• 제목/요약/키워드: nutritional care and management

검색결과 154건 처리시간 0.03초

항암화학요법 환자에게 적용된 주요 간호진단, 간호결과 및 간호중재의 연계성 확인 (Identification of Major Nursing Diagnosis, Nursing Outcomes, and Nursing Interventions (NNN) Linkage for Cancer Patients Undergoing Chemotherapy)

  • 송수미;소향숙;안민정
    • 성인간호학회지
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    • 제26권4호
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    • pp.413-423
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    • 2014
  • Purpose: This study was aimed to identify NANDA-NOC-NIC linkage in cancer patients receiving chemotherapy. Methods: This study was a descriptive study conducted in three steps. First, nursing diagnoses were identified from the electronic nursing records. Second, content validity of nursing diagnoses and outcomes were evaluated. Third, major nursing interventions associated with expected nursing outcomes were collected from 97 nurses who worked in the oncology unit. Data were analyzed using descriptive statistics. Results: Four major nursing diagnoses were identified: acute pain, knowledge deficit, health seeking behaviors, and ineffective protection. Associated with each respective diagnosis, 3 major outcomes (pain level, pain control, and comfort state) for acute pain, 8 major nursing outcomes (diet, disease process, treatment regimen, illness, ostomy care, prescribed activity, health behavior, and infection management) for knowledge deficit, 4 major outcomes (health promoting behavior, health promotion, health belief, and knowledge: health resource) for health seeking behaviors, and 3 major outcomes (fatigue level, immune status, and nutritional status) for ineffective protection were identified. In addition, nursing interventions frequently used in clinical practice for each major nursing outcome were identified. Conclusion: The identified NANDA-NOC-NIC linkage can contribute to improving the applications of nursing process and care plans.

우리나라 2006년 약제비의 규모 및 구성 (Scale and Structure of Pharmaceutical Expenditure for the year 2006 in Korea)

  • 정형선;이준협
    • 보건행정학회지
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    • 제18권3호
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    • pp.110-127
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    • 2008
  • Expenditures on pharmaceuticals of different concepts were estimated and their functional, financing and providers' breakdowns were examined in line with the OECD's System of Health Accounts (SHA) manual. This study also shows the way such estimates are made. The results are then analyzed particularly from the international perspective. Data from both Household Survey by the National Statistical Office and the National Health and Nutritional Survey by the Ministry of Health and Welfare of Korea were used to estimate pharmaceutical expenditures that. are financed by out-of-pocket payments of the household, while national health insurance data etc. were used for estimation of pharmaceutical expenditures that are financed by public funding sources. The 'per capita expenditure on pharmaceutical/medical non-durables' in Korea stood at 380 US$ PPPs, less than the OECD average of 443 US$ PPPs in 2006, but its share of the per capita health expenditure of 25.9% noticeably outnumbered the OECD average of 17.1%, due partly to low per capita health expenditure as a denominator of the ratio. This indicates that Koreans tend to spend less on health care than an OECD average, while tending to spend more on pharmaceuticals than on other health care services, much like the pattern found in relatively low income countries. An international pharmaceuticals pricing mechanism is most likely responsible for such a tendency. In addition, it is to be noted that the percentage comes down to 21.0%, when expenditures on both medical non-durables and herbal medicine, which is locally quite popular among the elderly, have been excluded.

노인구강건강평가지수(GOHAI)와 낙상 경험의 관련성: 고령화연구패널조사(KLoSA) 2018년도 제7차 자료를 이용하여 (Relevance between Geriatric Oral health Assessment (GOHAI) and Falls : Using KLoSA 2018 7th Data)

