• 제목/요약/키워드: long-term care center

검색결과 322건 처리시간 0.027초

호흡부전환자의 재택산소치료 실태: 한 대학병원에서의 관찰 (Long-term oxygen therapy in patients with chronic respiratory failure in one university hospital)

  • 허진원;이정연;홍상범;오연목;심태선;임채만;이상도;김우성;김동순;김원동;고윤석
    • Tuberculosis and Respiratory Diseases
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    • 제58권2호
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    • pp.160-166
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    • 2005
  • 연구배경 : 최근 국내에서도 만성폐질환을 가진 저산소증 환자에게 재택산소요법이 증가하고 있으나 그 실태는 잘 알려져 있지 않다. 이에 한 대학병원 호흡기내과에서 재택산소요법을 처방 받은 환자들의 실태를 알아보고자 하였다. 방 법 : 2000년 1월부터 2003년 8월까지 서울아산병원 호흡기내과에서 재택산소요법을 처방 받은 환자들을 대상으로 의무기록 검토와 설문조사를 시행하였다. 산소를 중단한 4명의 환자는 제외하였다. 결 과 : 총 86명의 환자가 산소요법을 처방받았고, 2000년 이후로 매년 빈도가 증가되는 추세였다.남/녀비는 52/34명, 평균연령은 61.3세였다. 환자들의 기저질환으로 만성폐쇄성폐질환 29명, 결핵파괴폐 18명, 기관지확장증 15명, 간질성폐질환 12명, 척추후측만증 7명 등으로 다양한 질환을 보였다. 산소 처방 당시 평균 53명의 폐기능 소견은 $FEV_1/FVC$$58.4{\pm}25.2%$, FVC $54.5{\pm}17.1$ (% pred.), $FEV_1$ $41.7{\pm}20.6$ (% pred.)로 측정되었다. 산소요법은 1.5 L/min에서 시작하여 평균 14.5시간 동안 사용하였다. 산소 처방 당시 동맥혈 산소농도는 77.7 mm Hg, 동맥혈 이산화탄소농도는 49.6 mm Hg 정도로 조절하였다. 전체 환자 중에서 가정간호사 방문이나 맥박산소측정기로 집에서 산소포화도를 모니터링 하는 경우는 16.5%에 불과하였고 대부분의 환자는 외래 방문시 시행하는 동맥혈가스분석이나 증상에 따라 산소량을 조절하였다. 재택산소치료를 하는 환자들의 3년 생존율은 56%였고 고탄산혈증을 가지는 환자에서 더 좋은 예후를 보였다. 결 론 : 재택산소치료는 다양한 폐질환 환자에게 시행되고 있고, 점차 빈도도 증가하고 있어 효율적인 관리 체계의 확립을 위한 보험제도의 개선이 필요할 것으로 사료된다.

Telemetry를 통합한 재택 진료시스템의 개발 (Development of Home-care Medical Information System integrating Telemetry)

  • 함지훈;지영준;임상현;박광석
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 춘계학술대회
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    • pp.295-298
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    • 1997
  • We developed the system that enables patients to be treated at home during their daily life through digital telemetry and public communication line. This system records and transfers ECG signals through wireless digital telemetry unhindering the patient's normal activities in long-term recording, and transmits the processed data, which enables real-time remote examination via ISDN phone line. Patient's image, voice, and transmitted signals are transferred to medical experts in remote medical center interactively.

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비뇨기 암으로 인한 남성 외성기 림프부종의 물리치료 -사례연구- (Physical Therapy of Male External Genitalia Lymphedema from Urological Cancer -Case Report-)

  • 소운영;김성중
    • The Journal of Korean Physical Therapy
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    • 제21권4호
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    • pp.103-109
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    • 2009
  • Purpose: Cases of male external genitalia lymphedema are relatively uncommon in the clinical physical therapy field. Of more than two thousand clinical cases treated by the author in the lymphedema treatment center, only 4~5 cases of male external genitalia lymphedema were encountered. The present case report presents the experience and treatment results of male external genitalia lymphedema from urological cancer. Method: This case was a 47-year-old man, who was treated with complex decongestive physical therapy consisting of manual lymph drainage, compression bandage (including the external genitalia), remedial exercise, skin care. Result: The results were relatively good. The clinical experience would suggest that early treatment and education can reduce the external genitalia lymphedema. However, the treatment efficacy remains limited. Therefore, early treatment is vital for more successful outcomes. Conclusion: The relief of symptoms and a decrease in male external genitalia lymphedema may be the best result from long-term conservative management.

