• 제목/요약/키워드: definition of records

검색결과 110건 처리시간 0.024초

간호업무 전산화를 위한 표준화된 간호계획의 개발에 관한 연구 (A Study on the Development of Standardized Nursing Care Plans for Computerized Nursing Service)

  • 김조자;전춘영;임영신;박지원
    • 대한간호학회지
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    • 제20권3호
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    • pp.368-380
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    • 1990
  • A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to form a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of a standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalize patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows ; 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were “PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE”. 2. The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to the condition, recording pattern, desired outcomes and nursing orders (nursing interventions). 3. The plan was used with hospitalized patients on medical - surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research. The results of this study suggest that in order to increase the use of nursing diagnoses in the clinical area, it would be effective to select some wards as a pilot project, give the nurses training in the use of nursing diagnosis and develop and use the standardized nursing care plans. In addition to the ten diagnosis used in this study it is recommended that continual development of nursing diagnoses be done using diagnoses that are appropriate to Korea and testing them for validity through standardized care plans.

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폐섬유화증과 당뇨와 대사 증후군의 연관성 연구 (Association of Diabetes Mellitus and Metabolic Syndrome with Idiopathic Pulmonary Fibrosis)

  • 김유진;박정웅;경선영;안창혁;이상표;박혜윤;정만표;정성환
    • Tuberculosis and Respiratory Diseases
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    • 제67권2호
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    • pp.113-120
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    • 2009
  • Background: Reactive oxygen species (ROS) by oxidative stress may play an important role in the pathogenesis of various chronic diseases such as diabetes mellitus, obesity, hyperlipidemia, hypertension and malignancy that are linked to metabolic syndrome. Oxidative stress has been implicated in the pathogenesis of idiopathic pulmonary fibrosis (IPF). We examined the relationship between IPF and presenting factors associated with metabolic disorders. Methods: One hundred fourteen patients who met the current consensus of IPF definition were enrolled from March 2000 to April 2006 in Gil Hospital and Samsung Medical Center in Korea. One hundred thirty-four control subjects without pulmonary diseases were selected from subjects who visited Gil hospital for routine medical examinations, including low-dose chest computed tomography from January 2002 to July 2006. Retrospectively, we analyzed the clinical characteristics, the results of blood examinations, and lung function tests from medical records of both groups. Results: IPF patients and control subjects differed in the prevalence of diabetes mellitus as assessed by univariate analysis. Multivariate analysis demonstrated that diabetes mellitus and obesity were associated with IPF. The adjusted odds ratios for diabetes mellitus were 2.733 (95% confidence interval [CI], 1.282~5.827) and 2.001 (95% [CI], 1.063~3.766) for obesity. The remaining factors tested showed no differences between the patient group and the control. Conclusion: Diabetes mellitus and obesity may be associated with IPF development.

근골격계 질환에 대한 양약 및 한약 병용의 간과 신장에 대한 안전성: 후향적 관찰 연구 (Hepatic and Renal Safety of Concurrent Use of Conventional and Herbal Medications for Musculoskeletal Disorders: A Retrospective Observational Study)

  • 김세윤;김형석;강도영;고준혁;김종연;김고운;김보형;조재흥;송미연;정원석
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.131-140
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    • 2022
  • Objectives This study aimed to investigate whether the concurrent use of conventional and herbal medications affects liver and kidney function, by examining blood test data. Methods We retrospectively reviewed the electronic medical records of 590 inpatients with musculoskeletal diseases between 2013 and 2017. We investigated cases of drug-induced liver injury (DILI) according to the Roussel Uclaf Causality Assessment Method criteria and cases of drug-induced kidney injury (DIKI) based on the Kidney Disease Improving Global Outcomes definition. Results One case (0.17%) of DILI and one case (0.17%) of DIKI were identified. Significant improvements in serum laboratory data were observed after the concurrent use of both types of medications (p<0.05). The kappa coefficients ranged from 0.26 to 0.72, indicating that the values after the concurrent use of conventional and herbal medications showed a fair similarity to the baseline values of the patients. The linear regression test showed that female sex and high body mass index (BMI) were risk factors for an increase in the serum blood levels of liver function parameters. Conclusions The concurrent use of conventional and herbal medications for musculoskeletal disorders is relatively safe; however, clinicians should exercise caution when prescribing these medications to female patients and patients with a high BMI because of their potential effect on hepatic function.

