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Effects of Abdominal Meridian Massage with Aroma Oils on Relief of Constipation in Institutionalized Children with Cerebral Palsy (향 요법 복부 경락마사지가 뇌성마비 아동의 변비완화에 미치는 효과)

  • Kim, Tae-Im;Nam, Mi-Jung
    • Child Health Nursing Research
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    • v.13 no.1
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    • pp.90-101
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    • 2007
  • Purpose: To evaluate the effects of abdominal meridian massage either with the use of aroma oils or without using the oils for the relief of constipation in institutionalized children with cerebral palsy. Method: Using a nonequivalent control group pretest-posttest design, 40 children were randomly assigned to experimental (n=21) and control (n=19) groups. The experimental group received abdominal meridian massage with mixture of aroma oils, and the control group received abdominal meridian massage only. Prior to the intervention, baseline data were collected, and then abdominal meridian massage with or without aroma oils were given to both groups every morning for 15 minutes a day, six days a week, for 2 weeks. Outcome measures were number of bowel movements, amount of stool (gm), and frequency of laxatives, suppositories or enema. Using SPSS/Win 12.0 program, data were analyzed by $X^2$ test, t-test, and repeated measures ANOVA. Results: Children in the experimental group defecated a larger volume of stool, and used fewer laxatives than those in the control group. The treatment effects lasted for 1 week after treatment. Conclusion: Abdominal meridian massage with aroma oils appears to be an effective adjunct maneuver in relieving constipation among institutionalized children with cerebral palsy.

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Right Bochdalek hernia with pneumothorax in adult (성인에서 기흉을 동반한 우측의 Bochdalek Hernia 1)

  • 백광제
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.729-734
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    • 1984
  • Bochdalek hernia is a type of congenital diaphragmatic defect in the posterolateral portion of the diaphragm. The defect is usually Lt. sided due to protective effect of liver on right. Sex distribution is male preponderance [2:1] and it is diagnosed during neonate, mostly first 24 hours, due to severe respiratory distress. We experienced a rare case of old aged female patient with congenital Bochdalek hernia on Rt. side which was found incidentally during treatment of spontaneous pneumothorax of Rt. side. 17 year old female patient was admitted to CS department for chest discomfort on right and mild dyspnea with duration of 20 days. Under the diagnosis of spontaneous pneumothorax, Rt. closed thoracostomy and underwater sealed drainage with continuous suction was applied. On follow-up chest x-ray, poorly defined hazy increased density with multiple air-fluid levels in Rt. lower lung field and Lt. subphrenic free air were noted. So, Barium enema was done under the impression of Rt. diaphragmatic hernia, and nearly entire colon proximal to sigmoid was demonstrated in the Rt. hemithorax. Operation was done-for surgical repair of defected diaphragm through Rt. posterolateral thoracotomy. Operative findings were as follows; 1.Hypoplastic Rt. lung, esp. RML & RLL. 2.Nearly entirely intestines were herniated. 3.Diaphragmatic defect was located on posterolateral portion of the diaphragm, about 10x3cm in size with blunt smooth margin. 4.A large bleb on apex of RUL of lung. Herniated intestines were repaired into abdominal cavity manually and defect of diaphragm was repaired with No. I black silk interrupted sutures directly, and bleb was resected. Postoperative courses were uneventful and the patient was discharged with good condition on POD 14th.

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Traumatic Diaphragmatic Hernia: A Report of 3 Cases (외상성 횡격막 헤르니아: 3례 수술 보고)

  • 유세영
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.59-64
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    • 1969
  • Three cases of traumatic diaphragmatic hernia were repaired in this department from June 1967 to Nov.1968. The first case, a 14 year old girl, was diagnosed as diaphragmatic hernia during the operation of the diffuse peritonitis from jejunaI perforation 3 days after the traffic accident at local clinic and she was transfered to this hospital after the closure of the perforated jejunum. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture at the posterolateral portion of the left diaphragm was repaired with two layer sutures by transthoracic approach. The second case. a 26 year old man. was diagnosed immediately after the traffic accident at local clinic and transfered to this hospital 24 hours later. Herniated and distended stomach, transverse colon and jejunum were repositioned and the large diaphragmatic rupture, about 9 cm in length, from the posterolateral portion to the base of the pericardium was directly repaired with two layer sutures. The third case, a 26 year old man, who had a history of stab wound at left lower lateral chest two years ago,was admitted with the sudden onset of abdominal pain and vomiting. The diaphragmatic hernia was confirmed with barium enema. The herniated stomach and transverse colon through the defect, about 3.5 cm in diameter, at anterolateral portion of the left diaphragm, were repositioned and the defect was repaired with two layer sutures. All of the cases recovered uneventfully.

