범위를 줄여 피폭선량을 감소시키기 위한 노력이 필요하다.

골반고정장치에 의한 감압치료가 임산부 요통환자의 통증, 일상생활 제한 및 요추만곡에 미 치는 영향에 관한 연구 (The Effects of Decompression Therapy by Fixed Pelvic System on Low Back Pain During Pregnancy)

  • 김희라;김윤신;김성호;김명준
    • 대한물리치료과학회지
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    • 제15권1호
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    • pp.1-9
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    • 2008
  • Background and Purpose : This study serves the purpose to present the effective way on back pain therapy for women during their pregnancy by comparing and analyzing the effects influencing on pain index, limits on daily life, and diminution of lumbar curve, when having treated for 6 weeks, dividing into therapy group, applied by decompression therapy on spine without unnecessary effects on the pregnant women and their fetus and the existent general physiotherapy group, applied on diminution of their back pain. Subject & methods : We made impregnate women of 30(25${\sim}$34years), as the subject of this study, who understood, and agreed with, this study, among pregnant women who were diagnosed as back pain. Pain intensity, limit index on daily life, and lumbar curve test, prior to experiment was implemented as paired t-test, comparison of the difference of average by each group before and after experiment was analysed as independent t-test, and statistical examination level was set up as 0.05. Results : The difference of average of pain and limit on daily life between the group, SDTG(spinal decompression therapy group), and the group, GPTG(general physical therapy group), before and after experiment was diminished as much as 44.4% and 16.79% each after completed 6 weeks' experiment, limit on daily life in both groups showed as much as 37.2% and 21.5% each, in the end, they statistically showed conspicuous difference(p<.05). Comparison of lumbar curves between both groups, SDTG and GPTG, before and after experiment, were diminished from -23.13${\pm}$4.85 to -15.66${\pm}$3.71, and there was no remarkable difference(p<.05). Conclusion : As, in this study, decompression therapy is more effective than general physical therapy with pregnancy low back pain in pain, limitation of daily life, lumbar curve.

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