  • 김세연;김재현
    • 한국병원경영학회지
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    • 제26권4호
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    • pp.51-58
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    • 2021
  • Purpose: This study is based on the results of previous studies that falls, which is a frequent social problem, causes physical, mental and social health problems in the elderly. In order to identify risk factors for falls in the elderly, this study derives a relationship with oral health and proposes the necessity of oral health care as part of countermeasures to prevent falls in the elderly. Methodology: The final 6,936 people were analysed using the 2018 Korean Longitudinal Study of Ageing(KLoSA) survey data, and the analysis was conducted using the multiple logistic and multiple regression analysis to investigate the relationship between Geriatric Oral Health Assessment Index (GOHAI) and falls experience. Findings: As a result of the analysis in this study, the number of falls experiences and whether or not falls were higher in the elderly female group than in the male group. The likelihood of falls experience has been statistically reduced as Geriatric Oral Health Assessment Index increases by one unit.(OR : 0.991) The number of falls has also been statistically reduced as Geriatric Oral Health Assessment Index increase by one unit.(B : -0.001) Practical Implications: The results of this study, which showed that higher Geriatric Oral Health Assessment Index was lower risk of falls, explained by the connection that oral health may affect nutritional intake, which leads to sarcopenia and physical loss, which in turn increases the risk of falls. As a way to solve the fall problem, efforts should be made to improve the oral health of the elderly, and furthermore, the importance of nutrition management thorugh oral health care of the elderly is increasd.

여대생 대상 체중조절 프로그램의 영양 교육 효과 평가 (Effectiveness of Nutrition Education in a Weight Control Program for Female College Students)

  • 이현정;이윤정;이경옥;김화영
    • 한국식생활문화학회지
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    • 제24권5호
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    • pp.570-580
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    • 2009
  • The purpose of this study was to evaluate the multilateral weight control program provided by the university health care center for female college students. The program was 8weeks long and composed of nutrition consultation, exercise, and behavior modification. Nutrition education focused on a low calorie and balanced diet, increasing the intake of protein and micronutrients and reducing carbohydrate and fat consumption. Evaluations were made upon completion of an 8-week program and upon follow-up at 6 months after the end of program. A total of 92 women completed the 8-week program, while 20 completed the follow-up survey. Upon completion of the 8-week program, significant decreases in body weight, BMI, body fat (kg), and %body fat were observed, and muscle mass was also reduced. The total energy and carbohydrates intake were also significantly decreased in subjects with weight loss, while the percentage of subjects whose consumption of protein, calcium, iron, vitamin $B_1$, $B_6$, and niacin did not meet the EAR, were decreased. The blood values of glucose, total cholesterol and HDL-cholesterol were decreased. The follow-up survey revealed that the subjects continued to lose weight after completion of the program. In addition, a Mini nutrition assessment revealed that diet quality improved, especially with respect to reductions in the consumption frequency of fried, greasy and salty food. In conclusion, the multilateral weight control program with diet education for female college students was effective for long lasting weight control and improved dietary behavior. Nutrition education for weight reduction should focus on balanced nutrition as well as lowering the total caloric intake.

신장이식 환자와 가족의 퇴원후 교육요구 (A Study on the Educational Needs of Patients with Kidney Transplants and their Family Members after Discharge from Hospital)

  • 안재현;김남초
    • 대한간호학회지
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    • 제29권6호
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    • pp.1324-1335
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    • 1999
  • The purpose of this study was to explore the educational needs of patients with, kidney transplants and their family members to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to April 20, 1999 with interviews using a structured questionnaire. There were 184 subjects in this study. of them, 107 were patients who had kidney transplants and had visited at the out-patient department of three general hospitals located in Seoul and 77 were family members. The questionnaire used for this study was developed by the investigator through a literature review and from data collected from 11 professional personnel and three kidney transplant patients and their families. The data were analyzed using the SAS program with t-test, ANOVA, Scheff test, Pearson correlation coefficient. The results are as follows; 1) In the patient group, total mean score for educational needs was 154.61 and the item mean score was 3.96. For the family group, total mean score for educational needs was 168.84 and the item mean score was 4.15. So in the family group, educational needs were scored higher than by the patient group. With regard to domains, both patient and family groups had as the highest educational needs, the domain of physical health and the top ten items in the educational needs were also in the domain of physical health. 2) In the patient group, women and the divorce/ bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than four weeks from their kidney transplant had higher educational needs in the domain of physical health and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the family group, those who were Catholics and had high school education had higher educational needs in the domain of nutritional management. 3) In the patient group, academic background was positively correlated(r=.208, p=.031) to educational needs.

