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The Efficacy of Immediate Diet for Reducing Local Adverse Events of Inhaled Corticosteroid: A Pilot Study

  • Lee, Myoung Kyu;Lee, Won Yeon;Yong, Suk Joong;Shin, Kye Chul;Kim, Chong Whan;Lee, Ji-Ho;Jung, Saehyun;Jung, Ye-Ryung;Kim, Hyun Sik;Yu, Tae-Sun;Kim, Sang-Ha
    • Tuberculosis and Respiratory Diseases
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    • v.73 no.2
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    • pp.93-99
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    • 2012
  • Background: Local adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients. Methods: The study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months. Results: The mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly. Conclusion: The immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.

Contents Analysis on the Image of Nurses in the Television Drama (텔레비전 드라마의 간호사 이미지에 대한 분석)

  • Moon, Young-Im;Im, Mi-Lim;Yun, Kyung-Yi
    • The Korean Nurse
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    • v.37 no.2
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    • pp.44-52
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    • 1998
  • The purpose of this study is to inquire the people's views on nursing for nurses, correct the image of nurse and take it as basis to be applied on nursing education examining the image of nursing on Television drama playing important role of mass media. 22 nurses of the characters in drama is applied to the analysis object of this study by selecting 6 dramas of Television ones the nurse play on the prime time from June 1 to August 31 in 1997. Contents analysis method was used in Data Analysis, 4 items was used after Coders previously modify and compensate it based on research documents of 1m Milim(1996) 2 Coders made the Coding the article on each person by them seeing the recorded film making the Coding Paper each items is written by the character. The average of reliability degree was 90% which measured the reliability degree by the mathod of Holsti. The statisic method of frequency, percentage was used SPSS Program in data processing The results were as follows. 1. Relative importance of 86.2% nurses in drama was depicted as extra characters 2. The affair attitude of nurses shown on drama was revealed as mechanical(84.7%), passive(45.5%), dependent(54.4%) unkind(68.2%). 3. The activity of nurses was classified with professional! simple affair. The professional affairs such as I.V., Blood Pressure Check, Rounding, Nursing Recording, Patient Education, Assist of Operation, Assistant meal of Patient, etc is mainly depicted and the screen of simple affair such as Receiving telephone, Carrying Tray or Dragging, Stretcher Car, Dressing Car and or Wheel Chair than professional affair. 4. The appearance feature of nurses was shown on thin physique(68.2%), common stature(68.2), dirty costume(45.4%), common appearance(81.9%), unnoble action(63.6%). The image of nurses is illuminated as the exterial scene of technical affair such as assisting the doctors and affair focused on accident and educational activity of nureses or extended role is nor depicted on Television drama. Therefore, the people regard the nurse as sexual object with good appearance than professional worker working professional nursing We want the following, epigraph based on above conclusion. 1. The continuous research is required on the image of nurse shown on various mass media. 2. The later research is required on appliction strategy of mass media for advancing the image of nurse. 3. The research to strengthen the objectivity by comparing analyzed data on drama & analyzing it is required 4. Through the deep study, the standard to show a concrete and professional work of nurses to scenario writers of TV drama is suggested by the association. 5. The monitoring about the mass media must be activated, not by some nurses, on a national scale and much study on the basis of this is needed.

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Quality of Life after Esophageal Surgery for Esophageal Surgery (식도암 환자의 수술 후 삶의 질에 관한 연구)

