• 제목/요약/키워드: Stress in Clinical Practice

검색결과 307건 처리시간 0.026초

Nitrous Oxide를 이용한 흡입진정 (Inhalation Sedation with Nitrous Oxide in Dental Treatment)

  • 윤형배
    • 대한치과마취과학회지
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    • 제2권1호
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    • pp.1-6
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    • 2002
  • The usage of nitrous oxide is increased for the anxious patient to dental treatment. There are two methods to induce the sedation during dental treatment. One is sedation with drugs the other no need of drugs. We discussed here about sedation with drugs. The methods of drug administration are oral, intramuscular, intravenous, inhalation. The method of oral administration of drugs are convenient to patient and doctor but poor controllability. Intramuscular method is a parenteral technique that maintains several advantages over the enteral technique. However its pales in comparison to other parenteral technique. Intravenous method represents most effective method of ensuring predictable and adequate sedation in all patients. But it has inability to reverse the action of drugs after they have been injected except some drugs (e.g., narcotics and benzodiazepine). A variety of gaseous agents may be administered by inhalation to produce sedation. In dental practice, the inhalation administration of gas means use of nitrous oxide. There are many advantages of nitrous oxide administration. First, very short latent period and rapid onset of drug action which lead to possible titration of drug concentration. With nitrous oxide, clinical effects may become noticeable as quickly as 15 to 30 seconds after inhalation. Recovery from inhalation sedation is also quite rapid. In out patient dental practice rapid recovery is very important because it permit to discharge the patient without escort and the patient return to their ordinary life without limit. To success the conscious sedation with nitrous oxide, the administrator should be keep the mind that always titration of nitrous oxide concentration during induction and treatment. Careful observation need during treatment to prevent oversedation because the adequate nitrous oxide concentration to patients changed by environmental stress. Always begins with 100% oxygen and ends with 100% oxygen to prevent diffusion hypoxia which rare in clinical practice.

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국내 병원에서 이루어지고 있는 인수인계 현황에 대한 조사연구 (An Exploration about Current Nursing Handover Practice in Korean Hospitals)

  • 김선호;김은만;최윤경;이향열;박미미;조의영;김을순
    • 임상간호연구
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    • 제19권2호
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    • pp.181-194
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    • 2013
  • Purpose: Examining current status of nursing intershift handover practice would provide opportunity to identify areas in need of improvement. The aim of this study was to describe nursing intershift handover practice in Korean hospitals. Methods: A cross-sectional survey using questionnaire was used to collect data. A total of 788 nurses working in general hospitals had participated. Results: More than half of the nurses participated responded that they used kardex for verbal handover (51.8%). The average time took for handover was 40.2 minutes (SD=14.7). Only 5.8% of nurses were satisfied with intershift handover practice. 72.9% of respondents did not have manuals for handover and 86% of nurses considered intershift handover manuals were necessary. Most nurses considered intershift handover pratice as an important component for patient safety (99.2%). The causes of handover error were interruption during handover, high work load, and stress/fatigue of nurses. Conclusion: The findings of this study indicated a need to develop handover practice guidelines which outline pertinent details. Intershift handover practice guidelines could provide consistency and structure to the information that is handed over.

영성 증진 프로그램이 임상 간호사의 영적 및 심리사회적 상태에 미치는 효과 (Spiritual and Psychosocial Effects of the Spirituality Promotion Program on Clinical Nurses)

  • 서임선;용진선;박준양;김주후
    • 대한간호학회지
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    • 제44권6호
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    • pp.726-734
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    • 2014
  • Purpose: The purpose of this study was to evaluate the effects of the Spirituality Promotion Program(SPP) for young nurses working in the stressful university hospital environment. Methods: The study included 41 nurses in the experimental group, nurses who had worked less than 5 years and completed 8 weeks of SPP between June and July in 2011. The control group, 44 nurses, also received the same program after the study was completed. For the study, a survey was conducted of all participants concerning spirituality, perceived stress, positive and negative affect, empathy, job satisfaction, and leadership practice. Results: No significant difference was found between the two groups on study variables. Perceived stress decreased significantly in the experimental group (p=.012). Spirituality (p=.019), positive affect (p=.014), empathy (p=.004), job satisfaction (p=.016), and leadership practice (p=.021) increased significantly in the experimental group. Conclusion: The results show that the Spirituality Promotion Program has positive effects on the spiritual and psychosocial aspect of young nurses. Continuation of this program for nurses is recommended in order to help them develop their self-care ability and improve nursing competency.

