• Title/Summary/Keyword: pattern of care

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The Relationship between Noise and Sleep Patterns in Intensive Care Units (소음과 수면양상에 관한 연구 - 중환자실을 중심으로 -)

  • Son, Youn-Jung
    • Korean Journal of Adult Nursing
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    • v.13 no.2
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    • pp.209-222
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    • 2001
  • The environment in the ICU leads to negative changes in a patient's usual sleep pattern and so contributes negatively to the patient's health condition as compared to patients in general wards. Therefore, it is thought that an important nursing intervention would be to identify the relation between noise and sleep patterns which play an important role in illness recovery. The purpose of the present study was to explore the relationship between noise in the ICU and the sleep pattern of patients admitted to the ICU. A descriptive correlation design was used to examine the relationship. Thirty-four subjects were recruited from a Medical ICU (MICU), Surgical ICU (SICU) and Coronary Care Unit (CCU) at a large university hospital in Suwon. Data were collected from September 28 to October 31 in 1999. In the present study, noise was categorized into noise level and patients' perception of noise. The objective noise level was measured using the A-Weighted Sound Level Meter. The patients' preception of noise was measured using a self-reported questionnaire developed by the researcher. Sleep patterns in this study includes both quantity and quality of sleep. These were measured using open ended questionnaires and the 'Korean Sleep Scale A' developed by Oh, Song, Kim(1998). The data was analyzed using the SPSS-WIN to test the research question, Pearson product moment correlation coefficient was run. Ancillary analysis were conducted with demographic variables to determine their relation to the main study variables. For the ancillary analysis, t-test and one-way ANOVAs were performed. The results of the present study are summerized as follows : 1. The total mean of objective noise level (10pm-6am) was 56.2dB. The means for night time noise level in individual ICUs for the SICU, MICU and CCU, were 58.7dB, 58.6dB and 48.3dB, respectively. The total mean for patients' noise perception was 42.8 out of a maximum possible score of 76. For item means of noise perception, the one ranked highest was "conversations between doctors and nurses" (3.2). The one ranked lowest was "noise from the radio" (1.2). Regarding the degree of perception for each type of noise source, the one ranked highest was "equipment noise" (2.6), the second was "conversation between medical staff" (2.4), the third was "conversation between patients, caregivers and visitors" (2.3), and the one ranked lowest was "environment noise" (1.8). 2. Looking at quantity of sleep of ICU patients, the mean nocturnal sleep time was found to be 4.9 hours. The total mean of sleep quality for ICU patients was 21.0 out of a maximum possible score of 40. 3. The relationship between perception of noise and quantity of sleep was statistically significant(r= - .41, p<.05). The relationship between perception of noise and quality of sleep was also statistically significant(r= - .47, p<.01). The results of the study indicate that personal perception of noise is related to sleep patterns. Therefore, it is suggested that nursing interventions be developed to reduce the degree of personal perception of noise and, thus, decrease sleep pattern disturbances in patients in the ICU.

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A Study on Requirements for Facilities' Changes with the changes in Legislations and Education Curriculum of Infants (영유아 관련 법령 및 교육과정 변천 비교에 따른 시설 변화 요구사항 연구)

  • Jung, Eu-Gene;Oh, Byeong-Uk;Jung, Jin-Ju
    • Journal of the Korean Institute of Educational Facilities
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    • v.21 no.1
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    • pp.3-11
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    • 2014
  • The policies is always changes according to the changing times, and changes take place in educational facilities welfare policy. Early childhood facilities, is no exception. Recent, increase in the number of kindergarten and kindergarten children according to policy changes of government's active welfare. This change in pattern, policy changes and increased support to know the impact on the community, and this is not just a simply agenda that they need to be recognized social change. In addition, it can be seen changes in relevant laws and educational process according to childhood policy change flow and depending on social change. In this study, comparative study infants and installation of the facility based on criteria, ensuring standards of early childhood facility site, facilities of evolution of infants care act, act infants, infants of activities safety management. And Standards and facilities that are required to change the direction of the revision is for the purpose of research through changes in kindergarten curriculum to respond the policies flow. Research methods are literature on the various laws and research analysts, leading comparison of different child care and child care policy changes in laws and regulations to review materials are analyzed.