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The Influences of Critical Thinking Ability, Communication Skills, Leadership, and Professionalism on Clinical Practice Ability in Nursing Students (간호학생의 비판적 사고능력, 의사소통능력, 리더십, 전문직관이 임상실무능력에 미치는 영향)

  • Lee, Jia;Jang, Mi Heui
    • Journal of East-West Nursing Research
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    • v.23 no.2
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    • pp.124-133
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    • 2017
  • Purpose: The purpose of this study was to identify factors that affect nursing students' clinical practice ability. Methods: The data were collected from 303 nursing students who had more than 500 hours of experience in clinical practicum at 4 universities in Seoul and the metropolitan area. The instruments consisted of 27 items of critical thinking, 19 items of professionalism, 40 items of self reported leadership, 20 items of communication evaluation tool, and 61 items of nursing practice performance evaluation. Results: For the clinical practicum, most difficult for nursing students were cardiopulmonary resuscitation, fecal enema, stoma care, and blood transfusion. Clinical practice abilities were positively correlated with nursing professionalism(r=.26, p<.001), leadership (r=.16, p=.007) and critical thinking(r=.12, p=.031). Professionalism(${\beta}=.32$, p=.001) was the most significant factor influencing the clinical practice ability of nursing students. Critical thinking was the second largest factor but not significant(${\beta}=.16$, p=.058). Conclusion: The findings suggest that the nursing curriculum should include nursing knowledge and nursing skills as well as various case-based or field-based decision making training programs to cultivate professionalism, critical thinking and other abilities for clinical practice.

The Effect of Meridian Acupressure on Constipation in the Bed-ridden Aged with Stroke (경혈지압이 뇌졸중 와상노인 환자의 변비완화에 미치는 효과)

  • Jung, Young-Hoe;Jun, Jum-Yi
    • Korean Journal of Adult Nursing
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    • v.20 no.4
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    • pp.664-673
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    • 2008
  • Purpose: The purpose of this study was to identify the effect of meridian acupressure on constipation in bed-ridden aged inpatients. Methods: The research design was a non-synchronized non-equivalent control group pretest-posttest design. The subjects consisted of 28 bed-ridden aged inpatients. Meridian acupressure was administered to the experimental group at 30 minutes before breakfast every morning for two weeks. Each meridian was pressured for 10 seconds, 10 times. The frequency of defecation and stool form were examined every day. The data was analyzed by the $x^2$-test, Fisher's exact test, t-test and repeated measures ANOVA. Results: The experimental group given Meridian Acupressure had a higher frequency of defecation(F = 59.372, p = .000) and normal stool(F = 46.046, p = .000) than the control group. Conclusion: The results suggest that Meridian Acupressure was an effective method for the relief of constipation for bed-ridden aged inpatients. A follow -up research is needed to validate that other patients with constipation can use the Meridian Acupressure as a non-invasive nursing intervention instead of a laxative or enema.

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Perceived Confidence in Practice of Core Basic Nursing Skills of New Graduate Nurses (신규졸업간호사가 지각한 핵심기본간호술 수행 자신감)

  • Kim, Yeon-Ha;Hwang, Seon Young;Lee, Ae-Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.20 no.1
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    • pp.37-46
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    • 2014
  • Purpose: This study was to measure and identify the differences of perceived confidence in practice of core basic nursing skills performed by new graduate nurses in Korea. Methods: The tool used in this study was a questionnaire for measuring the confidence in 20 items of core basic nursing skills which was structured based on Korean Accreditation Board of Nursing Education tool. 231 new graduate nurses participated in this study. The reliability of this questionnaire had Cronbach's ${\alpha}$ .918. Results: Subjects who experienced simulation education and standard patient education were 86.6% and 35.9%, respectively. Item enema intervention, tracheostomy care, and blood transfusion showed low practice confidence level. These items showed significant differences on whether the subjects experienced simulation and clinical practicum or not. Conclusion: Developing and managing clinical education program under deep cooperation between practicum agency and clinical instructor are needed. Simulation practicum will complement insufficient core basic nursing skills between newly graduated nurses before they allocate at the clinical department.

