• Title/Summary/Keyword: blood management program

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The Effectiveness of a Hospital-Based Obesity Management Program using Korean Medicine in Uzbekistan (우즈베키스탄 한방병원에서 진행한 한의약 비만관리 프로그램의 효과)

  • Lee, Eun-Kyoung;Chong, Myongsoo;Ryu, Young Jin;Kwon, Donghyun;Lee, Joonseok;Jang, Bo-Hyoung;Yun, Jin Won;Park, Yu Lee;Park, Haemo;Lee, Sundong;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.2
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    • pp.23-35
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    • 2015
  • Objective : As part of the Korean Medicine Official Development Assistance(ODA) and Public Health Project, we implemented a obesity management program(OMP) using Korean medicine in Uzbekistan and its follow-up study was conducted to evaluate the effectiveness of the program. Method : We recruited the participants of whose Body Mass Index(BMI) were over $25kg/m^2$ and who agreed to participate in the program at the South Korea-Uzbekistan Friendship Korean Medical Hospital in Uzbekistan. The program consisted of auricular acupuncture, functional food, and education program on diet and exercise. It was provided once a week during 7-week period. Anthropometric measurements and blood test measuring total cholesterol, triglyceride, and glucose were performed at the baseline, the end of the program, and 10-month follow-up. At the end of the program and the follow-up, survey on satisfaction and self-evaluation of the effectiveness of the program was additionally conducted. Results : 43 out of 78 participants completed the program and were included in the analysis. The analysis of the main outcomes showed that there were significant decreases in anthropometric measurements such as body weight, waist circumference, body mass index (BMI) and body fat content as well as blood test including triglycerides, total cholesterol and blood glucose levels. In the follow-up study, 24 subjects participated and 19 subjects (79.1%) reported that they succeeded in weight control. Furthermore, many participants reported that they maintained healthy lifestyles like healthy diet and regular exercise. The satisfaction with the program was also relatively high, and the education program was selected as the most motivating intervention for weight control. The outcomes such as body weight, BMI, body fat content, and blood glucose level were maintained to be at the decreased level; however, waist circumference, total cholesterol and triglycerides levels either returned back to the baseline level or were elevated to the level higher than the baseline. Conclusion : This study suggests that the OMP using Korean medicine may contribute to weight control of obese population in Uzbekistan. It is meaningful in that the study shows the possibility of implementing health promotion programs using Korean medicine in other countries with different cultures. In the future, more efforts to evaluate the effectiveness of the programs using rigorous methodologies and utilize the effective programs in ODA project will be needed.

Effects of an Extreme Heat Adaptation Program in Hypertensive Patients (고혈압환자의 폭염 적응력 증진을 위한 프로그램 효과)

  • Jeong, Seong Hee;Kim, Nam Soon;Chae, Sumi;Lee, Eun Ju
    • Journal of Korean Biological Nursing Science
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    • v.16 no.3
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    • pp.164-172
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    • 2014
  • Purpose: The purpose of this study was to identify the effects of an extreme heat Adaptation Program on the blood pressure, stress response, self-efficacy, and knowledge of management of hypertension and extreme heat of patients who suffered from hypertension. Methods: A quasi-experimental study with a non-equivalent control group pretest-posttest design was used. The data collection period was between July 2 and August 20, 2012. Thirty-seven patients participated in the study (18 in the experimental group and 19 in the control group). Data were analyzed using $X^2$-test, t-test, and Cronbach's alpha coefficients with SPSS/WIN 19.0. Results: Patients who participated in the program showed statistically significant improvements in systolic blood pressure (SBP), self-efficacy, and knowledge of management of hypertension and extreme heat. Conclusion: The results indicate that this extreme heat adaptation program can be utilized for patients suffering from hypertension in order to reduce their SBP and to increase self-efficacy and knowledge of management of hypertension and extreme heat. Therefore, it is recommended that this program be used for elderly patients suffering from chronic disease.

Health Incentive Program and Hypertensive Patients' Blood Pressure Control (건강 인센티브 프로그램이 고혈압 환자의 혈압 조절에 미치는 영향)

  • Kang, Kyunghee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.9
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    • pp.4388-4393
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    • 2013
  • This study described hypertensive patients characteristics associated with a health incentive program, and analyzed the effects of the health incentive program on blood pressure control. Based on the Incheon Chronic Disease Management System (iCDMS), a community partnership program for hypertensive patients, a cross-sectional design was used. There were statistically significant differences between the control group (n=17,278) and the experimental group (n=5,020) in gender, age, points earned, and number of hospital visits. Furthermore, being male, being over 60 years of age, and points earned were statistically significant factors associated with blood pressure control. To increase the effectiveness of chronic diseases management systems, various health incentive programs will be developed and introduced.