  • Kim Chong-Wook;Moon Hye-Won;Kim Yong-Hee;Park Seung-Il
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.310-316
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    • 2006
  • Background: We study the QOL (quality of life) & functional improvement in patients underwent esophageal surgery for cancer by the viewpoint of the patient and would like make the guideline of recovery course. Material and Method: Between Dec. 1996$\sim$Aug. 2002, 250 patients were operated and 57 patients was enable interview, didn't have evidence of recurrence & survived more than 1 year postoperatively at Asan Medical Center. Questionnaire made by direct or telephone interview & include diet habitus, change of body weight, G-E (gastroesophageal) reflux, dumping symptom, change of daily life. Result: There were 53 men (93%), 4 women (7%) with mean age of $62.05{\pm}8.7$ (range: $37{\sim}94$). Operation method was Ivor Lewis operation in 43 case (75.4%), Esophagocolojejunostomy 4 case (7.1%), Mckeown operation 10 case (17.5%). In Diet habitus, 55 patients (96.5%) ate more than three times in a day with mean diet frequency was 3.5 times/day, 51 patients (89.5%) have been ate solid, regular diet, 5 patients (8.8%) enable to eat liquid diet. To compare with preoperative state, 32 patients (56.9%) had a diet speed more than 80%, 28 patients (39.1%) had a diet amount more than 80%. 32 patients (56.9%) had a little change of body weight within a 10%, 25 patients (43%) had a improvement rather than preoperative state. In G-E reflux, 4 patients (7%) had a reflux after every diet, 27 patients (47.4%) had a little reflux after diet. In dumping symptom. 7 patients (12.3%) had a diarrhea after meal. 38 patients (66.6%) had a normal activity 19 patients (33.3%) had a decreased activity. At present state, majority (53 patient-93%) of patient were satisfactory to the operation result, in spite of discomfort from time to time. In the emotional status, 50 patients (88%) had a well sleeping without disturbance. 65% of patients were comfortable in the psychology state. 39% of patients had a libido. Compare with their median age (63 y), it's a normal varient. Conclusion: QOL in patients underwent esophageal surgery for esophageal cancer nearly recovery to preoperative state.

A Comparative Study of Stenting versus Surgical Bypass in Gastric Outlet Obstruction Caused by Gastric Cancer (위암 날문부 폐쇄 환자에게 시행한 치료의 비교고찰: 위-공장 우회술과 금속성 자가팽창성 스텐트 삽입술)

  • Jo, Seung-Jin;Yoon, Ki-Young;Choi, Kyung-Hyun;Park, Moo-In;Park, Seun-Ja;Ko, Ji-Ho;Lee, Sang-Ho
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.82-87
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    • 2007
  • Purpose: In gastric cancer patients with gastric outlet obstruction, there are several complications such as malnutrition and vomiting. Palliative enteral stenting is a less invasive procedure as compared with a gastrojejunostomy. The aim of this study was to determine whether there was a significant difference between patients that undergone palliative enteral slanting and patients that had received a bypass gastrojejunostomy. Materials and Methods: One hundred patients underwent palliative entering stenting and 3f patients were subjected to a surgical bypass gastrojejunostomy. We reviewed the medical records of the patients with gastric outlet obstruction secondary to far advanced gastric cancer that were diagnosed using a gastrofibroscope, UGI and abdominal CT, and were admitted to our institution between January 2000 and August 2006. The outcome of stent placement for gastric outlet obstruction was compared with palliative gastrojejunostomy during the same period. We excluded patients with recurrent gastric cancer and double cancer from this study. Results: There were significant differences between the group of patients that underwent slanting and the group of patients that received a gastrojejunostomy regarding the age of patients ($67{\pm}12$ vs. $57{\pm}9$, P<0.001) but not between the sex of the patients (M : F, 2 : 1 vs. 2 :1, P=0.637). The most common complication of stenting was tumor ingrowth (16/100, 16%) and the second most common complication was stent migration (14/100). Failure of the procedure occurred in only three patients. Twenty-three patients underwent re-slanting and one patient required open conversion with a gastrojejunostomy. The median time to the first meal was $4{\pm}2$ days in the stent group of patients and $6{\pm}2$ days in the gastrojejunostomy group of patients (P=0.001). The median postoperative hospital stays were 9 days in the stent group of patients and 15 days in the gastrojejunostomy group of patients (P=0.003). The mean survival periods were 11 months in the stent group of patients and 10 months in the gastrojejunostomy group of patients (P=0.937). Conclusion: There were no significant differences In the mean survival rates. An earlier first meal and a shorter hospitalization stay were found in the slanting group of patients compared to the bypass gastrojejunostomy group of patients. However, re-slanting was a concern due to tumor ingrowth and stent migration.