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Sacrococcygeal Teratoma : A Tumor at the Center of Embryogenesis

  • Phi, Ji Hoon
    • Journal of Korean Neurosurgical Society
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    • 제64권3호
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    • pp.406-413
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    • 2021
  • Sacrococcygeal teratoma (SCT) is an extragonadal germ cell tumor (GCT) that develops in the fetal and neonatal periods. SCT is a type I GCT in which only teratoma and yolk sac tumors arise from extragonadal sites. SCT is the most common type I GCT and is believed to originate through epigenetic reprogramming of early primordial germ cells migrating from the yolk sac to the gonadal ridges. Fetal SCT diagnosed in utero presents many obstetrical problems. For high-risk fetuses, fetal interventions (devascularization and debulking) are under development. Most patients with SCT are operated on after birth. Complete surgical resection is the key for tumor control, and the anatomical location of the tumor determines the surgical approaches. Incomplete resection and malignant histology are risk factors for recurrence. Approximately 10-15% of patients have a tumor recurrence, which is frequently of malignant histology. Long-term surveillance with monitoring of serum alpha fetoprotein and magnetic resonance imaging is required. Survivors of SCT may suffer anorectal, urological, and sexual sequelae later in their life, and comprehensive evaluation and care are required.

노인장기요양보험제도에 관한 치과위생사의 인지도 (Dental Hygienists' Awareness of Long-term Senior Care Insurance System)

  • 김지현;황지민;박용덕
    • 치위생과학회지
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    • 제10권1호
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    • pp.39-44
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    • 2010
  • 본 연구는 노인장기요양보험제도의 방문간호 중에서 치과위생사의 업무인 방문구강위생이 포함되어있으므로 치과위생사의 인지도를 파악하고자 2009년 1월부터 4월까지지 서울특별시, 인천광역시, 경기도의 치과병 의원에서 근무하는 치과위생사 259명을 대상으로 설문조사를 실시하였으며, 주요한 연구 결과는 다음과 같다. 1. 노인장기요양보험제도에서 치과위생사의 방문구강위생업무 중 중요한 업무순위에 대해 1순위가 '관리적, 예방적 처치 영역', 2순위는 '구강보건교육 영역'으로 나타났다. 구강보건교육 영역 중에서 중요한 교육분야는 '잇솔질'이 79.9%로 현저히 높게 나타났으며, 예방적 처치 영역 중에서도 '잇솔질 실행'이 64.5%로 가장 높게 나타났다. 2. 치과위생사가 방문구강위생업무를 하기위해 치과의사의 지시서가 필요한 것에 대한 인지여부에서 38.2%가 '예', 61.8%가 '아니오'라고 응답하였다. '예'라고 응답한 치과위생사 중 근무경력이 '1년 이상-4년 미만'인 치과위생사가 치과의사의 지시서 필요에 대해 인지하고 있는 비율이 13.9%로 가장 높게 나타났다(p<0.05). 3. 치과위생사가 노인장기요양소를 개설할 수 있는 것을 인지하고 있는 지에 대해 93.4%가 '아니오', 6.6%가 '예'라고 응답하였다. 학력에 따른 노인장기요양소 개설의향정도는 치과위생사의 학력이 '학사'인 경우가 3.48로 가장 높게 나타났다(p<0.001). 4. 노인장기요양보험제도의 인지정도에 대한 변수 중 '방문구강위생업무 시 치과의사의 지시서가 필요한 것에 대한 인지정도'와 '노인장기요양소 개설의향정도'와의 관계에서 음(-)의 상관관계(r=-0.300)를 보여주고 있으며, 통계적으로 유의한 차이를 보였다(p<0.01). 이상의 결과로 보아 노인장기요양보험제도의 수급자에게 구강위생업무를 제공해야할 치과위생사의 인지도가 낮으므로 노인장기요양보험제도에 대하여 치과위생사들에게 적극적인 홍보와 정기적인 교육을 통하여 인지도를 높여가야 할 것으로 사료된다.

