• Title/Summary/Keyword: adult patients

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Effect of Providing Information on Anxiety, Knowledge and Compliance of Patients with a Permanent Pacemaker (정보제공이 영구형 심박조율기 이식환자의 불안, 지식 및 치료지시이행에 미치는 효과)

  • Lee, Sun Kyung;Yoo, Yang Sook
    • Korean Journal of Adult Nursing
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    • v.17 no.3
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    • pp.484-492
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    • 2005
  • Purpose: This study was undertaken to identify the effect of providing information on anxiety, knowledge and compliance in permanent pacemaker patients. Method: A quasi experimental design with non-equivalent control group and non-synchronized design was used. The subjects of this study were 50 patients who had received permanent pacemaker implantation at a university hospital in Seoul. They were divided into an experimental group of 22 patients who received education and a control group of 28 patients. The education was composed of group education(twice) and individualized reinforcement education(once) using an education booklet. Results: Anxiety decreased in the experimental group. Knowledge significantly increased in the experimental group compared to that in the control group. Compliance significantly increased in the experimental group. Conclusion: It can be concluded that providing information is effective for reducing anxiety, increasing knowledge and improving compliance of the permanent pacemaker patients.

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Fall Risk Factors and Fall Risk Assessment of Inpatients (종합병원 입원 환자의 낙상 위험 요인 및 낙상 위험도 평가)

  • Kim, Yoon Sook;ChoiKwon, Smi
    • Korean Journal of Adult Nursing
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    • v.25 no.1
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    • pp.74-82
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    • 2013
  • Purpose: The purpose of this study was to identify the fall risk factors and to evaluate the effectiveness of the Morse Fall Scale(MFS) as an assessment tool among hospitalized inpatients. Methods: The medical records of a total of 294 patients who admitted to hospital from January 1 to December 31, 2010 were reviewed. One hundred forth seven patients who had experienced fall were matched with 147 patients who have never experienced fall. The fall information was obtained from electronic medical records and fall reports. Results: There were significant differences in visual disturbances, pain, emotional disturbances, sleep disorder, urination problems and elimination disorder at admission between fallers and non-fallers. Patients who had higher MFS scores at admission were more likely to fall as compared to the patients with lower MFS scores. When falls did occur, these occurred within five days following admission, in the patient room, among patients with alert mental status, and among patients who were ambulant with some assistance. Conclusion: The findings of this study support the need of using risk assessment tool for predicting risk for falls. This finding can be used as a useful resource to develop nursing intervention strategies for fall prevention at the hospital.

A Study on Needs of the Spinal anesthesia Patients (척추마취 수술환자의 간호요구)

  • Nam, Soung Mi;Kim, Myung Hee
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.666-677
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    • 2000
  • The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.

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Phenomenological Approach of Self Regulation Related to Health of patients with Adult Disease (성인병 환자들의 건강과 관련된 자기조절에 대한 현상학적 연구)

