• Journal of Chest Surgery
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• 제55권4호
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• pp.325-331
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• 2022

Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.

• 성인간호학회지
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• 제19권2호
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• pp.274-282
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• 2007

Purpose: This study was designed to identify the self concept and clinical competency of nurses in hospitals and to examine the relationship between two concepts. Methods: A questionnaire was used for data collection which was done from July 1 to July 30 in 2005. The respondents were 267 staff nurses in a university hospital and general hospitals in two cities. The instruments were Son's(2002) self concept scale and Lee's(2002) clinical competency scale. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression using SPSS-WIN. Results: The results of this study were summarized as follows: First, the total mean score of self concept was 2.56, and clinical competency was 2.59 on a 4 point scale. Second, the self concept and clinical competency were significantly correlated. Third, the results of multiple regression showed that self concept explained 45.2% of clinical competency. Conclusion: Self concept has a strong influence on clinical competency. Therefore, individualized nursing management strategies and education programs must be developed in order to increase a nurses self concept.

• 의학교육논단
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• 제25권3호
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• pp.229-242
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• 2023

Health systems science is a new medical educational field added to the traditional medical education curricula of basic and clinical sciences. Health systems science emphasizes a more comprehensive approach utilizing systems thinking to care for patients, including interactions between multiple healthcare systems. In this review, I explore how health systems science education can be applied when medical instructors teach students in clinical clerkships through representative case studies. This study first looks at examples of health systems science education in clinical clerkship in the United States and suggests how to develop the curriculum of health systems science for clinical learning environments in Korea by combining Kotter's 8-step change management model and Kern's 6-step curriculum development model. Finally, based on practical examples from actual clinical practice education situations, suggestions are made regarding how to develop the entire educational program of a medical school from the stage of applying health systems science at the individual level to clinical practice education.

• 간호행정학회지
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• 제13권1호
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• pp.53-64
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• 2007

Purpose: This study was aimed to develop and evaluate of a Problem-based Learning (PBL) in the course of Nursing Management and Ethics. Method: The design of the study was both methodological and one group only pre-post design. The sample included 61 senior students who are currently enrolled in Nursing management and Ethics course in college of nursing. Data regarding PBL evaluation were collected on the critical thinking and clinical reasoning using structured questionnaires during March to June, 2005. Data were analyzed using descriptives and paired t-test. Results: A total of three PBL packages was developed by the two faculty members and two teaching assistants who are majoring in nursing management. PBL packages that had been developed was applied to 61 senior students for three months. Critical thinking and clinical reasoning were measured twice pre and post the application of PBL packages. There were statistically significant differences in the critical thinking and clinical reasoning between the pre and post PBL application. Conclusion: PBL was considered to be effective in understanding the learning concepts in the Nursing Management and Ethics. Further research on the facilitative strategies and development model considering the characteristics of Nursing Management and Ethics course is needed.

• Asian-Australasian Journal of Animal Sciences
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• 제15권5호
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• pp.751-756
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• 2002

A study was carried out to evaluate the incidences and causes of bovine mastitis in Tanzanian shorthorn zebu (Bos indicus) in the traditional sector and crossbred cows (Bos taurus${\times}$Bos indicus) in the dairy ranching sector, both found under the extensive range management system. Management practices were evaluated through a survey study using structured questionnaires. A total of 120 lactating cows (60 cows from each sector) were screened for the disease using the California Mastitis Test (CMT). Confirmatory tests used for infected cows included; the Direct Microscopic Somatic Cell Count (DMSCC), culture, bacteriological and biochemical laboratory assays. Survey results showed that management practices were generally very poor in both sectors with 84% of the surveyed herds being kept and milked under very unhygienic environmental conditions. The level of infection was higher in the crossbred cows (5% clinical and 38.3% sub-clinical mastitis) and lower in the zebu cows with only sub-clinical mastitis (23.3%). Crossbred cows had (p<0.05) higher somatic cell counts than zebu cows. The four highest-ranking bacterial isolates in order of importance were Staphylococcus aureus, Escherichia coli, Streptococcus agalactiae and Bacillus spp. It was concluded that bovine mastitis under the extensive management system in Tanzania was a result of poor management practices and that zebu cows were more resistant to the diseases than crossbred cows.

