• 제목/요약/키워드: long-term care center

검색결과 322건 처리시간 0.031초

정맥주입 전문간호사가 삽입한 말초삽입형 중심정맥관(PICC) 사용 결과에 대한 후향적 분석 (Analysis of PICC Inserted Patient Data in a Hospital by IV CNS-Driven Intervention)

  • 박정윤;박광옥;백미경;김세라;권혜리;양수진
    • Journal of Korean Biological Nursing Science
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    • 제6권1호
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    • pp.33-42
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    • 2004
  • Background : Intravenous(IV) access is becoming an increasingly important part of health care today. The current drive for clinical effectiveness and cost-effective health care serves to increase the need for reliable vascular access. Venous access devices were developed to overcome problems associated with limited peripheral access and frequent venipuncture in patients with long-term therapy. Although the peripherally inserted central catheter(PICC) have become popular during recent years in USA, its procedure is rare in Korea. Purpose : The goal of this study was to analyze the PICC inserted patient data by IV CNS intervention. Method : A Total of 62 PICCs were inserted into 51 patients by the IV CNS during a 10-month period form November, 14, 2002, to October 2, 2002. Data was obtained retrospectively through chart review. Result : The patient population included 34(54.8%) men and 28(45.2%) women, with a mean age 50.6 years. The main indication for PICC placement was to access vein in poor peripheral venous status(40.3%). The mean served interval for PICC insertions was 16.7 days(range, $2{\sim}61$ days). The reasons for removal were completed therapy in 18 cases(29.0%), patient death in 13 cases(21.0%), and mechanical or functional PICC problem in 10cases(16.1%). The three PICCs removed for presumed infection, and one had only positive tip cultures(0.2%). Conclusion : PICCs are rapidly growing popularity and required an extended course of IV therapy.

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Chronological Changes in Quality of Life after Distal Gastrectomy for Gastric Cancer

  • Park, Ki Bum;Lee, Seung Soo;Kwon, Oh Kyoung;Chung, Ho Young;Yu, Wansik
    • Journal of Gastric Cancer
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    • 제17권2호
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    • pp.110-119
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    • 2017
  • Purpose: Patient quality of life (QoL) may be severely disrupted following distal gastrectomy for gastric cancer. This issue should be addressed to improve postoperative care. Materials and Methods: QoL data from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and its gastric cancer-specific module, were administered to 202 patients preoperatively, and 5 years postoperatively. Patients were classified into subgroups based on their answers to each questionnaire item: group I (good), answering "not at all"; group II (fair), answering "a little"; group III (poor), answering "quite a bit" or "very much." Results: At 5 years post-operation, the proportion of patients in group III on the functional scales ranged from 4.3% to 5.7%. The proportions of patients in group III with fatigue, insomnia, diarrhea, and financial difficulties were 8.9%, 9.0%, 11.5%, and 9.1%, respectively. The proportions of patients in group III with anxiety, dry mouth, body image concerns, and hair loss were 12.8%, 10.5%, 9.9%, and 12.6%, respectively. These proportions were less than 5% for other QoL symptom scales/items and for the gastric cancer-specific module. Conclusions: Most patients reported good or fair QoL following surgery. However, symptom management of fatigue, insomnia, diarrhea, anxiety, dry mouth, body image, and hair loss should be specifically targeted for long-term patient care in approximately 10% of patients.

Efficacy and Safety of Dexmedetomidine for Postoperative Delirium in Adult Cardiac Surgery on Cardiopulmonary Bypass

  • Park, Jae Bum;Bang, Seung Ho;Chee, Hyun Keun;Kim, Jun Seok;Lee, Song Am;Shin, Je Kyoun
    • Journal of Chest Surgery
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    • 제47권3호
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    • pp.249-254
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    • 2014
  • Background: Delirium after cardiac surgery is associated with serious long-term negative outcomes and high costs. The aim of this study is to evaluate neurobehavioral, hemodynamic, and sedative characteristics of dexmedetomidine, compared with the current postoperative sedative protocol (remifentanil) in patients undergoing open heart surgery with cardiopulmonary bypass (CPB). Methods: One hundred and forty two eligible patients who underwent cardiac surgery on CPB between April 2012 and March 2013 were randomly divided into two groups. Patients received either dexmedetomidine (range, 0.2 to $0.8\;{\mu}g/kg/hr$; n=67) or remifentanil (range, 1,000 to $2,500\;{\mu}g/hr$, n=75). The primary end point was the prevalence of delirium estimated daily via the confusion assessment method for intensive care. Results: When the delirium incidence was compared with the dexmedetomidine group (6 of 67 patients, 8.96%) and the remifentanil group (17 of 75 patients, 22.67%) it was found to be significantly less in the dexmedetomidine group (p<0.05). There were no statistically significant differences between two groups in the extubation time, ICU stay, total hospital stay, and other postoperative complications including hemodynamic side effects. Conclusion: This preliminary study suggests that dexmedetomidine as a postoperative sedative agent is associated with significantly lower rates of delirium after cardiac surgery.