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Use of sugammadex in Rett syndrome: A case report

  • Kupeli, Ilke;Tepe, Emine;Kuyrukluyildiz, Ufuk
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제18권4호
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    • pp.261-265
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    • 2018
  • Rett syndrome (RS) is a neurodevelopmental disorder characterized by loss of cognitive, motor, and social skills, epilepsy, autistic behavior, abnormal airway patterns, gastroesophageal reflux, nutritional problems, and severe scoliosis. Although girls with RS show normal or near-normal growth until 6-8 months, they lose their skills after that. The anesthetic management of these patients requires care because of all these clinical features. Especially in the postoperative period, prolonged apnea is common and extubation is delayed. In this case report, the effect of using sugammadex was presented in a 16-year-old girl with RS. The patient's all bimaxillary teeth and 4 wisdom teeth were extracted under general anesthesia in one session with minimal surgical trauma and moderate bleeding. Sugammadex can be a rapid and reliable agent for the reversal of the neuromuscular block in neurodegenerative patients.

Machine learning-based nutrient classification recommendation algorithm and nutrient suitability assessment questionnaire

  • JaHyung, Koo;LanMi, Hwang;HooHyun, Kim;TaeHee, Kim;JinHyang, Kim;HeeSeok, Song
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제17권1호
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    • pp.16-30
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    • 2023
  • The elderly population is increasing owing to a low fertility rate and an aging population. In addition, life expectancy is increasing, and the advancement of medicine has increased the importance of health to most people. Therefore, government and companies are developing and supporting smart healthcare, which is a health-related product or industry, and providing related services. Moreover, with the development of the Internet, many people are managing their health through online searches. The most convenient way to achieve such management is by consuming nutritional supplements or seasonal foods to prevent a nutrient deficiency. However, before implementing such methods, knowing the nutrient status of the individual is difficult, and even if a test method is developed, the cost of the test will be a burden. To solve this problem, we developed a questionnaire related to nutrient classification twice, based upon which an adaptive algorithm was designed. This algorithm was designed as a machine learning based algorithm for nutrient classification and its accuracy was much better than the other machine learning algorithm.

요양보호사의 구강건강관리실태 및 구강건강관리교육 요구도 조사 (Oral health care status and educational needs of care workers)

  • 김희경;김경미;김선일;김은주;남궁은정;배수명;손정희;신보미;신선정;엄미란;이민선;이혜린;최용금;최진선;류다영
    • 대한치위생과학회지
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    • 제2권2호
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    • pp.41-51
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    • 2019
  • Introduction: This study intended to identify the current oral health care status and demand of care workers for oral health education. Methods: A survey was distributed to care workers working in 11 nursing homes for older people located in the Chungcheongdo Province. Of those distributed, 217 questionnaires were collected and analyzed. To analyze the collected data, a frequency analysis, t-test, and one-way analysis of variance(ANOVA) were performed using SPSS version 18.0. Results: The demand for an educational course on the 'Management of Oral Health Care for the Aged People' had a score of 4.22 points(full marks were 5.0 points), whereas the score for the necessity for control of oral health was 4.29 points. The control of oral health for the aged people suffering dysphagia scored 4.27 points, whereas the control of oral health for older people who have dementia was 4.27 points. The score for a course on the nutritional control for aged people having difficulties in masticating foods was 4.27. Conclusion: It is clear that the development of educational courses and standardized manuals for care workers on aspects of oral health care is necessary. Therefore, it would be desirable to develop institutional infrastructure for dental hygienists to educate care workers on oral health.

지속적 신대체요법을 받은 중환자에서 영양공급이 임상결과와 영양상태에 미치는 영향 (The effect of nutritional supply on clinical outcomes and nutritional status in critically ill patients receiving continuous renal replacement therapy)