  • 김숙영
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.562-580
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    • 1995
  • This research was an attempt to make it possible to provide nursing care and health education meet- ing the need not of care givers but of patients by identifying the nature of patients' self regulation experiences. The specific objective of this study was : 1) to explore self regulation experiences of patients with adult disease. The phenomenological approach in qualitative studies is used to serve this purpose. Colaizzi's method is used for the phenomenological analysis of the data in this study, which were collected from 25 patients hospitalized in the internal medical ward and oriental medical ward of a Seoul hospital, suffering from adult disease such as hypertension, arteriosclerosis and diabetes mellitus. The research was conducted over a period of March to September, 1994. The investigator conducted participated observations and in-depth unstructured interviews which were audiotaped under the permission of patients. The investigator read the data repeatedly to identify and categorize significant statements, formulating meanings, themes and theme clusters. The result is categorized as follows : Self regulation activities, their barriers and predisposing factors of a disease. Thirteen theme clusters of self regulation activities related to health identified were. “maintaining diet regimen”, “maintaining exercise regimen”, “maintaining medication regimen”, “maintaining oriental medical regimen”, “maintaining health monitoring regimen”, “maintaining self effort”, “maintaining religious life”, “maintaining social sup-port systems”, “maintaining peaceful mind”, “maintaining moderation in life”, “maintaining sincere attitude in life”, “maintaining natural life”, and “maintaining folk remedy” This findings confirm the fact that self regulation is complicatedly and diversely influenced by oriental medicine and folk remedy, and Korean traditional ideas melted in Confucianism, Buddhism, Taoism and Shamanism, and modern medical care and western culture. Seven theme clusters of self regulation barriers identified were : "lack of knowledge and self aware-ness", "lack of social supports", "lack of awareness of need in continuous regimen and treatment", "dissatisfaction with hospital and health care provider", "lack of self management ", "lack of will to combat illness", and "overconfidence in folk remedy" Four theme clusters of predisposing factors of a disease were : "cumulation of stressors", "fatalism", "careless life style", and "family history". In conclusion, this. study will prove helpful not only in understanding clients in light of our traditional culture but also in providing them with the kind of nursing care and health education satisfying their demands and particularly cultural needs.

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The Symptomatic Accessory Navicular in Adult (성인의 증세가 있는 부주상골)

  • Lee, Woo-Chun;Nam, Ki-Heon;Park, Hyun-Su;Rha, Jong-Deuk;Lee, Cheol;Ko, Kang-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.1
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    • pp.62-68
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    • 2001
  • Purpose: to investigate the etiology and the results of surgical treatment of the symptomatic accessory navicular in adults. Materials and Methods: Between 1996 and 2000, 17 cases in 16 adult patients who were older than 20 years were diagnosed as painful accessory na vicular. 11 patients could recall a twisting injury of the ankle, and 8 of them were inversion sprain. 4 patients had tibialis posterior tendon lesions. 13 feet of 12 patients were treated by resection of accessory navicular, the synchondrosis, the medial portion of the navicular and reattachment of tibialis posterior tendon without transposition. 9 feet in 8 patients were followed for more than one year after surgery. In 4 patients with tibialis posterior tendon lesions, additional procedures were performed according to the state of the lesion. Results: All were type II accessory navicular bone which had synchondroses. There was gross motion of the synchondrosis in 'the operating field in all feet. Of the 9 feet which were followed for more than one year after surgery, results were excellent in five and good in four. Conclusion: The painful accessory navicular in adult might be closely associated with inversion ankle sprain, and also with the tibialis posterior tendon lesions. Satisfactory result could be obtained without transposition of the tibialis posterior tendon to the undersurface of the navicular and immediate postoperative weight bearing does not have harmful effect on the result.

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A Survey on Treatment Trend for Allergic Rhinitis in Korean Medicine Clinic (알레르기 비염의 한의 진료 현황 설문조사)

  • Kim, Young-Eun;Jeong, Ui-Min;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.4
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    • pp.75-96
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    • 2017
  • Objectives : The purpose of this study was to investigate the treatment trend for allergic rhinitis in Korean Medicine. Methods : We conducted an online survey for Korean Medicine Doctors who were registered in the association of Korean Medicine. The questionnaire was consisted of patient characteristics, diagnosis status, treatment status, and future research needs. Results : Data from total of 396 respondents were analyzed. More than 70% of the patient came to the Korean Medicine Clinic after visiting the Western Medicine Clinic in 43.9% of the respondents. 55.6% of the respondents performed combination therapy. History taking, nasal examination, x-ray, and Korean Medicine diagnostic test were used for diagnosis. The mean duration of treatment ranged from $4.9{\pm}2.91$ to $15.2{\pm}8.45$ for pediatric and early childhood patients and from $17.5{\pm}16.15$ to $5.3{\pm}3.85$ weeks for adolescents and adult patients. The mean number of treatment times was from $9.8{\pm}7.00$ to $33.5{\pm}24.45$ for pediatric and early childhood patients and from $10.8{\pm}11.55$ to $40.4{\pm}48.18$ times for adolescents and adult patients. 64.5%, 48.0%, and 91.2% of the respondents used herbal medication in national health insurance coverage, herbal medication uninsured in health insurance and herbal prescription filled at each medical institution, respectively for pediatric and early childhood patients and 67.6%, 42.8% and 86.1% for adolescents and adult patients. 36.9% and 36.4% of respondents answered that the study of acupuncture and herbal medicine are needed preferentially. Conclusions : The results of this survey will be used to develop clinical practice guideline that reflect actual clinical practice.