Radiotherapy for pituitary adenomas: long-term outcome and complications

  • Rim, Chai-Hong;Yang, Dae-Sik;Park, Young-Je;Yoon, Won-Sup;Lee, Jung-Ae;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • 제29권3호
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    • pp.156-163
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    • 2011
  • Purpose: To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. Materials and Methods: We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-five patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Results: Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing's disease). Amenorrhea was abated in 7 of 10 patients, galactorrhea in 8 of 8 patients, acromegaly in 7 of 11 patients, Cushing's disease in 4 of 4 patients. Long-term complication was observed in 4 patients; 3 patients with cerebrovascular accident, 1 patient developed dementia. Of these patients, 3 of 4 received more than 60 Gy of irradiation. Conclusion: EBRT is highly effective in preventing recurrence and reducing mass effect of non-secreting adenoma. Effort to improve tumor control of secreting adenoma is required. Careful long-term follow-up is required when relatively high dose is applied. Modern radiosurgery or proton RT may be options to decrease late complications.

한국 전통 심메마니 문화에 대하여 (Korean Traditional "SIMMEMANI (Wild Ginseng Expert Digger)" Culture)

  • 고승태
    • 인삼문화
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    • 제4권
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    • pp.59-102
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    • 2022
  • 산삼이라는 약초가 자생하는 나라가 흔하지 않은 만큼 산삼을 채취하는 직업의 문화인 심메마니(산삼채취인) 문화를 가지고 있는 나라는 아주 드물다. 정통어인마니가 사라진 작금에는 심메마니에 관한 유무형의 문화는 시간의 흐름과 함께 더욱 소실되고 있다. 지금까지의 산삼채취인에 관한 연구는 ① 심메마니 은어에 관한 연구, ② 심메마니 습속에 관한 연구, ③ 심메마니 습속 변화에 관한 연구, ④ 심메마니와의 면담을 통한 추가적 채록 등의 부분적이고 단편적으로 진행되어 왔으며 심메마니 문화에 관한 총체적 연구는 아직 이루어지지 않았다. 이 연구에서는 앞선 연구에서 미반영한 사료를 보완하며, 산삼의 정의부터 산삼의 분류·심메마니의 어원·채삼 업종·심마니의 분포·법사회적 관점에서의 산삼채취·입산 시기·입산 조직·입산 택일·준비물·금기·출발과 입산·사신제의·도사(禱詞)·해몽·산삼 수색·산삼 발견과 그에 따른 일련의 절차·산삼 채굴·하산·배분·산삼채취량과 그 가격까지 심마니 습속의 행위별 비교와 어인의 제문(祭文), 사료의 사진, 삽화까지 첨부하면서 인삼 종주국의 산삼채취문화의 총괄적으로 연구하였다.

고문헌을 통해 본 영릉(英陵)의 원형공간과 시공방법에 관한 고찰 (A Study on Yeongneung's Original Layout and Construction Method through the Works of Ancient Literature)

  • 이창환
    • 한국전통조경학회지
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    • 제30권4호
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    • pp.56-69
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    • 2012
  • 본 논문은 2009년 6월 유네스코 세계문화유산에 등재된 40기의 조선왕릉 중 우리 민족이 가장 존경하는 세종대왕의 영릉에 대하여 고문헌을 통하여 원형공간과 복원, 시공방법 등을 고찰해 본 문헌적 연구이다. 영릉(英陵)은 세종대왕과 그의 비 소헌왕후 심 씨의 능으로 조선의 42기 왕릉 중 그 조영 방법이 독특하며, 천장의 역사를 갖고 있어 인물사 못지않게 중요한 공간이다. 영릉의 고문헌은 정조(1786)때 작성된 (영릉보토소등록(英陵補土所謄錄))과 (춘관통고(春官通考)) 그리고 고종때 작성된 (영릉영릉보토소등록(英陵寧陵補土所謄錄), 1900년)과 (조선왕조실록) 등이 있어 이를 중심으로 살펴보았다. 그 결과 1) 능역조영의 용어정의, 2) 능원의 공간구성, 3) 능역시설물의 특성, 4) 공사규모 및 내역, 5) 능원의 식생 등의 내용을 검토할 수 있었다. 세계문화유산에 등재 된 문화시설은 그 원형을 잘 보존해야 하며 보존관리도 원래의 공법을 활용하는 등 신중한 검토가 요구된다. 따라서 본 논문은 원형 고증적 측면에서 이루어 졌다. 상기의 내용에서 세종과 소헌왕후의 영릉에 대하여 조영적 특성을 고찰할 수 있었다. 이를 바탕으로 영릉의 원형공간 이해와 향후 복원 등의 제안이 가능한 것으로 사료된다.

