• Title/Summary/Keyword: early interventions

검색결과 301건 처리시간 0.034초

Factors Affecting the Readmission Experience of Liver Cirrhosis Patients (간경변증 환자의 재입원 경험에 영향을 미치는 요인)

  • Yoon, Mi-Lim;Eun, Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제21권5호
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    • pp.111-120
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    • 2020
  • This study examined the factors affecting the readmission of patients with liver cirrhosis, and focused on self-care, social support, and drinking refusal self-efficacy. The subjects were 75 cirrhosis patients who were admitted to medium-sized hospitals at S-city for two months from May 2019 to June 2019. The data was analyzed with the SPSS (Version 25) program, and logistic regression analysis was performed on the factors affecting readmission. The results were self-care (27.49±0.53 out of 60), social support (52.80±16.44 out of 90), and drinking refusal self-efficacy (42.39±22.76 out of 80). The readmission method was classified into planned and unplanned admissions. Unplanned readmission was found to differ depending on the drinking experience (OR: 4.16) and the presence of complications (OR: 5.11) within a month of discharge rather than that of the planned readmissions, accounted for 19.7%. It will be very important to reduce the occurrence of complications by early management of patients with cirrhosis, and increase the drinking refusal self-efficacy, and so reduce unplanned readmission and prevent the progression and deterioration of cirrhosis. The drinking experience and the occurrence of complications can be reduced through interventions that increase self-care, social support, and drinking refusal self-efficacy. Nursing interventions are needed to prevent patients with cirrhosis from drinking and to manage the complications due to relapse into alcoholism.

Initiating Smokeless Tobacco Use across Reproductive Stages

  • Begum, Shahina;Schensul, Jean J.;Nair, Saritha;Donta, Balaiah
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7547-7554
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    • 2015
  • Background: The use of smokeless tobacco (SLT) among women is increasing in India, especially among those with limited education and resources. Preventing the initiation of SLT among women is critical since it has known negative consequences for oral and reproductive health. Most research on tobacco initiation in India focuses on adolescents. This paper addresses the unrecognized issues of post marital initiation among women of reproductive age, highlighting the importance of reproductive stages in women's tobacco initiation. The objective is to examine the correlates of SLT initiation among low income women in Mumbai from pre-marriage through early marriage, first pregnancy and beyond, using case examples to illustrate initiation during each of these stages. Materials and Methods: In 2011-2012, cross-sectional community level survey data were collected from a representative sample of 409 daily SLT-using married women aged 18-40 years in a low income community in Mumbai. Information on socio-demographics, initiation by reproductive stage, types of tobacco use, childhood exposure to tobacco, learning to use, and initiation influences and reasons were collected through a researcher-administered survey. Univariate and bivariate analysis assessed factors influencing initiation of SLT use by reproductive stage. In addition 42 narratives of tobacco use were collected from a purposive sample of pregnant and non-pregnant married women addressing the same questions in detail. Narratives were transcribed, translated, and coded for key concepts including initiation of tobacco use. Results: Thirty-two percent of women initiated SLT use before marriage, 44% initiated after marriage but before pregnancy, 18.1% initiated during their first pregnancy and the remainder started after their first pregnancy. Mean age of marriage among women in this study was 16 years. Younger women (i.e. age at time of the interview of less than 30 years) were 0.47 [95% CI (0.32, 0.87)] percent less likely to initiate after marriage than women aged more than 30 years. Women who got married before 18 years of age were 2.34 [95% CI (1.40, 3.93)] times more likely to initiate after marriage than their counterparts. Childhood exposure was a predictor for initiating SLT use prior to marriage but not after. Women reporting tooth and gum pain were 1.85 times more likely to initiate after marriage than their counterparts. Husband and neighbours were the most significant influences on post-marital initiation. Narratives highlighted differences in processes of initiation pre and post marriage and during pregnancy. Conclusions: Most tobacco prevention interventions are directed to adolescents in school. This study suggests that especially for low literate or illiterate women, school based interventions are ineffective. To be effective strategies to prevent SLT initiation must reach women in urban areas at or immediately after marriage and during their first pregnancy. Messages must negate culturally rooted beliefs about the health benefits of SLT in order to prevent initiation and onset of daily use.