An Analysis of John Bowlby's Mourning Stages in Family Art Therapy as a Way to Help the Family Mourning Process

  • Seon Ah Yang;Sung Hee An;Cho Hee Kim;Min-Sun Kim
    • Journal of Hospice and Palliative Care
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    • v.26 no.2
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    • pp.27-41
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    • 2023
  • Purpose: Pediatric palliative care is a rapidly developing multidisciplinary approach that supports children with life-limiting conditions and their families. However, there is limited evidence on how to effectively support bereaved parents and siblings. The purpose of this study is to explore the therapeutic impact of art therapy for bereaved families, in accordance with John Bowlby's four-stage theory of mourning. Methods: This single-case study employed the consensual qualitative research method. Art therapy records of bereaved families were reviewed individually, and records from one case were selected. Verbal statements made during the art therapy sessions and photocopies of the artworks were analyzed to understand the mourning process of the family. Results: A total of 113 statements and 12 artworks from 19 art therapy sessions were analyzed. As the art therapy progressed, each family member exhibited a pattern of engaging in more positive and healthy conversations in daily life, demonstrating the final stage of mourning: reorganization and recovery. The family dynamics also revealed that they reconstructed their inner world and redefined the meaning of loss, which is the final stage of mourning. The art therapy provided a safe environment for the family, allowing them to fulfill their wishes and regain the strength needed for recovery. Conclusion: This study suggests that art therapy supports bereaved families in alleviating their psychological difficulties, engaging in a healthy mourning process, and functioning as members of society. Further research is needed to better understand the effect of art therapy as a bereavement support tool in pediatric palliative care.

A Vision for Nursing Education Reform in Korea (한국 간호교육에 대한 개혁 전망)

  • 김모임
    • Journal of Korean Academy of Nursing
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    • v.24 no.2
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    • pp.313-318
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    • 1994
  • To build a suitable National Health Care System for the coming 21s1 century, Nursing must also be renewed. The future Korea will be united and the majority of its population will raidly consist of the aged. Economically standing on the same level with developed countries the growth of scientific technologies will foster communications, firing astounding changes in the medical field. While the overall life style pattern of Koereans not to mention the structure of diseases undergo change, the possibility that the reckless induction of high-tech health care may only cause medical fees to eascafate. It can전so be expected that the health care system will evolve towards the consumers. Nursing in the 21s1 century will be of two scenarios according to WHO, which presents the role of the nurse. The first scenario is that "a gen-eric health care work force" namely a "care giver" will replace all other health professions. If Nursing does not become the compatent profession fitting to this purpose it will eventually dei out. The second scenario is that nurses who are educated in a well grounded and extensive general background and have command of a specialized area will undertake services varying from health pro-motion to treatment and rehabilitation both direct and indirectly, while supervising other personnel. The nurse here would become the "care giver". To become the necessary health care profession in the 21s1 century, nurses should be provided with more educational opportunities, variating in its con-tents, course, and system, enabling them to grow. Clair Faign points out that the minimal educational entry for the nursing profession is a 4 year undergraduate education in this aspect, now in the time to set the future of Nursing into the course of the first scenario. A new educational system stipulating a baccalaureate nursing degree is in urgent need, and aside from govermental actions nurse themseives should formaily officiallze this process, striving for quality assurance. While considering 6 years nursing education programs, multifarious degree courses for existing 3 years educated nurse should be provided Junior nursing schools must devise measures to grow into baccalaucate institutions, also. Among the existing courses, the Self Study Degree Program should be converted into RN, BSN courese provided by universities, and clinical training for the University on the Air must be supplimented, The possibility of establishing nursing courses into commercial high school programs only jeopardizes the development of the nursing profession.