행정박물의 유형분류 및 선별방안에 관한 연구 (A Study on the Type Classification and Selection Methods of Archival Objects)

  • 이영학;김명훈;임은정
    • 기록학연구
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    • 제17호
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    • pp.115-156
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    • 2008
  • 공공기관의 활동과 관련하여 생성된 행정박물은 문자로는 표현할 수 없는 상징성, 역사성 및 심미성과 함께 형상물로서의 가치가 크기 때문에 향후 전시 및 활용의 가치가 높다. 우리나라에서는 지난 2006년 "기록관리혁신 종합실천계획"을 통해 행정박물을 공공기록으로 인식하고 그에 대한 적극적인 관리의지를 표명하였다. 이와 함께 개정 기록관리법에서는 행정박물 역시 업무와 관련하여 생산 접수한 기록물의 범주에 포함시킴으로써, 모든 공공기관에서 행정박물을 관리케 할 수 있는 기반을 마련하였다. 행정박물을 기록으로 인식하고 관리의지를 명문화했다는 점은 이전과는 다른 개혁적 의도로 볼 수 있지만, 행정박물에 대한 개념 규정 및 이를 체계적으로 관리 보존할 수 있게 하는 방안은 아직 미비한 상태이다. 이에 본고에서는 행정박물 관리체계 구축방안 마련을 위한 일환으로, 행정박물의 유형분류 및 평가 문제를 고찰하였다. 행정박물의 관리체계 구축을 위해서는 우선적으로 행정박물에 대한 명확한 개념 규정 및 구체적인 유형 파악이 선행되어야 한다는 전제 하에, 실제 조사자료 및 현행 유관법령을 기반으로 행정박물의 정의 및 유형분류를 시도하였다. 또한 공공기관의 업무와 관련하여 생산 활용되는 물품 중 어떠한 대상을 행정박물로 획득하여 관리할 것인가를 고찰하기 위해, 행정박물 선별 상의 특성을 분석하였다. 이를 바탕으로 우리나라 행정박물 선별 체제 및 영구보존 대상 선별기준 마련을 위한 방안을 제시하였다.

2002년 12월 10일 규모 3.6 철원지진의 진원요소 및 파상분석 (A source and phase identification study of the 10 December 2002 Cheolwon, Korea, earthquake of ML 3.6)

  • 김우한;박종찬;함인경;김성균;박창업
    • 한국지진공학회논문집
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    • 제7권5호
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    • pp.19-24
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    • 2003
  • 2002년 12월 10일 발생한 철원지진에 의해 기록된 지진파의 파상(phase)분석을 하고, 진원위치, 발생시간, 지진규모 등의 진원요소를 연구하였다. 이 연구에서는 기상청과 한국지질자원연구원의 지진관측망에 의해 기록된 속도 및 가속도 자료를 사용하였다. 이 지진은 휴전선 이북에서 발생한 관계로 휴전선 이남에서 직접파인 Pg가 기록된 관측소는 5곳에 불과하다. 또 굴절파의 초동파인 Pn은 대부분의 관측소에서 구분하기 어렵다. 이러한 이유로 진원 결정에서 기존의 방법으로는 오차가 클 가능성이 있다. 기록된 각 파의 구분을 위하여 Kim et a1. 개발한 파상 분석법과 주시곡선을 사용하여 P 및 S파의 직접파, 반사파 및 굴절파를 구분하였다. 진원위치 및 발생시간을 결정하기 위하여 기존의 방법에서 사용되는 Pg, Pn, Sg, Sn 파 외에 PmP 및 SmS 파를 추가로 사용하여 정확도를 증가시켰다. 진앙거리 200km 미만의 11개 자료로 결정한 철원지진의 진앙은 북위 38.81도, 동경 127.22도, 그리고 진원 깊이는 12.0km이며, 발생시간은 7시 42분 51.4초(한국시간)이다. Richter의 지진규모 정의에 따라 계산된 각 관측소의 평균적 지진규모는 $M_{L}$ 3.6이다. 이 규모는 기상청과 한국지질자원연구원에서 결정한 규모보다는 각각 0.2와 0.5만큼 작다.

癰疽에 대한 文獻的 考察;(病因.病機를 중심으로) (A literatual studies on the Ong-Jeo in the special consideration of etiology and pathologic mechanism)