Inter-Rater Reliability of the Korean Triage and Acuity Scale (한국형 응급환자 분류도구의 간호사-응급구조사 간 신뢰도 평가)

  • Son, Jeong Ah;Lee, Eun Ja
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.1
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    • pp.107-116
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    • 2020
  • Purpose: This study was a prospective survey to evaluate the Korean Triage and Acuity Scale (KTAS) inter-rater reliability and to identify discordant areas in the KTAS classification between nurses and paramedics in emergency department (ED). Methods: Inter-rater reliability were evaluated using triage deta from January 11 to May 31, 2019. A convinience sample of a total of 800 patients who visited an emergnecy medical center in Incheon (400 adult and 400 pediatric patients in this study) were selected. The triages of this study a pair of one nurse and one paramedic performed triage at the same time, using the KTAS, Inter-rater reliability for the KTAS was evaluated with the weighted kappa. Results: The inter-rater reliability of the KTAS evaluated by weighted Kappa between nurse-paramedic KTAS score of adult patients was .71, and .66 for pediatric patients. Both were in the level considered as substantial. Among causes of triage discordance, the most frequently identified discordant item in triaging adults was the difference in the measurement of pain intensity (28.0%). For both adult and pediatric patients, multiple chief complaint was identified as the major discordant factor. In triaging pediatric patients the body temperature assessment by subjective judgments was the highest discordant item (50.7%). Conclusion: The study result suggested that the KTAS demonstrated a reasonable level of inter-rater reliability and functioned as a standardized triage tool for emergency medical services. In order to improve the inter-rater reliability and classification competence, it is necessary to revise the current all-integrated KTAS provider course to be differentiated for each job group.

Outcomes after repair of complete atrioventricular canal with a modified single-patch technique: a retrospective study

  • George Samanidis;Konstantinos Kostopanagiotou;Meletios Kanakis;Georgios Kourelis;Kyriaki Kolovou;Georgios Vagenakis;Dimitrios Bobos;Nicholas Giannopoulos
    • Journal of Yeungnam Medical Science
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    • v.40 no.2
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    • pp.187-192
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    • 2023
  • Background: This study aimed to present the short- and midterm outcomes after complete atrioventricular canal defect (CAVC) repair using a single-patch technique. Methods: This study included 30 children who underwent surgical correction of the CAVC using a single-patch technique. Results: The median age of the patients was 5.7 months (interquartile range [IQR], 5.0-7.5 months), and 23 patients (76.7%) had type A CAVC. Fourteen patients (46.7%) were female and 17 (56.7%) had been diagnosed with Down syndrome. The in-hospital mortality rate was 0%. No deaths were observed during a median follow-up of 4 years (IQR, 3.5-5.0 years). Patients without Down syndrome were associated with late moderate mitral regurgitation (MR) (p=0.02). Late MR less than moderate degree was observed in 96.6%, 78.5%, and 50% of patients after 2, 4, and 5 years of follow-up, respectively, while late tricuspid valve regurgitation less than moderate degree was observed in 96.7%, 85.9%, and 59.0% of patients after 2, 4, and 6 years of follow-up, respectively. After a median follow-up of 4 years, only one patient had required surgical repair of a left ventricular outflow tract obstruction, which occurred 26 months after the first operation. Multivariable logistic regression analysis adjusted for the type of CAVC, sex, Down syndrome, age, and weight revealed that the absence of Down syndrome was a risk factor for late moderate MR (MR-2) (odds ratio, 0.05; 95% confidence interval, 0.006-0.50; p=0.01). Conclusion: A single-patch technique for CAVC surgical repair is a safe method with acceptable short- and midterm results.