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Value orientation and the relationship between nurse′s role perception and patient′s expectation on selected routine nursing activities (간호원의 역할인식과 환자의 기대 -기본 간호역할의 가치의식을 중심으로-)

  • 한윤복;김순자;이인자
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.144-158
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    • 1974
  • This study was undertaken in an attempt to; 1) measure value orientation of nursing activities, 2) identify the relationship between nurse's role perception and patient's expectation, and 3) evaluate the pattern of nursing education and nursing service administration. 203 hospitalized adults and 203 professional nurses from 11 general hospitals in Seoul during the period of July to December 1973 were tested according to questionnaire based on 4 categories of clinical nursing activities, 1) physical care, 2) observation and control, 3) psycho-social care and 4) therapeutic measures. Results of the study are as follows: 1. Nurses were more concerned than patients in the physical care category. Significant difference was revealed by p<.01 level (t=2.800). Mean value score of nurses was average (2.84), and mean value score of patients was relative' y low (2.49). None of the physical care category questionnaire items were over 3.5. 2. Respondents from hospitals of total care system revealed significant difference in the physical care category by P〈.025 level. (t=2.242). Mean value score of both group were average level (nurse 2.90, patient 2.53), nurses showed higher concern. 3. Difference between nurse's role perception and patient's expectation in observation and control category was revealed non- significance by p〉0.05. level (t=1.238). Mean value score of both group revealed relatively high (nurse=3.44, patient 3.19). 4. Difference between nurse's role perception and patient〉expectation in psycho-social cart category revealed non- significance by p〉.05 level (t=0.758), Mean value score of both group revealed average level (nurse =2.71, patient =2.53), 5. Non- significant difference was noted between B. S. N. and diploma nurse's role perception in the psycho- social care category by p> 0.1 level (t=0.316). 4. Difference between nurse's role perception and patient's expectation in the rapeutic me assures category revealed non- significance by p〉0.05 level) t=0.503). Horses showed high concern by mean value score 3.56 level and patients relatively high by 3.41. All items of this category revealed very high or relatively high value score.

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Clinical Significant of Breathing in the oriental, western Medicine (조식(調息)의 동서의학적(東西醫學的) 임상(臨床) 의의(意義))

  • Park, Jin-Sung;Park, Young-Jae;Park, Young-Bae;Huh, Young
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.12 no.1
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    • pp.63-79
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    • 2008
  • Background: The consequences of disordered breathing patterns are not only distressing to the patient but also expensive to our health care systems if they are not diagnosed and treated. So we performed this study to investigate clinical significants trough gigong, yoga and hyperventilation in oriental medicine and westen medicine Method: Voluntary control of respiration is one of the main methods of physical and mental training such as meditation, qigong meditation or Yoga. So, this study focuses on breathing in qigong and yoga. This study appreciates a role that a control of respiration has in physical, mental aspects and searches side-effects in qigong and yoga Conclusions: A control of respiration has a function that manages Jung(精), Qi(氣), Shin(神) in Oriental Medicine. It manages Autonomic Nerve system, Endocrine system and induces natural awareness. So Briging the body and mind work through a control of breathing. Breathing pattern disorder has Damum and Qiher pattern in Oriental Medicine pattern. This disease pattern concearnes ATP metabolism. Qiher is concearned with a mitochondria disorder and Damum is concearned with a products of lactate. we guess that Lactate analysis may be utilized as a diagonostic criteria of Breathing pattern disorder. After this, It needs a study that Lactate analysis is concearned with Breathing pattern disorder as Damum pattern. Result: A control of respiration is related not only breathing but also spiritual and physical state. Joo-hwa-ip-ma as Breathing pattern disorder is smiliar to hyperventilation. HVS is patternated Damum and Qi-Weakness pattern in oriental medicine. Lactate is an important complement that diagonates HVS and will be concearned with Damum.