  • 노현찬;노석선
    • 한방안이비인후피부과학회지
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    • 제13권2호
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    • pp.20-50
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    • 2000
  • This paper was written into condsideration records about the definition of "Ong-Jeo", the difference between "Ong" and "Jeo", the Western medical approach to "Ong-Jeo", and the etiology and pathologic mechanism of "Ong-Jeo". After this study, I report the following results from it. 1. "Ong" is an acute diapyesis disease which is found is in our skin and muscle and flesh. The chrateristics of this disease is that the affacted site is shine, no head, and the size is 3-4 chon. The prossess of the diesease shows that it is very quick, and very easily swell, and becomes pus easily, easily become to ulcer, easily converge. But this don't damage to the muscle and bone. 2. "Jeo" is the disease which damages bone-skeleton, muscle and flesh, and even destroy the stationary tissue. Jeo can be divided into two. One is called "Yudujeo" and it is acute diapydesis disease. The characteriscs of this disease is the miliary abscess, swell, has fever, and has an ache which is feeled spaned. And this is diffused into periphrey tissue and is diffused into deep site. After the ulcer, this becomes to shape the cellula. The size is more than 3-4 chon and this disease goes into chuk if this is serious. The other one is called "Mudujeo" and this disease is the ulcerative one in our joint and skeleton. The characteristic of this disease shows that the color of skin be not changed, and swell diffusely, and is not easily vanished, not easily becomes ulcerative, and not easily becomes converged. 3. "Ong-Jeo" is caused by the bacteriunm named by the "Golden and Yeollw Staphylococcus" in the Western medicine. "Ong" can be applicable to the carbuncle, acute diapyesis lymphadenitis, and some of cellulitis. "Jeo" can belong to cellulitis, and Mudujeo can belong to suppurative arthritis, suppurative osteomyelitis, tuberculous arthritis and osteomyelitis, and tuberculous lymphadenitis. 4. The etiologies of "Ong-Jeo" can be divided three, which are internal, external and other etiology which can not be clasiffied by two etiologies above. The internal etiology is seven emotion, and the external etiology is the six eumsa, unki, chunhang and so on. Other etiology is inadequate absorption of food, and excessive bang-sa. 5. The etiology of "Ong" is suppurative one which is choked between our skin and muscle and flesh, and is congested, become to hot, and finally erodes the muscle and flesh because of the inbalance of cirrculation in the enegy and blood. "Jeo" is the same as the Ong, but this is the suppurative disease which damages the muscle, flesh, and skeleton, and even damages into five Zang, the internal intestine.

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중환자에서 Colistimethate 정맥내 투여와 관련된 급성 신손상에 대한 연구 (A Study on Acute Kidney Injury Caused by Intravenous Colistimethate in Critically Ill Patients)

  • 오명현;방준석
    • 한국임상약학회지
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    • 제23권4호
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    • pp.307-315
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    • 2013
  • Objective: Colistimethate was first became available in 1950s and used until the early 1980s to treat infections caused by gram-negative bacteria and was abandoned due to its nephrotoxicity and neurotoxicity. However, it was recently reintroduced into the clinical practices due to emergence of multidrug-resistance gram-negative bacteria, particularly Pseudomonas aeruginosa and Acinetobacter baumanii. Therefore, it is increasingly used in the intensive care unit settings as a salvage therapy. This study was designed to investigate the incidence rates and risk factors of acute kidney injury associated with colistimethate by using the standardized definition in critically ill patients. Methods: This study retrospectively reviewed the electronic medical records of 71 adult patients above 18 years old receiving intravenous colistimethate at least 48 hours at intensive care unit, university-affiliated hospital from Nov 2012 to Aug 2013 and excluded patients with end-stage renal disease (ESRD) and required renal replacement therapy before initiation of the colistimethate therapy. Acute kidney injury (AKI) was determined by using the standardized RIFLE criteria, classified with risk, injury, failure, loss and ESRD according to serum creatinine (Scr) levels. Results: Among the 71 patients included in the analysis, AKI developed in 40 patients (56.3%) and 6 patients (8.4%) had irreversible kidney injury. AKI occurred within 5 days in 20 patients (50.0%). Maximum Scr level showed a significant increase in the patients with AKI ($1.92{\pm}0.86mg/dL$ vs. $1.12{\pm}0.46mg/dL$ p=0.001), maximum BUN also increased ($64.2{\pm}28.7mg/dL$ vs. $48.4{\pm}24.9mg/dL$ p=0.017) and minimum creatinine clearance (CLcr) was significantly decreased in the patients with AKI than non-AKI ($34.5{\pm}18.6ml/min$ vs. $64.4{\pm}33.7ml/min$ p=0.185). The patients with AKI had significantly longer duration of colistimethate therapy ($21.1{\pm}17.0$ days vs. $13.0{\pm}11.5$ days, p=0.020) and larger cumulative doses of colistimethate ($6465.9{\pm}4717.0mg$ vs. $4438.1{\pm}3426.7mg$, p=0.040). Conclusion: The incidence and severity of AKI associated with colistimethate in critically ill patients was high and serious. Drug monitoring program should be performed to shorten duration of therapy and reduce cumulative dose from initiation of colistimethate therapy for minimizing AKI of colistimethate.