Clinical Features of the Midgut Volvulus in Children (소아 중장 염전의 임상 양상)

  • Kim, Hyun-Ah;Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.10 no.2
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    • pp.112-116
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    • 2004
  • Midgut volvulus secondary to intestinal malrotation usually presents within the first month of life. Diagnostic delay may result in midgut infarction and mortality. In this retrospective study, we review seventeen cases of midgut volvulus to assess the importance of early recognition for midgut volvulus in pediatric patients of any age.. These patients were diagnosed as having a midgut volvulus by operation at Ewha Womans University Hospital. Eleven patients (64.7 %) were less than 1 month of age, and fifteen were boys (88.2 %). The mean gestational age was 38.3 weeks and the birth weight was 3.1 kg. Eight patients (47.1 %) had one or more combined anomalies such as heart malformation, brain ischemia, Down's syndrome or duodenal atresia. Vomiting was the most common symptom. Only thirteen patients underwent preoperative diagnostic procedures; 13 abdominal sonography demonstrated the whirlpool sign in 8 patients, upper gastrointestinal tract roentgenography showed a cork-screw pattern in 7 patients, and barium enema or small bowel series demonstrated positive findings in 7 patients. A Ladd's procedure was was formed on all patients.. There was no mortality or severe morbidity such as short bowel syndrome. Midgut volvulus should be included in the differential diagnosis in any infant or child who presents with the symptoms of acute abdomen, especially with vomiting.

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Failure of Fecal Microbiota Transplantation in a Three-Year-Old Child with Severe Refractory Ulcerative Colitis

  • Kumagai, Hideki;Yokoyama, Koji;Imagawa, Tomoyuki;Inoue, Shun;Tulyeu, Janyerkye;Tanaka, Mamoru;Yamagata, Takanori
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.214-220
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    • 2016
  • Fecal microbiota transplantation (FMT) is a treatment designed to correct gut dysbiosis by administration of feces from a healthy volunteer. It is still unclear whether FMT for children with ulcerative colitis (UC) is effective or hazardous. Here we describe a young patient to have received FMT for UC. A three-year-old girl was admitted to our hospital with severe active UC, and treated with aminosalicylates and various immunosuppressive drugs. As remission was not achieved, we decided to try FMT before colectomy. We administered donor fecal material a total of six times by retention enema (${\times}2$) and via a nasoduodenal tube (${\times}4$) within 10 days. The patient developed abdominal pain and pyrexia after each FMT session. Analyses revealed the transferred donor fecal microbiota had not been retained by the patient, who ultimately underwent colectomy. The severity of the UC and/or timing of FMT may have partly accounted for the poor outcome.

Neonatal Intestinal Pseudo-obstruction Associated with Deficiency of the Interstitial Cells of Cajal in a Premature Infant (카할세포 결핍과 연관된 미숙아 가성 장폐쇄 1례)

  • Lee, Soo-Jung;Lee, Woo-Ryoung
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.196-199
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    • 2008
  • The interstitial cells of Cajal are the pacemakers in the gastrointestinal tract that modulate gastrointestinal motility. A case of a neonate with intestinal pseudo-obstruction caused by a decreased number of the interstitial cells of Cajal is presented. A premature male infant born at 32 weeks of gestation showed progressive abdominal distention beginning 3 days after initiation of enteral feeding at 15 days of life. No etiologic factors were identified on radiologic studies, a gastrographin enema, and an intestinal biopsy other than a markedly decreased number of the intestinal cells of Cajal. An ileostomy, followed by repair of the ileostomy was done, which resulted in but a limited improvement of the abdominal gas pattern. Respiratory distress, pancytopenia, and abdominal distention persisted, and the infant expired on 142 days of life.

Effects of Hands Moxibustion Therapy and Hand Press Pellet on Decreasing Constipation among Homebound Elders (수지 뜸요법과 압봉 자극법이 재가노인의 변비 완화에 미치는 효과)

  • An, Youn-Hye;Kim, Yeong-Kyeong
    • Korean Journal of Adult Nursing
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    • v.24 no.2
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    • pp.109-118
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    • 2012
  • Purpose: This study was conducted to contribute on nursing practice for elderly people by identifying the effects of hand moxibustion and hand press pellet therapy on the alleviation of constipation. Methods: The data were collected from October to November, 2009, and the subjects included 39 elders (experimental group: 20, control group: 19) from a senior citizens center in B City who reported constipation. Experimental group received an intervention of hand moxibustion and hand press pellet therapy three times a week for six weeks (total: 18 times). Data about the number of defecations per week and constipation degree scores were collected one week after each treatment. Results: 1. The number of defecation in the experimental group were different from that of the control group (F=228.26, $p$ <.001). 2. The degree of reported constipation in the experimental group differed from the control group (F=170.59, $p$ <.001). Conclusion: Hand moxibustion and hand press pellet therapy was shown to be effective in alleviating the constipation of elderly people by increasing the number of defecation per week and reducing the constipation degree scores. These two interventions can thus be used for alleviating the constipation of elderly people, replacing the stool softener and enema.