• Title/Summary/Keyword: e-clinical data

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Relationship between the Practice Environment of Nursing and Critical Thinking Disposition of Nurses in Local General Hospitals (지방 종합병원 간호사의 근무환경과 비판적 사고성향)

  • Lee, Ji Yun;Pak, So Young
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.2
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    • pp.145-153
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    • 2014
  • Purpose: The purpose of this study was to identify the relationship between the practice environment of nursing and the critical thinking disposition of clinical nurses in local general hospitals. Methods: A convenience sample of 468 registered nurses was obtained from three local general hospitals. Data were collected by a self-administered questionnaire during November, 2012. The survey tools were the K-PES-NWI verified by Cho et al (2011) and the critical thinking disposition instrument developed by Yoon (2004). Data were analyzed using descriptive statistics, one-way ANOVA with Scheff$\acute{e}$ test and multiple regression with SPSS/WIN 18.0. Results: The mean score for practice environment of nursing was $3.3{\pm}0.4$ and for critical thinking disposition, $2.3{\pm}0.4$. There were statistically significant differences in critical thinking disposition according to age, education, length of career, current position, and marital status. In multivariate analysis, factors related to critical thinking disposition were collegial nurse-physician relations and education level. Conclusion: The results of the study indicate that collegial nurse-physician relations in the nursing practice environment are related to nurses' critical thinking disposition, and thus, it is important to improve the practice environment as well using individual approaches including on-the-job training to improve nurses' critical thinking disposition.

Burden, Social Support and Quality of Life of the Family Caregiver's of Hemodialysis Patients (혈액투석환자 가족의 부담감, 사회적 지지 및 삶의 질)

  • Yoon, Su Kyung;Tak, Young Ran
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.395-405
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    • 2014
  • Purpose: This study was a descriptive correlation research designed to provide basic data on family nursing interventions by examining burden, social support and quality of life for family caregivers of patients on hemodialysis. Methods: Data were collected from 132 family caregivers of patients on hemodialysis and analyzed using frequency analysis, correlation analysis, independent samples t-test method, one-way ANOVA and post-hoc analysis of $Scheff{\grave{e}}$, and multiple regression analysis. Results: Burden for family caregivers of patients on hemodialysis was 3.03, social support, 4.77, and quality of life, 3.26. Burden showed a negative correlation with social support (r=-.34, p<.001), and with quality of life (r=-.54, p<.001). There was a positive correlation between social support and quality of life (r=.54, p<.001). Factors predicting quality of life for family caregivers, were a significant and positive effect from social support (t=5.72, p<.001) and a negative effect from family burden (t=-5.62, p<.001). Conclusion: Results of the study indicate that burden of these family caregivers can be reduced by social support which plays an important role in improving quality of life. A nursing intervention program which goes beyond simply caring for patients and includes assessment of family burden and support for overall family caretaking needs to be developed.

Relationship between Lateral Position Change and Sternal Complications after Cardiac Surgery through Median Sternotomy (정중 흉골 절개술을 이용한 심장수술 후 환자의 체위변경과 흉골 합병증 발생과의 관계)

  • Kang, Young Ae;Bae, Su Jin;Song, Chie Eun
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.66-76
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    • 2016
  • Purpose: This study was conducted to examine the relationship between lateral position change and sternal complications after cardiac surgery through median sternotomy. Methods: This study was a retrospective descriptive case-control study, involving 241 patients who underwent cardiac surgery through median sternotomy. Data from October 2011 to September 2014 were collected. Results: Sternal complications (i.e. dehiscence, sternal instability, mediastinitis) developed in 33 patients (13.7%). Primary symptoms of complications were discharge and erythema, and the mean time difference from surgery to appearance of symptoms was 15 days (range, 1-138 days). The factors associated with sternal complications were cancer comorbidity (${\chi}^2=5.22$, p=.039), internal mammary artery procedure (${\chi}^2=4.16$, p=.041), and duration of extra-corporeal membrane oxygenation (p=.033). Position change was not related to incidence of sternal complications (${\chi}^2=0.14$, p=.704). Pressure ulcers appeared in 63 patients (26.1%). Mean time difference from surgery until occurrence of ulcers was 6.7 hours (range, 0-323.0 hours), but position change was started from 132.4 hours (range, 27.1-503.2 hours) after intensive care unit admission. Conclusions: These results provide baseline data to create a standard position change and activity protocol for patients after median sternotomy. Furthermore, the study could help clinical practitioners establish evidence-based nursing practices.