치과위생사의 근로생활의 질(QWL)에 관한 연구 (A study of quality of working life to dental hygienist's)

  • 오혜승;김은희
    • 한국치위생학회지
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    • 제10권2호
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    • pp.375-392
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    • 2010
  • Objectives : Dental hygienist's work satisfaction and stress affect the overall quality of work life(QWL). Therefore, this research is intended to suggest fundamental data to improve QWL by finding out characteristics of each work satisfaction and stress element. To this end, a total of 327 dental hygienists working at general hospitals, university hospitals, dental hospitals and dental clinics across Seoul, Gyeonggi and Incheon were surveyed. Results of survey are as follows. Methods : The collected data were analyzed by using an SPSS 12.0 statistical program, obtaining the following results. The collected data conducted a questionnaire survey for 327 dental hygienists who work at the hospitals, university hospitals, dental hospitals, and dental clinics located at Seoul, Gyeonggi-do, and Incheon district from January until March, 2009, and drew the conclusions as follows. Result : 1. Demographic characteristics, income from 1.5 to 1.99 million were the whole lot, more than 2 million to less than 1.5 million was similar. Marital status Married Unmarried higher than the atheist religion, Christianity, Catholicism, Buddhism, and other, respectively. Classification by level of education in the college graduate, university graduate, graduate diploma, respectively. 2. Are working in a job-related characteristics of dentistry, dental hospital, general and university hospital, respectively. The making in position, Mount, contractor, responsible, senior, was an intern in the order. The five-day workweek whether working at night and is not going to care whether the conduct was similar. Classification of working hours and 8 hours, 8 hours, 8 hours or less orderly, and total of less than 1-3 years of clinical experience, 5 years, less than one year, less than 3-5 years, respectively. 3. There comes out a significant difference according to age, income, position, gross clinical experience, and whether to put night shift into practice in job stability in terms of the quality subsequent to general characteristics(p<.05). 4. There comes out a significant difference according to marital status, one's place of work, position, whether to put a five-day workweek into practice in work environment and benefits package in terms of the quality subsequent to general characteristics (p<.05). 5. There comes out a significant difference according to age, marital status, income, position, and gross clinical experience in education & training and benefits packages in terms of the quality subsequent to general characteristics(p<.05). 6. There comes out a significant difference according to whether to put night medical treatment into practice in social usefulness in terms of the quality subsequent to general characteristics(p<.05). 7. There comes out a significant difference according to marital status, income, one's place of work, gross clinical experience, work hours, and whether to put a five-day workweek into practice in leisure activity in terms of the quality subsequent to general characteristics(p<.05). 8. There comes out a significant difference according to income, one's place of work, and position in wage level in terms of the quality subsequent to general characteristics(p<.05). 9. There was no significant difference in all items related to human relations and free communication in terms of the quality subsequent to general characteristics(p>.05). Conclusions : It is necessary to analyze factors related to work satisfaction and stress in order to improve dental hygienist's quality of work life. Hospitals must support them systematically and institutionally and related organizations must conduct practical research.

Stress distributions in peri-miniscrew areas from cylindrical and tapered miniscrews inserted at different angles