Application of Occupation-Based Practice for Neurodevelopmental Children's Subway Use (신경발달 장애 아동의 지하철 이용하기 작업에 대한 작업기반 중재의 적용)

  • Ra, Dae-Yeop;Kong, Myung-Ja;Chang, Ki-Yeon
    • Korean Journal of Occupational Therapy
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    • 제26권4호
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    • pp.27-41
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    • 2018
  • Objective : This study implemented occupation-based practice as a group program for children with neurodevelopmental disabilities, and investigated the quality of occupational performance, performance and satisfaction, and efficacy levels of the program. Methods : ADOC-S(Aid for Decision making in Occupation Choice-School) and COPM(Canadian Occupational Performance Measure) were used to establish common meaningful occupational goals for 10 children with neurodevelopmental disabilities. After occupational analysis of the 'subway use', the Performance Quality Rating Scale(PQRS) were used to evaluate the quality of occupational performance. Occupation-based interventions were implemented by participants individually performing meaningful occupations in the most natural and real-life environments as possible. The trial consisted of 1 session of pre-intervention assessments, 8 sessions of intervention, where a single session of 100 minutes is provided once a week. Post-intervention evaluation was conducted over one session. Results : The quality of occupational performance by PQRS was 38.10 higher than before intervention. The occupation-based intervention as a group program used the maintain and modify(compensation, adaptation) approaches and acquisition model. In the early stages of intervention (1 to 4 sessions), the occupational performance was greatly improved. The performance level of COPM increased by 5.80 and the satisfaction level was increased by 7.00. In addition, high scores were found in program satisfaction through parental interview. Conclusion : The results of implementing occupation-based interventions to children with neurodevelopmental disabilities showed increase in quality of occupational performance, performance, and satisfaction along with positive effects of satisfaction levels for the program.

Is Interventional Therapy Superior to Medical Treatment in Chronic Low Back Pain?: Yes, in Considerable Cases (만성요통의 치료에서 중재적인 치료가 보존적 치료보다 우세한가?: 긍정적인 입장에서)

  • Chang, Sang-Bum
    • Annals of Clinical Neurophysiology
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    • 제12권1호
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    • pp.3-6
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    • 2010
  • The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.

Study of Cohort Construction for Development of Early Alarm System (EMS) for Breast Cancer - based on women living in a rural area - (유방암 조기경고체계 개발을 위한 코호트 구축 - 일 농촌지역 여성을 중심으로 -)

  • Hur, Hea Kung;Park, So Mi;Kim, Gi Yon;Lee, Hae-Jong;Jean, Eun-Po
    • Korean Journal of Adult Nursing
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    • 제18권1호
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    • pp.146-156
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    • 2006
  • Purpose: 1) to construct cohorts according to risk scores calculated with the Gail Breast Cancer Risk Assessment Tool (Gail et al., 1989) (Gail) and the Breast Cancer Risk Appraisal (Lee et al,. 2003) (Lee) 2) to identify the distribution of risk factors and preventive behavior stages between the cohorts 3) to identify abnormal breast conditions in risk cohort. Method: Using convenience sampling, 775 rural women were selected. Risk appraisal was scored using Gail and Lee. Preventive behavior stages for BSE (Breast self examination) and mammography were measured using 4 stages of the Transtheoretical Model (Prochaska & DiClemente, 1983). Results: 1) The risk cohort according to Gail was 12.3% (n=95), and Lee, 3.1% (n=24). 2) There were significant differences in the distribution of risk factors (age, family history, age at 1st live birth, age at menarche, number of breast biopsy, history of breast disease, and breast-feeding) between cohorts. 3) There was a significant difference in the distribution of the stage of BSE according to Lee. 4) Six women in the risk group detected masses or nodules and physician consultation and ultrasonography were recommended. Conclusion: On the basis of the constructed cohorts, further longitudinal studies of cohorts are recommended with interventions according to characteristics of cohorts.

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Subjectivity on Health and Lifestyle among Middle-aged Women -Q Methodological Approach- (중년 여성의 건강과 생활양식에 대한 주관성 연구)

  • Lee, Si-Eun;Kim, Jin-Kyung;Kim, Boon-Han
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제16권7호
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    • pp.4786-4797
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    • 2015
  • The purpose of this study was to understand the subjectivity on health and lifestyle of middle aged women and to explore the relationship between health and lifestyle. Q methodology was applied of the study. 29 statements for health and 27 statements for lifestyle were classified by 30 women of the age 40~60 years living in Seoul. The obtained data were analyzed by means of PC Quanl program. The result showed that the health and lifestyle of middle aged women were classified in 4 types and the characteristics and the relationship between health and life style have been identified. The types of health included 'health worrying type', 'daily living management type', 'discordance between one's words and action type', and 'early management type'. The types of lifestyle included 'occupation focused type', 'self norm value type', 'satisfying type', and 'religion focused type'. This study provided basic data to improve the health and life style of middle aged women, as well as to supply theoretical frame to prepare individualized nursing interventions.