요양보호사의 직업의식과 영향요인 (The Factors Influencing of Professional Consciousness of Long-term Care Workers)

  • 김향수;김희경;박연숙
    • 한국노년학
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    • 제31권3호
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    • pp.591-606
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    • 2011
  • 본 연구의 목적은 노인장기요양보험제도로 신설된 요양보호사의 직업의식 정도와 영향요인을 파악하여 요양보호사의 직업의식을 높이기 위한 간호중재 개발에 기초자료를 제공하는데 있다. 서술적 연구로써 D시, C도 G시, C도 C시, K도 O시에 소재하고 있는 요양원 3곳, 재가복지센터 3곳, 요양병원 3곳의 요양보호사 185명을 대상으로 2009년 11월 12일에서 4주 동안 설문지를 이용하여 자료수집 하였고, 서술적 통계, t-test, ANOVA, Pearson's correlation coefficients, Multiple regression으로 분석하였다. 연구결과, 요양보호사의 평균연령은 48.1세, 대다수 여성(95.1%)이며, 기혼자로서 배우자가 있고(79.5%), 고등학교 이상 졸업자(76.8%)가 많았다. 요양보호사의 자기효능 정도는 평균점수 3.68점, 소명의식 3.41점, 외적 통제위 성격 3.23점으로 보통 이상이며, 내적 통제위 성격은 4.12점으로 내적 통제위 성격이 강한 것으로, 교육훈련 유효성은 3.71점, 직업의식은 3.97점으로 다소 높은 것으로 나타났다. 직업의식과 관련 요인들의 관계에서, 직업의식과 내적 통제위 성격은 낮은 정 상관관계(r=.378, p=.000)를, 외적 통제위 성격은 낮은 역 상관관계(r=-.356, p=.000), 자기효능(r=.420, p=.000), 소명의식(r=.636, p=.000), 교육훈련 유효성(r=.441, p=.000)은 보통 정도의 정 상관관계를 보였다. 요양보호사의 직업의식에 영향을 미치는 요인으로는 소명의식(B=.329, p=.000)이 가장 높은 영향을 주는 것으로 나타났으며 교육훈련 유효성(B=.250, p=.000), 내적 통제위 성격(B=.216, p=.000), 외적 통제위 성격(B=-.165, p=.002), 요양보호사 선택시 자기 특성 고려(B=.207, p=.004) 순으로 전체 설명력은 57.5%로 나타났다. 추후 요양보호사에게 소명의식 제고 교육을 위한 체계적인 교육과 내적 통제위 성격 강화훈련, 요양보호사의 역할과 업무를 정확히 규명 하는 것이 필요하며 이러한 요인들을 활용하여 직업의식을 높일 수 있는 교육과 연구를 제언한다.

지역사회 거주 예비노인과 노인의 건강상태와 보완대체요법 사용정도 (Health Status and the Use of Complementary and Alternative Therapies in the Community Dwelling Pre-elderly and Elderly)

  • 정명실;임경춘
    • 재활간호학회지
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    • 제18권1호
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    • pp.46-56
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    • 2015
  • Purpose: The purpose of this study was to identify health status and the use of complementary and alternative therapies in the community dwelling pre-elderly and elderly. Methods: A total of 193 subjects participated in this study. They were recruited from one senior welfare center, four senior citizen centers and subjects' home in two cities. Data were collected with self-reported questionnaires to measure health status and the use of complementary and alternative therapies. Data were analyzed by t-test, ANOVA using SPSS/WIN 22.0. Results: Health status in this subjects was different depending on their age, sex, education, religion, type of family, and average monthly living expenses. Most used items as complementary and alternative medicine are diet therapy, herbal medicine such as health supplement food therapy, vitamin therapy, and Korean folk remedies. There were statistically significant differences in using complementary and alternative therapies according to one's current health status (F=7.09, p<.001), comparing health status to peers (F=3.67, p=.013), and chronic disease having more than three months (t=-2.50, p=.013). Conclusion: This study suggest that individualized health care should be continued for the pre-elderly and elderly. Moreover, we need to prepare long term care plans such as educations for applying complementary and alternative therapies.