The Effect of Nutrition Education and Excercise Program on Body Composition and Dietary Intakes, Blood Lipid and Physical Fitness in Obese Women (영양교육과 운동중재 프로그램이 성인비만여성의 신체성분과 식이섭취, 혈중지질 및 기초체력에 미치는 효과)

  • Lee, Hee-Seung;Lee, Ji-Won;Chang, Nam-Soo;Kim, Ji-Myung
    • Journal of Nutrition and Health
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    • v.42 no.8
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    • pp.759-769
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    • 2009
  • This study investigated the effects of the nutrition education and exercise program on body composition, dietary intakes and physical fitness in obese women. The subjects were 44 obese women (BMI${\geq}$ 25 kg/$m^2$) who had been participating in nutrition education (1 time/week) and exercise program (3 time/week) for 12 weeks. Nutrition education was focused on low energy, high protein and low carbohydrate diet to reduce the body weight and improve the diet quality. To evaluate the effectiveness of the program, daily nutrient intakes were assessed by 24-hour recall method. Body composition, blood lipid profiles and physical fitness test were assessed before and after the intervention. After the intervention, body weight, BMI, percent body fat, soft lean mass and waist/hip ratio were significantly decreased (p < 0.001). Fasting blood sucrose, total cholesterol, LDL-cholesterol and atherogenic index (AI) were significantly decreased (p < 0.001), while HDLcholesterol was significantly increased (p < 0.001). Energy adjusted protein, fiber, vitamin A, vitamin $B_2$, vitamin $B_6$, vitamin C, vitamin E, niacin and folate were significantly increased. After the intervention, the muscle endurance, muscle strength, agility, balance were significantly increased. The changes in obesity indices (body weight, BMI, percent body fat, waist-hip ratio) were correlated with the changes of the nutrient intakes, serum lipid profiles, physical fitness. These results show that nutrition education and exercise program was effective not only for weight reduction but also for the improvement of physical strength and cardiovascular disease risk factors in obese women.

An Effect of the Self-Regulation Program for Hypertensives -Synthesis & testing of Orem and Bandura's theory- (본태성 고혈압 환자의 자가간호증진을 위한 자기조절 프로그램 효과 -Orem이론과 Bandura이론의 합성과 검증-)

  • Park, Young-Im;Hong, Yeo-Shin
    • Research in Community and Public Health Nursing
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    • v.5 no.2
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    • pp.109-129
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    • 1994
  • Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

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Assessing the Quality for Blood Transfusion Service since the 1st National Quality Assessment Program in South Korea (국내 1차 수혈 적정성 평가 시행에 따른 수혈서비스 질관리 현황)

  • Jin-Ah Kwon;Eun-Jeong Cho;A-Hyun Jung;Dong-Sook Kim
    • Quality Improvement in Health Care
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    • v.28 no.2
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    • pp.30-38
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    • 2022
  • Purpose: The Health Insurance Review and Assessment Service (HIRA) in South Korea initiated a quality assessment (QA) program for blood transfusion healthcare services in 2020 to ensure patient safety and appropriate blood use. This study examines the quality of blood transfusion services since the first national QA program for blood transfusion services in Korea. Methods: We analyzed HIRA claims and QA investigation data based on inpatient medical records from all tertiary, general, and primary hospitals between October 2020 and March 2021. The target population was patients aged 18 years and older who received either total knee arthroplasty or red blood cell transfusion. The QA indicators for transfusion healthcare service consisted of four quality indicators and four monitoring indicators. Results: We analyzed the results of QA indicators for transfusion service from the medical records of 189,668 patients from 1,171hospitals and expressed indicators as proportions. The average results for evaluation indicators were as follows: transfusion checklist presence, 64.8%; irregular antibody tests, 61.8%; transfusions in which the hemoglobin levels before transfusion met the transfusion guidelines for patients undergoing total knee arthroplasty, 20.6%, and transfusions in patients undergoing total knee arthroplasty, 59.3%. The average results for monitoring indicators were as follows: transfusion management implementation in medical institutions, 56.9%; preoperative anemia management in anemia patients undergoing total knee arthroplasty, 43.9%; one-unit transfusions, 82.5%; and the transfusion index. Conclusion: The quality of blood transfusion healthcare varied and the assessment revealed that there is scope for improvement. Hospitals require more effective blood transfusion management and this can be facilitated by providing feedback on the QA results about blood transfusion healthcare services to medical institutions, and by disclosing the results to the public.