  • Choi, Sung-Hwan;Kim, Seong-Jin;Lee, Kee-Joon;Sung, Sang-Jin;Chun, Youn-Sic;Hwang, Chung-Ju
    • 대한치과교정학회지
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    • 제46권4호
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    • pp.189-198
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    • 2016
  • Objective: The purpose of this study was to analyze stress distributions in the roots, periodontal ligaments (PDLs), and bones around cylindrical and tapered miniscrews inserted at different angles using a finite element analysis. Methods: We created a three-dimensional (3D) maxilla model of a dentition with extracted first premolars and used 2 types of miniscrews (tapered and cylindrical) with 1.45-mm diameters and 8-mm lengths. The miniscrews were inserted at $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$ angles with respect to the bone surface. A simulated horizontal orthodontic force of 2 N was applied to the miniscrew heads. Then, the stress distributions, magnitudes during miniscrew placement, and force applications were analyzed with a 3D finite element analysis. Results: Stresses were primarily absorbed by cortical bone. Moreover, very little stress was transmitted to the roots, PDLs, and cancellous bone. During cylindrical miniscrew insertion, the maximum von Mises stress increased as insertion angle decreased. Tapered miniscrews exhibited greater maximum von Mises stress than cylindrical miniscrews. During force application, maximum von Mises stresses increased in both groups as insertion angles decreased. Conclusions: For both cylindrical and tapered miniscrew designs, placement as perpendicular to the bone surface as possible is recommended to reduce stress in the surrounding bone.

Right ventricular failure in congenital heart disease

  • Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • 제56권3호
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    • pp.101-106
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    • 2013
  • Despite developments in surgical techniques and other interventions, right ventricular (RV) failure remains an important clinical problem in several congenital heart diseases (CHD). RV function is one of the most important predictors of mortality and morbidity in patients with CHD. RV failure is a progressive disorder that begins with myocardial injury or stress, neurohormonal activation, cytokine activation, altered gene expression, and ventricular remodeling. Pressure-overload RV failure caused by RV outflow tract obstruction after total correction of tetralogy of Fallot, pulmonary stenosis, atrial switch operation for transposition of the great arteries, congenitally corrected transposition of the great arteries, and systemic RV failure after the Fontan operation. Volume-overload RV failure may be caused by atrial septal defect, pulmonary regurgitation, or tricuspid regurgitation. Although the measurement of RV function is difficult because of many reasons, the right ventricle can be evaluated using both imaging and functional modalities. In clinical practice, echocardiography is the primary mode for the evaluation of RV structure and function. Cardiac magnetic resonance imaging is increasingly used for evaluating RV structure and function. A comprehensive evaluation of RV function may lead to early and optimal management of RV failure in patients with CHD.

스트레스가 간호대학생의 행복지수에 미치는 영향 : 낙관성의 매개효과를 중심으로 (The Effect of Stress on the Happiness Index of Nursing College Students : Focusing on Mediating Effects of Optimism)

  • 김은영;임경숙
    • 디지털융복합연구
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    • 제15권12호
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    • pp.381-391
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    • 2017
  • 본 연구의 목적은 낙관성을 매개로 스트레스가 행복지수에 주는 영향을 파악하고자 하는데 있다. 대상자는 G광역시 소재 3개 대학 간호학과 학생 중 임상실습경험이 있는 3, 4학년을 대상으로 시행하였으며, 362부의 설문지를 연구 자료로 사용하였다. 자료분석은 회귀분석과 SPSS Macro 및 부트스트래핑(bootstrapping) 방법을 이용하여 대학생의 스트레스와 행복감에 있어 낙관성의 매개효과를 검증하였다. 연구결과 스트레스, 행복지수, 낙관성은 유의한 상관관계가 있었고, 스트레스가 대학생의 행복지수에 직접적인 영향을 주었다. 즉, 스트레스의 수준이 높을수록 대학생의 행복지수를 저하시켰다. 낙관성은 스트레스와 대학생의 행복지수 사이에서 부분적으로 매개효과를 보였다. 따라서 대학생의 행복지수를 높이기 위해서는 스트레스 관리와 낙관성을 높일 수 있는 프로그램 전략의 하나로 행복증진 프로그램 개발 및 시행이 요구된다.

간호대학생의 대학캠퍼스 환경인식과 건강지각이 스트레스에 미치는 영향 (The Influence of Perceptions of the Campus Environment and Health Perception on Stress of Nursing College Students)