보건진료소에서의 말기 암 환자 간호사례 (Case Report of Terminal Cancer Patient by Community Health Practitioner)

  • 정미경
    • 한국농촌간호학회지
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    • 제15권1호
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    • pp.30-40
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    • 2020
  • Purpose: This study was done to describe a community health practitioner's nursing case management for a terminal cancer patient registered in the public health post. Methods: For this purpose, data were collected through the patient and family through home visits, health clinic offices, and phone calls. The nursing process was carried out from August to November 2019. Results: The patient suffered the most from anorexia and lack of energy. Also he expressed psychologically uncertainty about disease and death anxiety caused by long-term treatment. In order to reduce the death anxiety, Community Health Practitioner (CHP) asked him to express his life stories and listened to him. CHP provided information of appropriate medications and alternative foods for symptoms such as gastrointestinal disorders and anorexia to the patient and family. Observing the situation of the patient and family, CHP guided the patient and family to prepare for death and has confirmed to them that the process was not with the patient alone. Conclusion: CHP's this experience has shown the possibility for CHP to help the terminal cancer patient and family to prepare peaceful death in their communities.

Tumor Immunology and Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer

  • Jung, Chi Young;Antonia, Scott J.
    • Tuberculosis and Respiratory Diseases
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    • 제81권1호
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    • pp.29-41
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    • 2018
  • Lung cancer is one of the most commonly diagnosed cancers and the leading cause of cancer-related deaths worldwide. Although progress in the treatment of advanced non-small cell lung cancer (NSCLC) has been made over the past decade, the 5-year survival rate in patients with lung cancer remains only 10%-20%. Obviously, new therapeutic options are required for patients with advanced NSCLC and unmet medical needs. Cancer immunotherapy is an evolving treatment modality that uses a patient's own immune systems to fight cancer. Theoretically, cancer immunotherapy can result in long-term cancer remission and may not cause the same side effects as chemotherapy and radiation. Immunooncology has become an important focus of basic research as well as clinical trials for the treatment of NSCLC. Immune checkpoint inhibitors are the most promising approach for cancer immunotherapy and they have become the standard of care for patients with advanced NSCLC. This review summarizes basic tumor immunology and the relevant clinical data on immunotherapeutic approaches, especially immune checkpoint inhibitors in NSCLC.

밴드형 첨족예방기구의 효과와 유용성 (The Effects of the Band Type Foot Drop Device)

  • 강현숙;김원옥;이혜숙
    • 기본간호학회지
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    • 제7권3호
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    • pp.391-400
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    • 2000
  • A long-term bed rest results in an inevitable foot drop. Yet preventive device such as a foot board and high-neck tennis shoes, are not widely used. This study was conducted to compare the effects of a pillow-type foot board with that of the band-type device. The band-type device of a resonable price is designed for an effective prevention of foot drop, and the convenience for it use. Among the non-equivalent control group design, foot drop preventive effects, usefulness of the device, as well as its cost effectiveness were examined. The study was carried out for four months from December 1999, and its subject had been patients and nurses of two intensive care units at K medical center in Seoul. According to the study purpose, the data collected were analyzed by $x^2-test$ and t-test. The results are as follow : 1. The ROM of ankle joint is promoted in the experimental group with a band-type device comparing the control group with a pillow type one. Dorsiflexion is particularly increased in the experimental group as compared with the control group, while planterflexion hardly shows any change. 2. The usefulness score of the experimental group nurses using the band-type device (23.97) is higher than that of the control group nurses (18.88). 3. In an aspect of the unit production cost, band-type devices are low-priced compare with pillow-type or other foot board (wooden) or high-neck tennis shoes. In summary, the newly developed band-type device is both useful and preventive for a foot drop. It is also desirable regarding to the production cost and the cost effectiveness. This fact proves that the new anti-foot drop device could be practical both for clinical care and home care. Yet the results were obtained by some subjects, it should be used after a further examination. More effective nursing intervention could be observed throughout general studies, including proper positioning and foot and ankle exercises which are the important variables of the foot drop prevention.

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