Adult Proximal Humeral Locking Plate Is a Good Alternative Option in the Treatment of Adolescent Subtrochanteric Femur Fractures: A Case Series and Literature Review

  • Ceyhun Caglar;Serhat Akcaalan;Merve Bozer;Mustafa Akkaya
    • Hip & pelvis
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    • v.34 no.4
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    • pp.245-254
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    • 2022
  • Purpose: Management of pediatric subtrochanteric femur fractures (SFFs) is difficult. The aim of this study was to evaluate the outcomes of adolescent SFFs treated with adult proximal humeral locking plates (PHLPs). Materials and Methods: A retrospective analysis of 18 adolescents (11 male, 7 female) with a diagnosis of SFF who underwent internal fixation with a PHLP was conducted. Data regarding injury mechanism, fracture pattern, and time to union were recorded for all patients. In addition, a clinical and functional evaluation of patients was performed using the Harris hip score (HHS), Iowa hip score (IHS), modified Merle d'Aubigne-Postel score (MMAPS), Flynn criteria, and hip range of motion (ROM). Results: The mean age of the patients was 12.72±2.05 years (range, 10-16 years). Radiological observation was performed for evaluation of five different injury mechanisms and different fracture patterns in patients. The mean postoperative HHS was 92.27±5.61, the mean IHS was 90.88±6.46, and the mean MMAPS was 17.22±0.94. According to the Flynn criteria, excellent results were achieved in 14 cases and satisfactory results were obtained in four cases. Measurements of the patients' mean hip ROM values were as follows: 17.77±3.52° in extension, 115.27±6.74° in flexion, 43.05±3.48° in abduction, 27.50±4.28° in adduction, 42.22±4.60° in internal rotation, and 42.22±3.91° in external rotation. Conclusion: Surgery performed on adolescent patients using an adult PHLP showed good, safe results. Therefore, it should be considered as an alternative option.

Evaluation of the Quality of Care among Hospitalized Adult Patients with Community-Acquired Pneumonia in Korea

  • Hong, Ji Young;Kang, Young Ae
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.3
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    • pp.175-186
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    • 2018
  • Pneumonia is an important cause of morbidity and mortality. Since 2014, the Health Insurance Review and Assessment Service (HIRA) has assessed the overall quality of care among hospitalized adult patients with community-acquired pneumonia (CAP) provided by all medical institutions in Korea. A committee of the Korea Academy of Tuberculosis and Respiratory Diseases developed the hospital inpatient quality measures set for CAP consisting of eight core measures and five monitoring measures. The composite measure score was calculated. The medical records of hospitalized adult patients ages 18 years or more with CAP from October to December 2014 were evaluated. The data of 523 hospitals (42 tertiary hospitals [8.0%], 256 general hospitals [49%], and 225 hospitals [43.0%]) and 15,432 cases (tertiary hospitals, 1,673 cases [10.8%]; general hospitals, 8,803 cases [57.1%]; hospitals, 4,956 cases [32.1%]) were analyzed. We found large variations among institutions in terms of performance of care measures for CAP. For the composite measure score, the mean value was 66.7 (tertiary hospitals, 98.5; general hospitals, 79.2; hospitals, 43.8). Despite significant differences in measure scores between tertiary, general hospitals and hospitals, no significant differences were found in mortality between hospitals. Further studies are needed to determine the care measures appropriate for CAP.