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A study on the oral health knowledge and behavior of the volunteers in practice for oral prophylaxis (치면세마 실습 대상자의 구강보건지식 및 행태에 관한 연구)

  • Nam, Sang-Mi
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.1
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    • pp.13-27
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    • 2011
  • Objectives : The purpose of this survey research was to investigate the relationship among oral health State, behavior and knowledge of oral health of patients who participate in dental hygiene students voluntarily. Methods : The subject in this were patients who got a scaling at the oral hygiene practice lab in the department of dental hygiene in S university dental clinic from April 1 to May 31, 2010. For the data analysis, an SPSS WIN 11.5 program was used and its signification level was 0.05. Results : 1. For the oral health state according to sex distinction, it showed the men's 0.78 MT index was higher than women's 0.48 MT index and statistically significant difference. For FT index, women(4.72) was higher than men(3.50) and it showed statistically significant difference(p<0.05). 2. For the oral health state according to age distinction, DT index of under 20years(2.44) was higher than the others and it showed statistically significant difference(p<0.05). 3. For the oral health state according to marriage distinction, not married DT index(1.59) was higher than married DT index(2.56) and it showed statistically significant difference(p<0.05). 4. For the oral health behavior according to age distinction, 87.0% 20~29years patients replied as I have experience of my teeth scaled and it showed statistically significant difference. 18.5% more than 30 years replied as I use interdental brush and it showed statistically significant difference. 18.5% more than 30 years replied as I use powered brush and it showed statistically significant difference(p<0.05). 5. For the oral health state according to oral health behavior distinction, there were significant difference that regular visit of dental clinic, experience of teeth scaled, toothbrushing, oral hygiene device(p<0.05). 6. For the oral health state according to oral health knowledge distinction, there were significant difference that toothbrushing time after each meal, appropriate toothbrushing time, toothbrushing method, dental caries foods(p<0.05). Conclusions : I suggest with the result of the study that there was a very close relationship between oral health status, behavior and knowledge of oral health. Therefore student of the dental hygiene should be encouraged to pay more attention to oral health care of the patient, and they should be well educated oral health care personnels who volunteers in practice for oral prophylaxis.

A Study on the Use of Oral Health Care Devices and the Oral Hygiene in Some Colleges (일부 대학의 구강건강관리용품 사용과 구강위생에 관한 연구)

  • Lee, Sun-Hee;Park, Il-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.6
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    • pp.2629-2635
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    • 2011
  • This study carried out questionnaire survey and experiment on oral hygiene effects according to the actual condition of using oral care products and the amount of toothpaste used targeting 40 freshmen and sophomores in dental hygienics in some universities from November 8, 2010 to November 26. The collected data was analyzed by using SPSS WIN 15.0 program. The following conclusions were obtained. 1. The result of actual condition of toothbrushing is as follows. As the answer of a question about whether or not toothbrushing after every meal at ordinary times, the largest was 47.5% of being average. The occasion of toothbrushing before going to bed at ordinary times was the largest with 47.5%. The daily toothbrushing frequency was 3 times mostly and the general toothbrushing method at ordinary times was a rolling method. The frequency of exchanging toothbrushes for the past 1 year was 3 times, which is the largest with 45.0%. 2. As a result of the actual condition of using oral care products, the majority of students don't use electric toothbrush, interdental brush, or mouth-rinse except dental floss. Accordingly, there need to be education and promotion with diverse methods so that a patient oneself can prevent oral disease by selecting and using oral care products that are proper for each individual. Also, it was indicated that there is no big difference in oral hygiene effects depending on the amount of toothpaste used. Thus, to avoid wasting toothpaste, we need to educate and promote to use the amount of toothpaste under 0.3g.

The Assessment of Management Practices on Foodservice , Clinical Nutrition Service in Hospital Foodservice Operations (병원 급식소의 급식 및 임상영양 서비스 업무 실태 조사)

  • Hong, Wan-Su;Kim, Hye-Jin;Jang, Eun-Jae
    • Journal of the Korean Dietetic Association
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    • v.6 no.2
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    • pp.136-147
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    • 2000
  • The aim of this research was to examine the management practices related to foodservice.clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25-29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52 $m^2$, with 133.63$m^2$ for modified diet space and 18.13$m^2$ for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals. The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.