일부 보건소 모자보건실 연계 비외과적 치주처치 중심의 치위생관리 프로그램 운영 사례연구 (Case study on Dental Hygiene Care Program with the Focus on Non-surgical Periodontal Treatments with the Maternal and Child Health Center)

  • 손정희;김상희;배수명
    • 한국콘텐츠학회논문지
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    • 제19권2호
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    • pp.269-276
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    • 2019
  • 본 연구는 제천시보건소 모자보건실을 이용하는 임산부를 대상으로 비외과적 치주처치 중심의 치위생관리 프로그램을 시범운영하고, 시범운영의 구조평가, 과정평가, 결과평가를 통하여 보건소에서 치과위생사가 지역사회 임산부를 대상으로 구강건강증진 프로그램을 운영하는데 기초자료로 제공하기 위해 수행되었다. 총 3회의 치위생관리 프로그램에 모두 참여한 9명의 임산부를 대상으로 하였다. 치위생관리 프로그램 결과 4mm 이상 치주낭 보유율은 40.4%에서 14.0%로(p<0.05), 치은출혈 치아 보유율은 4.6%에서 2.7%로(p=0.180), 치석형성 치아 보유율은 23.7%에서 0%로(p<0.05) 감소하였다. PHP Index(Patient Hygiene Performance index)는 2기 임산부의 경우 1차 1.7점에서 3차 1.4점으로 개선되었고, 3기 임산부의 경우 1차 2.4점에서 1.3점으로 개선되었다(p<0.05). 본 연구 결과 비외과적 치주처치 중심의 치위생관리 프로그램을 보건소 구강보건실에서 적용 및 확대할 수 있는 가능성이 높다는 것에 의의가 있으며, 향후 본 프로그램의 장기적인 운영과 지속적인 모니터링이 필요할 것으로 사료된다.

Prognosis of Pulmonary Function in Patients with Multiple Rib Fractures

  • Park, Hee Beom;Hyun, Sung Youl;Kim, Jin Joo;Jang, Yeon Sik
    • Journal of Trauma and Injury
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    • 제30권4호
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    • pp.179-185
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    • 2017
  • Purpose: Rib fracture is the most common complication of blunt thoracic trauma. We investigated the effect of rib fracture on pulmonary function in the conservatively treated patients. Methods: From January 2000 to February 2017, we reviewed the records of 72 patients with rib fracture and pulmonary function tests were performed. According to the number of rib fractures, patients were classified into two groups: less than six fractured ribs (group A) and more than six fractured ribs (group B). The groups were compared concerning demographics, underlying diseases, associated thoracic injuries, surgery, mechanical ventilator times, days spent in the intensive care unit and pulmonary function test. Results: There were no statistically significant differences in the demographic data between the two groups. Mean hospitalization was 13.5 days in group A and 27.0 days in group B (p<0.001). There was no statistically significant difference between the two groups in the pulmonary function test. Conclusions: We conclude that pulmonary function is restored by conservative treatment in patients with rib fractures even if the number of rib fractures increases. In patients with multiple rib fractures, studies comparing open rib fixation and conservative treatment of long term pulmonary function are required.

경증치매노인과 가족의 VR 활용도 분석 (Analysis of VR Usability of MCI People and Family)

  • 한정원
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2022년도 추계학술대회
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    • pp.523-525
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    • 2022
  • 현재 경증치매노인은 노인장기요양보험법에 의해 치매안심센터나 지역의 주간보호센터에서 인지프로그램을 제공받을 수 있지만, 인지프로그램 운영에 대한 명확한 정의나 지침은 미비한 상황이다. 최근 VR에 대한 관심도가 높아지면서 다양한 노인복지시설에서 VR을 활용한 프로그램을 시도하고 있지만 신기술에 대한 친밀도나 활용도에 대한 분석이 많지 않은 편이다. 따라서 본 논문에서는 노인주간보호센터에서 경증치매노인을 대상으로 VR 활용도를 조사하고 분석하였다. 활용도는 친밀도와 활용가능성으로 나누어 조사하였고, 친밀도화 활용도 모두 높은 편으로 분석되어, 향후 경증치매노인을 대상으로 VR 인지프로그램 개발이 필요함을 알 수 있었다.