Estimating the Economic Burden of Lung Cancer in Iran

  • Rezaei, Satar;Sari, Ali Akbari;Woldemichael, Abraha;Soofi, Moslem;Kazemi, Ali;Matin, Behzad Karami
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권10호
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    • pp.4729-4733
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    • 2016
  • Objectives: Lung cancer is a major public health problem and one of the most costly illnesses. The study aimed to estimate the economic burden of lung cancer in Iran in 2014. Methods: A cross-sectional study was conducted to estimate the direct and indirect costs for patients with lung cancer using a prevalence-based approach. A human capital approach was employed to estimate the indirect costs. Data were obtained from several sources such as through patient interview using structured questionnaire, medical records, the GLOBOCAN databases, the Iranian Statistical Center, the Iranian Ministry of Cooperation, Labor and Social Welfare, and the Institute for Health Metrics and Evaluation (IHME). Results: The economic burden of lung cancer in Iran in the year 2014 was 3,225,998,555,090 IR. The main components of the cost were associated with mortality (81.9 %) and hospitalization (7.6 %). The costs of direct medical care, non-medical aspects, patient time, and mortality accounted for 10.8%, 2.7%, 4.5%, and 81.5% of the total cost, respectively. Conclusion: Findings from this study indicated that the economic burden of lung cancer is substantial both to Iran's health system and to society as a whole. Early diagnosis, strengthening cancer prevention, implementing new cancer therapy and medical technology, and effective smoking-cessation interventions could offset some of the costs associated with lung cancer in Iran.

The sequential management of recurrent temporomandibular joint ankylosis in a growing child: a case report

  • Cho, Jung-Won;Park, Jung-Hyun;Kim, Jin-Woo;Kim, Sun-Jong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제38권
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    • pp.39.1-39.6
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    • 2016
  • Background: Temporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible. Case report: This is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood. The multiple surgeries including a costochondral graft and gap arthroplasty using interpositional silicone block were performed, but re-ankylosis of the TMJ occurred after surgery. Alloplastic TMJ prosthesis was conducted to prevent another ankylosis, and signs or symptoms of re-ankylosis were not found. Additional reconstruction surgery was performed to compensate mandibular growth after confirming growth completion. During the first 3 years of long-term follow-up, satisfactory functional and esthetic results were observed. Conclusions: This is to review the sequential management for the recurrent TMJ ankylosis in a growing child. Even though proper healing was expected after reconstruction of the left TMJ with costal cartilage graft, additional surgical interventions, including interpositional arthroplasty, were performed due to re-ankylosis of the affected site. In this case, alloplastic prosthesis could be an option to prevent TMJ re-ankylosis for growing pediatric patients with TMJ ankylosis in the beginning.

Glucose Variations in the First Day of Life of Newborns under Observational Surveillance (관찰감시를 요하는 저위험신생아의 생후 초기 혈당변이 탐색)

  • Cho, Jung Ae;Son, Kyoung Hee;Eom, Hyun Young;Lim, Seo Hae;Jun, Yong Hoon;Ahn, Young Mee
    • Child Health Nursing Research
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    • 제26권2호
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    • pp.212-221
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    • 2020
  • Purpose: Nursing protocols for glucose management are well known for both healthy term newborns and high-risk newborns. However, for less risky newborns who are under only observation surveillance, hypoglycemia could be overlooked unless clinical symptoms develop. Methods: A retrospective study was performed to explore factors influencing variations in glucose levels in 91 newborns who did not require any interventions, but were under nursing surveillance, at a level II neonatal intensive care unit. Data were retrieved from electrical medical records on glucose levels, demographic characteristics, and other clinical characteristics of newborns in their first day of life from January 2016 to May 2019. Results: Glucose levels tended to stabilize within the normal range (60~80 mg/dL) as time passed during the first day of life. Cesarean section, multiple gestation, abnormal growth, and later preterm birth were associated with low glucose levels in the first 2 hours of life. Thirty-one newborns experienced a hypoglycemic episode (< 45 mg/dL) during the first 24 hours of life. Conclusion: The findings of this study support the active encouragement of early feeding within 2 hours of birth and urgent adoption of a structural protocol for glucose surveillance in newborns with potential health problems immediately after birth.

Feeding Children with Disabilities and Related Evaluations and Interventions (감각처리와 관련된 섭식기능의 평가와 중재방법에 대한 고찰)

  • Kang, Hyun-Jin;Kim, Kyeong-MI
    • The Journal of Korean Academy of Sensory Integration
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    • 제8권1호
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    • pp.73-86
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    • 2010
  • Problems in feeding habits could affect various aspects of children including growth, learning, communication, interaction with other children, etc. Oral consumption was defined as a participant opening his/her mouth, accepting food/liquid, and swallowing. A goal of the study is to find a method of evaluation and intervention of a child's feeding habits. Feeding is an important component in the early development of children and may have later consequences in the child's ability to participate successfully in their activities of daily life. Children show personal difference on the foods which they try first because stimuli from the foods are revealed as a mealtime behavior through sensory registration and processing. Feeding problems in sensory processing consist of tactile oversensitivity, oral refusal, tactile undersensitivity, and oral dyspraxia. In order to identify problems of sensory processing among feeding difficulties and plan intervention, the understanding of neurological processing and sensory processing characteristics related to feeding is necessary. Reviewing intervention for feeding problems related to sensory processing is required for an effective approach for feeding and providing better life for children.

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