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Surveillance Study of Acute Gastroenteritis Etiologies in Hospitalized Children in South Lebanon (SAGE study)

  • Ghssein, Ghassan;Salami, Ali;Salloum, Lamis;Chedid, Pia;Joumaa, Wissam H;Fakih, Hadi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.3
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    • pp.176-183
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    • 2018
  • Purpose: Acute gastroenteritis (AGE) is a major cause of morbidity and remains a major cause of hospitalization. Following the Syrian refugee crisis and insufficient clean water in the region, this study reviews the etiological and epidemiological data in Lebanon. Methods: We prospectively analyzed demographic, clinical and routine laboratory data of 198 children from the age of 1 month to 10 years old who were admitted with the diagnosis of AGE to a private tertiary care hospital located in the district of Nabatieh in south Lebanon. Results: Males had a higher incidence of AGE (57.1%). Pathogens were detected in 57.6% (n=114) of admitted patients, among them single pathogens were found in 51.0% (n=101) of cases that consisted of: Entamoeba histolytica 26.3% (n=52), rotavirus 18.7% (n=37), adenovirus 6.1% (n=12) and mixed co-pathogens found in 6.6% (n=13). Breast-fed children were significantly less prone to rotavirus (p=0.041). Moreover, children who had received the rotavirus vaccine were significantly less prone to rotavirus (p=0.032). Conclusion: Our findings highlight the high prevalence of E. histolytica infection as the major cause of pediatric gastroenteritis in hospitalized children, during the summer period likely reflecting the insanitary water supplies and lack of hygiene. Moreover the 42.4% of unidentified causative pathogens should prompt us to widen our diagnostic laboratory arsenal by adopting new diagnostic technologies.

A Study on Urinary Tract Infections in Intensive Care Unit Patients with an Indwelling Urinary Catheter

  • Seong, Hee-Kyung;Kim, Yoo-Ho
    • Biomedical Science Letters
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    • v.7 no.3
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    • pp.117-125
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    • 2001
  • This study was performed in order to evaluate the risk factors for nosocomial urinary tract infection and the frequencies of organisms isolated, and to provide the epidemiologic and basic data of hospital acquired urinary tract infection in intensive care unit. A prospective analysis was performed with 1,235 urine samples following urinary bladder catheterization in 569 patients, who had no evidence of UTI at the time of catheter insertion, admitted to intensive care unit in Pusan P hospital between June 1997 and May 1998. To identify risk factors for UTI, clinical characteristics of infected patients were analyzed. We analyzed these data by percentage, chi-square and odd ratio. Obtained results were as follows: A total of 569 patients (male 341 and female 228) were an average age of 50.8 years and catheterization of 8.04 days. Incidence of UTI was 16.1% (199/1,235) and The risk factors of UTI were duration of catheterization over 7 days, no use of systemic antibiotics, summer and female, and During the first 7 days these risk factors were no use of systemic antibiotics, summer, place of first catheter insertion (ICU) and type of intensive care unit (NSICU). A total of 220 the isolated strains were Gram negative rod 83 (37.7%), yeast like fungi 74 (33.6%) and Gram positive cocci 63 (28.6%). The common organisms isolated were Enterococcus faecalis 23 (10.5%), Serratia marcescens 19 (8.6%), Pseudomonu spp.17 (7.7%), E. ooh 16 (7.3%), Staphylococcus epidemidis 11 (5.0%) mdklebsiellapneumoniae 8 (3.6%). Therefore, in these results 199 of 569 (35%) patients in ICU with indwelling urinary catheter developed UTI. The risk factors for UTI are prolonged duration of catheterization, no use of systemic antibiotics, summer, and female.