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한국 보건진료원 제도의 시작 (Beginnings of the Community Health Practitioner (CHP) System in Republic of Korea)

  • 이꽃메
    • 한국농촌간호학회지
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    • 제4권1호
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    • pp.31-40
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    • 2009
  • Purpose: This research was done do identify and analyze the beginnings of the community health practitioner system in the Republic of Korea (ROK) around 1980. Method: Primary sources were collected and analyzed, mainly newspapers around 1980, the act for health service for rural areas, and other relative publications. Results: The government of the ROK was trying to solve the problem of doctorless villages and regarded the introduction of primary health care (PHC) services using registered nurses (RNs) to be an economic solution to this problem. The Korean Nurses' Association presented 'a plan for community health service' to the government party and medical association in 1976. In this plan, RNs would provide primary care at the sub-county (myun) level, and hospital would provide secondary care. The Korean Public Health Development Research Center was awarded the project 'RNs and nurse aids as CHP for primary care service and their training'. In 1977, 25 RNs began to work as PHC in 3 areas, and interim findings showed that RNs were very capable of doing PHC. The Ministry of Health and Welfare announced long term plans for health and welfare administration including a tertiary health care delivery system. RNs after training were posted to rural areas with no medical services to do medical treatment for mild cases. The Act for health services for rural areas was enacted on December 31, 1980. Enforcement Ordinance and Enforcement Regulations were enacted in 1981. In 1981, 257 CHP were selected, trained, and deployed. In 1983, the president of the ROK announced continuation of the CHP system for residents of medically vulnerable areas. The number of CHP increased from 257 in 1981 to 2038 in 1989.

여성의 피부미용 교육이 건강생활습관 개선에 미치는 영향 -관련 교육 수강생을 중심으로- (The Affection on Improvement of Healthy Life habit toward Skin Care Education for Women -Trainee on Related Education Center-)

  • 김문주
    • 한국산학기술학회논문지
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    • 제13권8호
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    • pp.3452-3459
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    • 2012
  • 본 논문은 피부미용을 공부하고 있는 평생교육원 및 문화센터의 여성 수강자를 대상으로 피부 미용과 건강 전반에 걸친 영향 정도를 교육시키고, 이들이 피부 미용 교육을 통해 그들의 건강 생활습관측면, 특히 생활습관, 운동, 영양을 중심으로 어떤 변화가 있는지 살펴 보고자 한다. 본 연구를 위해 2011년 현재 서울 및 경기도에 위치한 대학 및 문화센터에서 피부미용 관련 과목을 수강하는 여성들을 모집단으로 설정하였으며, 경기도 소재 A,D 대학, H 학원, 서울 소재 M 대학에서 피부 미용 과정 이수자 343명을 실제 분석에 이용하였다. 연구 결과 첫째, 피부미용 수강 전후와 건강생활습관 특성의 관계에서 부분적으로 차이를 보였는데, 피부 미용 수강을 한 후 수강자들은 수강하기 전에 비해 수면 습관 및 스트레스 관리가 잘 되고 있는 것으로 나타났다. 둘째, 피부 미용 수강 기간과 건강생활 습관 특성과의 관계에서 긴 시간 동안 피부 미용 교육을 받은 군에서 수면 습관 및 스트레스 관리를 잘 하고 있는 것으로 나타났고, 운동에 있어서도 운동 여부, 강도 시간, 유산소 운동을 더욱 많이 하고 있으며, 영양 면에서도 식사 분배, 칼로리 섭취 제한, 식이 섬유 등을 더욱 많이 섭취하는 것으로 나타났다. 셋째, 피부미용 수강정도와 건강생활 습관 특성의 관계에서 부분적으로 차이를 보였는데, 생활 습관 관리 면, 운동면에서 유의한 차이를 보였다. 넷째, 피부미용 수강 빈도와 건강생활 습관 특성의 관계에서는 피부미용 수강을 보다 자주 수강하는 군에서 스트레스 관리를 더욱 잘 하고 있었고, 운동에서도 유의한 차이를 보였다. 이러한 결과를 통해 여성들의 피부미용 강좌는 수강자들에게 건강에 대한 관심을 높여 주었고, 전반적인 건강생활습관에 큰 영향을 주는 것으로 보여진다. 따라서 여성들이 평소 관심을 가지고 있는 피부미용과 건강을 접목한 프로그램 개발을 통해 여성들의 전반적인 건강 관리 습관을 개선시킬 수 있고, 이를 통해 한 가정의 건강관리 습관에 주도적인 역할을 하는 여성들의 올바른 건강 관리 행태 확립을 통해 국민 건강에 일조 할 수 있는 토대를 마련할 수 있을 것으로 생각된다.