• 한국의료질향상학회지
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• 제3권1호
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• pp.126-143
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• 1996

Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

• 대한간호학회지
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• 제47권5호
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• pp.700-711
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• 2017

Purpose: This study aimed to test a proposed structural equation model in which bullying experience, conflict management styles and psychological empowerment predict psychological well-being among Chinese nursing students in clinical placement. Methods: Three hundred and sixty-six nursing students recruited from five hospitals in J city and Y city were assessed with self-report questionnaires on bullying experience, conflict management styles, psychological empowerment and psychological well-being including depression, self-esteem, and academic major satisfaction. Data were analyzed using SPSS version 20.0 and AMOS version 22.0. Results: The evaluation parameters included the comparative fit index at .90, the goodness of fit index at .93, the root mean square error of approximation at .07, and ${\chi}^2/df$ ratio at 2.66, indicating that the proposed structural equation model provided a good fit to the data. Experience of being bullied during clinical placement, conflict management styles and psychological empowerment explained 93.0% of the variance and had significant effects on psychological well-being, with conflict management styles and psychological empowerment mediating the association between bullying and psychological well-being. Conclusion: The findings indicated that mediation by conflict management styles and psychological empowerment alleviated the negative influence of bullying on psychological well-being. To limit bullying and its negative effects, development of effective guidelines to deal with bullying will be a critical tool for both Chinese nursing students and their instructors. Further research should incorporate conflict management styles and psychological empowerment into the specific intervention strategies for handling bullying behaviors among nursing students and staff nurses and promoting nursing students' psychological well-being.

• 보건의료산업학회지
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• 제10권3호
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• pp.27-37
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• 2016

Objectives : This study was conducted to test the influence of job stress and calling on the organizational commitment of clinical nurses. Methods : 220 clinical nurses at two university hospitals in Busan were recruited. They were asked to complete a questionnaire, and 192 data sets were included in the statistical analysis. Results : The mean score of the clinical nurses' organizational commitment was 4.0. All subdomains of job stress and calling were found to have correlations with organizational commitment. The organizational system (t=-6.099, p<.001), lack of reward (t=-3.990, p<.001), purpose/meaningfulness (t=3.624, p<.001), and occupational climate (t=-3.581, p<.001) were revealed to have influences on the organizational commitment. The model was statistically significant, explaining 52.2% of the variance (F=47.808, p<.001). Conclusions : To help clinical nurses become committed to their organizations, administrators need to build fair and rational organizational systems, strengthen various types of rewards, and help nurses reconcile nursing and the meaning of their lives. In addition, every nurse should endeavor to change the nursing organizational climate which is based on vertical collectivism, to a rational climate.

• 한국보건간호학회지
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• 제28권3호
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• pp.644-657
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• 2014

Purpose: The purpose of this study was to try to understand the essence of the experience early turnover of the new nurse by applying the phenomenological method and to provide basic data for a community-based management program. Method: Phenomenological approach was used to identify subjects experience. Subjects were five new nurses, with less than one year of clinical experience in clinical practice. This study used in-depth interview. Results: there were 104 meaningful sentences or phrases, with 41 generally comprehensive thema. Finally, thema were classified into 12 thema clusters. Conclusion: Finally, based on the results, some suggestions regarding management of early turnover of new nurses are needed. First, we proposed a new characterized of hospital selection method for each hospital. Second, practical training in clinical practice in the school and the community is necessary in order to reduce the real impact of new nurses. New nurses require various support elements in order to mitigate the real shock the first time they encounter clinical practice. Third, addition of work-related training and promotion of a self-esteem program will be needed. Fourth, interview opportunities with seniors who adapted successfully in clinical should be provided for new nurses. In addition, continuous communication should be provided for new nurses.

• Annals of Clinical Neurophysiology
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• 제3권1호
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• pp.43-46
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• 2001

Acute pandysautonomic neuropathy(APN) is an uncommon clinical entitiy involving vasomotor, sudomotor, pupilomotor, secretomotor and other autonomic systems. Both sympathetic or parasympathetic fibers are involved with relative preservation of somatic sensory and motor function. Although APN shares several clinical features with GBS, it is not clear whether APN is a subvariety of GBS. We report two young patients with APN. Patient 1 was a 18-year-old girl with recurrent fainting spells. Patient 2 was a 23-year-old man sufferring from unexplained nausea and vomiting. Both had a history of previous upper respiratory infection. They presented with gastroparesis, anhydrosis and orthostatic hypotension. Mild numbness and tingling sense was present, but motor power was intact. Neurologic examination showed bilateral tonic pupil, decreased pain and vibration sense, and absent tendon reflexes. Nerve conduction study indicated diffuse sensorimotor polyneuropathy. Nerve biopsy in patient 2 revealed axonal degeneration. After conservative management, gastrointestinal symptoms were improved in patient 2, however, patient 1 suffered from the symptoms lasting more than several months. These cases suggest that post-infectious dysautonomic symptoms in young patient may indicate the diagnosis of APN. Although the natural course is generally benign, accurate diagnosis and proper management may be mandatory for the better clinical outcome.