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Outsourcing in Hospital Services: Experience of Korean Hospitals (우리나라 대형 종합병원의 아웃소싱 실태)

  • Noh, Tae-Hoon;Lee, Hae-Jong;Park, Eun-Cheol;Kang, Hye-Young
    • Korea Journal of Hospital Management
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    • v.8 no.4
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    • pp.59-75
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    • 2003
  • This study was conducted to investigate the degree of utilization of outsourcing in large hospitals in Korea. We also investigated the outcome and the level of satisfaction for adopting outsourcing in these hospitals. Types of work areas that were currently operated by outsourcing and were planned to adopt outsourcing in the future were identified. A total of 83 hospitals were eligible for this study, which had more than 500 beds, and were identified from the 2003 National Hospital List published by the Korean Hospital Association. A self-administered Questionnaire survey was conducted between April 25th and May 20th in 2003 with a personnel being charged of arrangement of outsourcing in each hospital. Among the 58 hospitals responding the survey(response rate=69.9%), 49 hospitals(84.5%) utilized outsourcing in at least one work field in their organizations. The largest proportion of the hospitals(85.7%) using outsourcing responded that the biggest outcome after introducing outsourcing were cost reduction(49.0%), followed by improved efficiency in operating the organization or human resources(34.7%) and the improved quality of the work(6.1%). The degree of satisfaction for outsourcing among the hospital managers(3.43) was significantly higher than that among the employees(3.l4) on a S-point Likert-type scale(p<0.05). Among the 7 work areas, the hospitals used outsourcing most frequently in facility management(housekeeping, building maintenance, hospital security and parking management), followed by non-medical profit business(funeral, convenient store, and cafeteria), logistics(provision of patient meal, in-house delivery, and purchasing), and information and computing system(hospital information system, maintenance of personal computers and printers). The work areas that the hospitals planned to adopt or expand the outsourcing in the future most frequently were facility management, non-medical profit business, logistics, and information and computing systems. In conclusion, outsourcing was highly diffused in large Korean hospitals, particularly in the work field of facility management and non-medical profit business. The satisfaction for outsourcing was not high yet in Korean hospitals.

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Self-management levels of diet and metabolic risk factors according to disease duration in patients with type 2 diabetes

  • Cho, Sukyung;Kim, Minkyeong;Park, Kyong
    • Nutrition Research and Practice
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    • v.12 no.1
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    • pp.69-77
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    • 2018
  • BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

A Correlational Study on Activities of Daily Living, Self-efficacy, Stroke Specific Qualify of Life and Need for Self-help Management Programs for Patients with Hemiplegia at Home (재가 뇌졸중환자의 일상생활활동, 자기효능감, 삶의 질, 자조관리프로그램요구도와의 관계에 관한 연구)

  • Kim Keum-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.1
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    • pp.81-94
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    • 2001
  • The purpose of this study was to identify levels of activity of daily living, self-efficacy. stroke specific quality of life and need for self-help management program for patients with hemiplegia in the home. Data were collected from June to November, 2000 and subjects were 88 poststroke patients who lived in Seoul and Kyunggi-do. The questionnaire consisted of 5 scales: activities of daily living, self-efficacy, stroke specific qulaity of life and need for a self-help management program. Data were analyzed using frequencies, percent, paired t-test, and Pearson's correlation coefficient with the SAS(version 6.12) program. The results are as follows ; 1) Most of subjects were Partially independent in ADL, but they needed assist once to do dressing, bathing meal preparation and house keeping work. 2) The mean self-efficacy score was 54.89(range : 1 to 80) and the individual differences were large. 3) Subjects responded that they were satisfied on the stroke specific quality of life scale totaled 65.8%. This value is comparatively low, especially for social role(51.4%), family functioning(58.3%) and mood (62.2%). 4) The highest needs for self-help management programs were for physical therapy, stress management, and range of motion exercise and the lowest needs were for elimination management and training, family counseling, and speech therapy. 5) On the demographic variables, sex showed significant differences for the dependent variables. Females had higher scores than males for IADL, self-efficacy, stroke-specific quality of life, and need for self-help management. 6) Age had high negative correlation with ADL, self-efficacy and stroke specific quality of life. Age was also correlated with need for self-help management. In conclusion, there was a high correlation for ADL, Self-efficacy and Quality of life in poststroke patients of home. The patient with a stroke also had a strong need for self-help management programs especially physical therapy and stress management. Therefore rehabilitation programs based on self-efficacy enhancement need to be developed in order to promote independent living for patients with hemiplegia.

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