The Effects of Simultaneous Pulmonary Rehabilitation during Thoracic Radiotherapy in the Treatment of Malignant Diseases

  • Choi, Myeong Geun;Lee, Hyang Yi;Song, Si Yeol;Kim, Su Ssan;Lee, Seung Hak;Kim, Won;Choi, Chang-Min;Lee, Sei Won
    • Tuberculosis and Respiratory Diseases
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    • 제84권2호
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    • pp.148-158
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    • 2021
  • Background: Radiotherapy is a common treatment option for lung or esophageal cancer, particularly when surgery is not feasible for patients with poor lung function. However, radiotherapy can affect pulmonary function and thereby induce pneumonitis or pneumonia, which can be fatal in patients with respiratory impairment. The purpose of this study is to evaluate if reductions in pulmonary function after radiotherapy can be minimized through simultaneous pulmonary rehabilitation (PR). Methods: In this matched case control study, we retrospectively analyzed patients who had undergone radiotherapy for thoracic malignant disease between January 2018 and June 2019. We analyzed results from pulmonary function tests and 6-minute walking tests (6MWT) conducted within the six months before and after radiotherapy treatment. Results: In total, results from 144 patients were analyzed, with 11 of the patients receiving PR and radiotherapy simultaneously. Of the 133 patients in the control group, 33 were matched with 11 patients in the PR group. Changes in forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity were significantly different between the PR group and the matched control group (240 mL vs. -10 mL, p=0.017 and 5.5% vs. 1.0%, p=0.038, respectively). The median distance of 6MWT in the PR group also increased significantly, from 407.5 m to 493.0 m after radiotherapy (p=0.017). Conclusion: Simultaneous PR improved pulmonary function, particularly in measures of FEV1, and exercise capacity for patients with lung or esophageal cancer even after radiotherapy treatment. These findings may provide an important base of knowledge for further large population studies with long-term follow-up analysis in the identification of the PR's effects during thoracic radiotherapy.

초등학생에서 한의학적 치료를 접목한 시력증진 프로그램의 효과 분석 (An Analysis of Effects on Vision Care Program Including Traditional Korean Treatment for Elementary School Students)

  • 김창훈;안종민;김소희;설종소;김효진;박지현
    • 대한한의학회지
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    • 제32권2호
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    • pp.92-101
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    • 2011
  • Purpose: To evaluate the effects on vision care program including traditional Korean treatment for elementary school students. Methods: 172 eyes of eighty-six older elementary students underwent a vision care program, including traditional Korean treatment, for 3 months between March 2010 and June 2010. The vision care program included health education, such as lifestyle modification, vision strengthening exercises and a course of treatment with traditional Korean methods. Traditional Korean treatment covered periocular acupuncture point stimulation, periauricular acupuncture point stimulation and herbal drug therapy. All patients were examined for visual acuity and auto-refraction and filled out a satisfactory questionnaire about ocular discomforts and quality of life before and after treatments. Results: Patients with mild myopia (-0.75~-2.00) were 61 (35.5%), and 46 (26.7%) were emetropia (${\pm}0.50$ or less). After treatment, uncorrected visual acuity in both eyes was $0.77{\pm}0.46$, which was lower than that before treatment ($0.82{\pm}0.51$), but corrected visual acuity was $0.98{\pm}0.21$, which was higher than that before treatment ($0.93{\pm}0.28 $). About the refractive change, the emetropia group showed a slightly myopic shift while the mild myopia group intended to reduce the myopic error. However, this was not statistically significant. The scales of eyeball pain or discomfort decreased significantly from $17.59{\pm}22.5$ before treatment to $10.28{\pm}17.80$ after treatment, and the scales of the quality of life increased from $1.85{\pm}1.25$ before treatment to $2.25{\pm}1.30$ after treatment. Most patients (90.7%) were satisfied with their treatment results. Conclusions: The vision care program including traditional Korean treatment for elementary school students was effective to improve corrected visual acuity in both eyes and delay the progression of school myopia. In addition, it helped to reduce eyeball pain and discomfort and ultimately to enhance quality of life. Long-term follow-up studies will be needed.