  • 김주연;김지명;김유리
    • Journal of Nutrition and Health
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    • 제48권3호
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    • pp.211-220
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    • 2015
  • 본 연구는 지속적 신대체요법을 받은 급성 신손상 환자 239명을 대상으로 영양공급 충족률이 환자의 임상적인 결과에 미치는 영향을 알아보고자 수행하였으며 대상자의 영양요구량 및 실제공급량을 조사하여 영양공급 충족률에 따른 임상결과를 비교하였다. 대상자의 평균 에너지 충족률이 68.06%, 평균 단백질 충족률이 43.13%로 나타났고 체중 당 에너지 공급량은 16.62 kcal/kg/일, 단백질 공급량은 0.63 g/kg/일로 지침에서 권장하는 요구량에 미치지 못하는 수준이었다. 에너지 충족률 70%, 단백질 충족률 50% 기준으로 두 군간 임상결과의 차이를 관찰한 결과 에너지 충족률이 높은 군에서 총 재원일수, 중환자실 재원일수와 지속적 신대체요법 적용일수, APACHE II score가 유의하게 감소하는 것으로 분석되었고 단백질 충족률이 높은 군에서는 총 재원일수, 중환자실 재원일수, 지속적 신대체요법 적용일수, APACHE II score 이외에 사망률도 유의하게 감소한 것으로 분석되었다. 생화학적 검사 결과의 경우 에너지 충족률 70% 이상 충족군에서는 헤마토크릿 수치가, 단백질 충족률 50% 이상 충족군에서는 총 임파구수, 헤마토크릿 수치가 유의하게 개선된 것으로 나타났다. 사망환자를 제외하고 영양공급량과 임상결과를 나타내는 항목의 상관관계를 분석한 결과 에너지 공급량과 중환자실 재원일수가 의미 있는 음의 상관관계를 가지는 것으로 나타났으며 영양공급량과 생화학적 검사 결과의 상관관계를 파악한 결과 에너지 공급량에 따라서는 유의한 상관계수가 도출되지 않았고 단백질 공급량과는 따라서는 헤마토크릿과 칼슘이 유의한 양의 상관관계를 가지는 것으로 나타났다. 본 연구 결과 영양공급 충족률이 높은 군에서 임상적인 결과 및 영양상태와 관련한 생화학적 검사결과가 개선되는 것으로 나타나 요구량에 적정한 영양공급이 환자의 치료에 긍정적인 영향을 준다는 것을 확인할 수 있었다. 이를 위해서 의료진의 타당한 영양처방이 중요하겠으며 영양지원의 체계적인 관리를 위해 다학제적인 접근과 함께 영양공급의 적정성을 지속적으로 모니터링하는 것이 중요하겠다.

입원 환자용 초기 영양검색도구의 타당도 검증 (Validation of initial nutrition screening tool for hospitalized patients)

  • 김혜숙;이선희;김혜숙;권오란
    • Journal of Nutrition and Health
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    • 제52권4호
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    • pp.332-341
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    • 2019
  • 본 연구는 입원환자의 초기영양평가를 위해 개발된 영양검색도구의 타당성을 평가하고자 입원 후 24시간이내 동일한대상자에게 PG-SGA와 개별면담을 시행 후 그 결과를 비교 평가하였다. CKUNRS와 PG-SGAS 두 그룹 모두 나이는 고위험군이 평균 연령보다 높았고, BMI, 혈청 알부민과 헤모글로빈은 영양불량이 심할수록 유의적으로 낮게 나타났다. CKUNRS와 PG-SGA를 비교 분석한 영양 평가결과 전체 686명 중 영양불량 위험 환자는 각각 107명(15.6%)과 380명 (44.6%)으로 조사되었다. 민감도와 특이도는 각각 98.7% (96.8 ~ 99.5)와 33.3% (28.1 ~ 39.0)로 나타났으며, 두 도구 간 유사성 kappa 지수는 0.34로 CKUNRS는 PG-SGA를 기준으로 어느 정도 타당한 검색도구로 검증되었다. 결론적으로, CKUNRS를 PG-SGA와 같은 공인된 영양검색도구와 비교한 결과 민감도와 유사성 면에서는 어느 정도 타당한 수준의 영양검색도구인 것으로 판정되었으나, 특이도가 높지 않은 부분에 대해서는 추가적인 고려가 필요할 것으로 보인다. 초기입원 영양평가로 효과적인 영양검색도구를 위하여 재원기간, 합병증 유무, 사망률, 환자의 질병 예후와 관련된 유용성은 검증되지 않아 이에 관련하여 추가적 연구가 필요하다고 사료된다. 그리고 보다 정확한 영양불량 환자의 검색을 위해서는 간호사의 입원환자 초기 평가 및 재평가 부분에서 누락 가능성이 있는 체중변화, 소화기계장애, 식욕상태, 저작곤란, 연하곤란 등의 정확한 기록을 할 수 있도록 간호사정 기록자의 지속적인 교육이 필요할 것으로 보이며, 효과적인 초기 영양관리를 위해서는 향후 CKUNRS의 영양검색 기준에 대한 수정보완이 필요하다고 사료된다.