Improvement of Transfusion Practice in Cardiothoracic Surgery Through Implementing a Patient Blood Management Program

  • Hee Jung Kim;Hyeon Ju Shin;Suk Woo Lee;Seonyeong Heo;Seung Hyong Lee;Ji Eon Kim;Ho Sung Son;Jae Seung Jung
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.390-398
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    • 2024
  • Background: In this study, we examined the impact of a patient blood management (PBM) program on red blood cell (RBC) transfusion practices in cardiothoracic surgery. Methods: The PBM program had 3 components: monitoring transfusions through an order communication system checklist, educating the medical team about PBM, and providing feedback to ordering physicians on the appropriateness of transfusion. The retrospective analysis examined changes in the hemoglobin levels triggering transfusion and the proportions of appropriate RBC transfusions before, during, and after PBM implementation. Further analysis was focused on patients undergoing cardiac surgery, with outcomes including 30-day mortality, durations of intensive care unit and hospital stays, and rates of pneumonia, sepsis, and wound complications. Results: The study included 2,802 patients admitted for cardiothoracic surgery. After the implementation of PBM, a significant decrease was observed in the hemoglobin threshold for RBC transfusion. This threshold dropped from 8.7 g/dL before PBM to 8.3 g/dL during the PBM education phase and 8.0 g/dL during the PBM feedback period. Additionally, the proportion of appropriate RBC transfusions increased markedly, from 23.9% before PBM to 34.9% and 58.2% during the education and feedback phases, respectively. Among the 381 patients who underwent cardiac surgery, a significant reduction was noted in the length of hospitalization over time (p<0.001). However, other clinical outcomes displayed no significant differences. Conclusion: PBM implementation effectively reduced the hemoglobin threshold for RBC transfusion and increased the rate of appropriate transfusion in cardiothoracic surgery. Although transfusion practices improved, clinical outcomes were comparable to those observed before PBM implementation.

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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Development and Evaluation of Integrated Management Program for Hemodialysis Patients (혈액투석 환자를 위한 통합적 관리 프로그램의 개발 및 효과)

  • Kim, Bora;Yoo, Hana
    • Journal of Home Health Care Nursing
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    • v.31 no.1
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    • pp.66-76
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    • 2024
  • Purpose: This study aimed to develop and evaluate an integrated management program to enhance self-efficacy, compliance with sick-role behaviors, symptom management, and biomarker indication in hemodialysis patients. Methods: The integrated management program was developed through a systematic review of literature, analysis of relevant online data, and expert validation. It comprised 480 min of video-based education delivered eight times over four weeks, supplemented by weekly phone consultations and text message support from a nurse. To evaluate the program's effectiveness, it was administered to 44 patients with hemodialysis in a single group in a pre-post test experimental study. Changes in self-efficacy, sick-role behavior compliance, dialysis symptom index, and biomarkers were assessed. Results: The program yielded statistically significant improvements in self-efficacy (t=-7.13, p<.001), sick-role behavioral compliance (t=-7.35, p<.001), dialysis symptom index (t=4.32, p<.001), and blood urea nitrogen levels (t=2.55, p=.014) among the participants. Conclusion: The integrated management program is an effective intervention for improving hemodialysis patients' self-efficacy, compliance with sick-role behaviors, and experience of symptoms. Additionally, it is considered an intervention with high clinical applicability and efficiency through video reproducibility.

Verification of the Effectiveness of a combined Exercise Program for Improving the Health of the Elderly (노인건강증진을 위한 복합운동프로그램의 효과 검증)

  • Soon-Gi Baek
    • Journal of Industrial Convergence
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    • v.21 no.12
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    • pp.75-81
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    • 2023
  • This study was conducted to verify the effectiveness of a combined exercise program to improve the health of the elderly. For this purpose, 10 people in the exercise group and 10 in the control group were selected among seniors aged 65 years or older. The subject of this study was a 12-week combined exercise program in which aerobic and anaerobic exercise were performed three times a week for 60 minutes. Before participating in exercise, blood lipid and inflammatory index tests were conducted, and blood lipid and inflammatory index tests were conducted upon completion of the combined exercise program. The test results were verified with basic statistics and treatment effects between groups using the SPSS statistical program. Based on this, the following conclusions were obtained. First, the combined exercise program for elderly health promotion showed significant differences in TC, LDL, and TG in blood lipids between the exercise group and the control group, and there was an interaction effect on the treatment program. Second, the combined exercise program for improving the health of the elderly showed significant differences in inflammatory indicators IL-6 and TNF-a between the exercise group and the control group, and there was an interaction effect with the treatment program.