  • 이정미
    • 디지털융복합연구
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    • 제17권2호
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    • pp.329-338
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    • 2019
  • 본 연구는 간호대학생의 대학캠퍼스 환경인식과 건강지각이 스트레스에 미치는 영향을 파악하여 스트레스를 감소하기 위한 프로그램 개발의 기초자료를 제공하기 위해 시행되었다. 자료수집은 2016년 12월 01일부터 12월 30일까지 G시의 3개 간호학과 학생을 대상으로 편의 추출하였으며 223명의 수집된 자료를 SPSS/WIN 21.0 프로그램을 이용하여 위계적 다중 회귀분석으로 분석하였다. 연구결과, 스트레스에 차이를 나타내는 일반적 특성은 연령, 실습경험, 성별, 주거형태, 성격과 식습관형태 및 학교보건실 이용경험이었다. 스트레스는 대학캠퍼스 환경인식과 건강지각 간에 부적상관관계를 나타내었다. 스트레스에 영향을 주는 요인은 식습관, 성별, 대학캠퍼스 환경인식과 건강지각이었으며, 스트레스에 대한 이들의 설명력은 23.1%로 나타났다. 따라서 간호대학생의 스트레스를 감소시키기 위해서 대학캠퍼스 환경을 개선하고 건강에 대한 지각을 높일 수 있는 다양한 프로그램을 개발하여 운영해야 할 것이다.

여성 난임 한의표준임상진료지침 개작을 위한 한의사의 인식과 치료에 관한 실태조사 (A Survey on Korean Medicine Doctors' Recognition and Treatment for Developing Korean Medicine Clinical Practice Guideline of Female Infertility)

  • 정효정;김동일;최수지;황수인;윤영진;박장경
    • 대한한의학회지
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    • 제43권3호
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    • pp.122-138
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    • 2022
  • Objectives: This study was conducted to develop a Korean Medicine(KM) Clinical Practice Guidelines(CPG) of female infertility. We conducted this questionnaire survey to reflect the experiences of Korean Medicine doctors(KMD) and clinical field in Korea. Method: We sent a questionnaire survey to KMD belonging to the Association of Korean Medicine by e-mail. We received 665 responds, and analyzed the answers. Results: 51.2% of respondents knew the previously developed CPG of female infertility, and 18.3% actually used. 83.3% agreed about the necessity of CPG of female infertility, and 80.3% had practical use plan. 90.2% of respondents treated less than 5 infertility woman for a month. 22.7% of respondents treated 50% of patients with collaborative treatment of KM and Western medical treatments. The main age group of patients was '35~40 years'(54.7%), and the most common cause was unexplained infertility(61.7%). The most common pattern identification of female infertility patients was Kidney deficiency(55.4%). KMD used 'a combination of decoction of herbal medicine, acupuncture and moxibustion treatment' the most(43%), and 'a decoction of herbal medicine treatment alone' was next(35%). 84.2% conducted lifestyle modification education about diet, stress, exercise etc. Conclusion: We figured out Korean Medicine doctors' recognition about CPG of female infertility, preference of treatments, and also characteristics of patients visiting Korean Medical clinics to make a practical CPG reflecting clinical situation.

통합적 간호실무 시뮬레이션 기반 훈련이 간호대학생의 스트레스, 학습흥미, 문제해결능력에 미치는 영향 (Effects of Integrated Nursing Practice Simulation-based Training on Stress, Interest in Learning, and Problem-Solving Ability of Nursing Students)

  • 박선남;주민선;황윤영;김선희;이선경
    • 기본간호학회지
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    • 제22권4호
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    • pp.424-432
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    • 2015
  • Purpose: In this study the time point of effects that repeat exposure to simulation-based nursing training has on stress, interest in learning, and problem-solving abilities were identified. Methods: Participants for this study were 75 nursing college students in Seoul. In a preliminary survey data were collected and measured for the general characteristics, stress, interest in learning, and problem-solving abilities of the students. Then, stress was assessed before performance of each of four-rounds of simulation training scenarios. After each simulation round, interest in learning and problem-solving abilities were assessed. Results: With respect to stress, no significant differences were found when comparing the results of the preliminary survey to those of each of the simulation-based training exercises. For the sub-items of interest in learning, interest in nursing knowledge and interest in clinical training significantly increased between the preliminary survey and the $4^{th}$ survey. Interest in lab training increased significantly at the $1^{st}$ survey. Problem solving abilities showed a significant increase from the preliminary at each of the survey points. Conclusion: Increasing the exposure of nursing students to simulation-based training enhances their interest in learning and problem-solving abilities. Therefore it is necessary to have education strategies that includes various simulation experiences for students.