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Relationship of Health Status, Self-Efficacy, Hardiness, Family Support and Pain in Patients with Rheumatoid Arthritis (류마티스 관절염환자의 건강상태와 자기효능, 강인성, 가족지지 및 통증과의 관련성)

  • Paik, Kwang-Mi;Shim, Seung-Cheol;Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.7 no.2
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    • pp.309-322
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    • 2000
  • This study was conducted to find out the relationship among several variables such as health status, self-efficacy, health related hardiness, family support and pain in patients with rheumatoid arthritis. The subjects were 108 patients with rheumatoid arthritis who visited the out patient department of Rheumatism at E university hospital in Teajon. Data were collected by questionnaire from November 26, 1999 to January 14, 2000. The instrument used in this study were health status developed by Bae et al(1998), self-efficacy scale developed by KRHPS, health related hardiness modified by Suh(1988), family support scale developed by Kang(1984), Pain with graphic rating scale. Data were analyzed by descriptive statistics, one-way ANOVA, Pearson Correlation Coefficient, multiple regression using the SPSS Win program. The results were as follows; 1. There were no statistically significant differences between general characteristics and variables such as health status, self-efficacy, health related hardiness and family support respectively. 2. Statistically significant differences were not found between clinical characteristic and variables such as health status, self-efficacy, health related hardiness and family support respectively. 3. Significant correlations were found between health status and self-efficacy, self-efficacy and hardiness, hardiness and family support, health status and pain, self-efficacy and pain respectively(p<0.01), and health status and hardiness, self-efficacy and family support, hardiness and pain respectively(p<0.05). 4. Self-efficacy and pain were significant affecting factors of a health status. In these results, it is suggested that nursing intervention to increase self-efficacy and to reduce pain was very important for patients with rheumatoid arthritis.

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Using Quality of Life Scales with Nutritional Relevance after Gastrectomy: a Challenge for Providing Personalized Treatment

  • Lee, Seung Soo;Yu, Wansik;Chung, Ho Young;Kwon, Oh Kyoung;Lee, Won Kee
    • Journal of Gastric Cancer
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    • v.17 no.4
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    • pp.342-353
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    • 2017
  • Purpose: This study evaluated the changes in nutritional status based on quality of life (QoL) item-level analysis to determine whether individual QoL responses might facilitate personal clinical impact. Materials and Methods: This study retrospectively evaluated QoL data obtained by the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and Quality of Life Questionnaire-Stomach (QLQ-STO22) as well as metabolic-nutritional data obtained by bioelectrical impedance analysis and blood tests. Patients were assessed preoperatively and at the 5-year follow-up. QoL was analyzed at the level of the constituent items. The patients were categorized into vulnerable and non-vulnerable QoL groups for each scale based on their responses to the QoL items and changes in the metabolic-nutritional indices were compared. Results: Multiple shortcomings in the metabolic-nutritional indices were observed in the vulnerable groups for nausea/vomiting (waist-hip ratio, degree of obesity), dyspnea (hemoglobin, iron), constipation (body fat mass, percent body fat), dysphagia (body fat mass, percent body fat), reflux (body weight, hemoglobin), dry mouth (percent body fat, waist-hip ratio), and taste (body weight, total body water, soft lean mass, body fat mass). The shortcomings in a single index were observed in the vulnerable groups for emotional functioning and pain (EORTC QLQ-C30) and for eating restrictions (EORTC QLQ-STO22). Conclusions: Long-term postoperative QoL deterioration in emotional functioning, nausea/vomiting, pain, dyspnea, constipation, dysphagia, reflux, eating restrictions, dry mouth, and taste were associated with nutritional shortcomings. QoL item-level analysis, instead of scale-level analysis, may help to facilitate personalized treatment for individual QoL respondents.

Relationships between Fatigue, Sleep Disturbance, Stress, Self-efficacy and Depression in Hemodialysis Patients (혈액투석환자의 피로와 수면장애, 스트레스, 자기효능감 및 우울 관계)

  • Seo, Nam Sook;Kang, Seung Ja;Kim, Jae Hee;Kim, Sea Ja
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.2
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    • pp.285-297
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    • 2013
  • Purpose: This study was conducted to investigate the differences in sleep disturbance, stress, self-efficacy and depression by fatigue level and to identify the factors influencing fatigue in hemodialysis patients. Methods: This study used a cross-sectional design and the subjects were 195 patients undergoing hemodialysis in a local unit. Data were collected using a structured questionnaire and medical records from June to August 2012. The data were analyzed using descriptive statistics, independent t-test, one way ANOVA, $Scheff{\grave{e}}$ test, and Pearson's correlation coefficients. Also a multiple regression analysis was used to assess the independent association between fatigue status and indices of sleep disturbance, stress, self-efficacy and depression. Results: A total of 99 (50.8%) subjects experienced a high level of fatigue and 96 (49.2%) experienced a low level of fatigue. There were significant differences in the levels of sleep disturbance, stress, self-efficacy and depression between the two groups. Fatigue was significantly correlated to sleep disturbance, stress, self-efficacy and depression. The most important factor related to fatigue was stress, followed by sleep disturbance. These factors explained about 37% of fatigue of the respondents. Conclusion: The results of this study showed that sleep disturbance and stress were significant predictors of fatigue in hemodialysis patients. Possible interventions for minimizing fatigue in patients undergoing long-term hemodialysis should be aimed to manage the known contributing factors.

Cotreatment with Growth Hormone in Controlled Ovarian Hyperstimulation for IVF in Women with Limited Ovarian Reserve (체외수정시술을 위한 성선자극호르몬 과배란유도에 Limited Ovarian Reserve를 갖는 환자에서 성장호르몬의 사용)

  • Kim, Sun-Haeng;Chang, Ki-Hoon;Ku, Pyoung-Sahm
    • Clinical and Experimental Reproductive Medicine
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    • v.21 no.3
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    • pp.241-245
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    • 1994
  • Despite increasing success rate of IVF, poor response to ovarian stimulation remains a problem. So, attempts to improve ovarian responses, for example, by using combined gonadotropin-releasing hormone analogue(GnRH-a) and human menopausal gonadotropin(hMG) have shown limited success. It is reported that response of granulosa cells in vitro to FSH is stimulated by co-incubation with IGF-l, and IGF-l production can be increased by growth hormone. This suggest that combination regimen of G.H. and hMG may augment follicle recruitment. In fifteen patients who had previous history of poor ovarian response to gonadotropin stimulation after pituitary suppression with mid -luteal GnRH-a, the effectiveness of cotreatment with G.H. in IVF program was evaluated using a combination regimen of G.R. and hMG at Korea University Hospital IVF Clinic. Ovarian responses to gonadotropin stimulation in control and GH-treated cycles assessed by total dose and duration of hMG treatment, follicular development and peak $E_2$ level, number of eggs retrieved, and fertilization rates were also assessed. In each group, serum and follicular fluid IGF-1 concentrations on day of egg collection were measured by RIA after acidification and extraction by reveresed phase chromatography. Patients receiving G.H. required fewer days and ampules of gonadotropins, developed more oocytes, and more embryos transferred. But, the differences were not statistically significant, except the duration of hMG treatment. Our data showed a significantly higher concentration of IGF-l in the serum, not in the follicular fluid, of patients treated with G.H. compared with control group. These data suggest that growth hormone treatment does not improve the ovarian response in women with limited ovarian reserve to gonadotropin stimulation for IVF.

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The Effect of Transcranial Direct Current Stimulation on Cognitive Function and Biochemical Change of Rats with Alzheimer's Desease

  • Kim, Jin-Young;Park, Seong-Doo;Song, Hyun-Seung;Yang, Kyung-Hee;Yu, Seong-Hun
    • The Journal of Korean Physical Therapy
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    • v.26 no.6
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    • pp.436-441
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    • 2014
  • Purpose: The objective of this study was to offer clinical primary data that it's aims to examine effects of transcranial direct current stimulation (tDCS) on cognitive function and biochemical change of rat with alzheimer's disease(AD) induced by injecting scopolamine. Methods: Subjects were instructed cognitive dysfunction model, rat of Sprague-Dawley system was injected with scopolamine and each experimental group was classified into three; group I (n=16) is non-treatment groups; group II (n=16) is applied with the tacrine; group III (n=16) is applied with the tDCS. The ziggurat task test was conducted to observe behavioral changes and cognitive function ability and 7, 14, 21, 28 days after the model. Acetylcholine Esterase (Ach E) activity was examined for biochemical assessment of which the results are followed. Results: Participants showed as to behavioral change, tacrine application group was the most significantly responded, following tDCS application group. As to biochemical change, same as above, tacrine application group was the most significantly responded, following tDCS application group. Conclusion: From these results, confirm that tDCS application to rat with alzheimer's disease leads to positive effects on behavioral, cognitive function changes, and biochemical changes, lasting for certain period of time. This study, in particular, tDCS, which can change excitability of brain cells non-invasively, could provide basic data that is useful as a new treatment way for the patients with cognitive dysfunction.