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Adherence to Clinical Guideline for Endotracheal Suction in ICU Nurses (중환자실 간호사의 기관내 흡인 임상지침 수행 현황)

  • Yang, Eunjung;Shin, Hyunsook
    • Journal of East-West Nursing Research
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    • v.23 no.1
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    • pp.53-62
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    • 2017
  • Purpose: This study aimed to evaluate the adherence to the clinical guideline for endotracheal suction in nurses working at intensive care units (ICU) and to identify the characteristics of nurses with good adherence. Methods: This study was a descriptive study to evaluate the pattern of adherence and its related factors to endotracheal suction. One hundred fifty five nurses working at ICU participated in this study. We used a questionnaire developed based on American Association for Respiratory Care (AARC) guidelines and other associated factors from previous studies. Results: Around half of the participants reported that their adherence to the clinical guideline was poor. Items deviated from the recommended guideline were reasons for initiating a suctioning, applied suction pressure ranged from 20 to 200mmHg, and applied catheter size from 6 to 17 french. Other factors deviated were the depth of inserted catheter, and inappropriate use of normal saline instillation. The most significant factor was related to hospital; the misused or misled clinical protocol. Conclusions: The adherence to the clinical guidelines of the endotracheal suction in ICU nurses was not appropriate, which might contribute to the patient health outcomes. More enhanced continuing education as well as hospital regulation is warranted.

A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness (만성질환자 배우자의 돌봄 경험에 대한 이론 구축)

  • Choi, Kyung-Sook;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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Correlations among Lifestyle and Health Status -A comparative study between nurses and clients- (생활양식과 건강수준간 상관성분석 -간호사와 비간호사 비교연구-)

  • Kim, Young-Im
    • Research in Community and Public Health Nursing
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    • v.5 no.1
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    • pp.53-63
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    • 1994
  • Health could be maintained and promoted by pursuing an active healthy lifestyle. Life-style include health habits and behavior pattern such as exercise, diatry change, weight control, stress management et al. The objectives of this studies are (1) to analyze recognition and practice of lifestyle between nurses and non-nurses, (2) to analyze health status of clients which presented healthy lifestyle, (3) to analyze factors that affected healthy lifestyle. The lifestyle assessment questionnaire is divided into ten sections: competence in selfcare, nutritional practices, physical activity, sleep patterns, stress management, self-actualization, sense of purpose, relation with others, environmental control, and use of health care system. The major results are as follows : (1) The level of recognition and practice of lifestyle was not high. Nurses showed more higher score than non nurses in lifestyle area such as competence in selfcare, stress management, environmental control, and use of health care system. (2) Good health status and lifestyle presented positive relation. (3) In mutiple classifiction analysis, competence in selfcare, nutritional practices, physical activity, sleep patterns, stress management, environmental control, and use of health care system had significant relation to independent variables. (4) Change of concept for healthy lifestyle after this survey was higher in nurses group and the most concern area was stress management. To sum up, lifestyle pattern of nurses as health professional was not desirably high. Therefore nurses ownself should effort to practice healthy lifestyle prior to others, and then educate importance of lifestyle for health promotion and disease prevention. In conclusion, it will be useful to consider significant lifestyle factors that was be identified in this study to develop health promotion program.

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Effects of Continuous Nutrition Care on Nutritional Status and Dietary Habits of Patients With Colorectal Cancer Receiving Adjuvant Chemotherapy After Surgery

  • Jina Son;Ha I Kang;Eun young Jung;Hae won Ryu;Kyung-Ha Lee
    • Clinical Nutrition Research
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    • v.12 no.2
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    • pp.99-115
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    • 2023
  • Patients with colorectal cancer may experience symptoms such as diarrhea, nausea, and anorexia, during surgery and chemotherapy, which can increase the risk of malnutrition. In addition, dietary habits play a key role in the onset of colorectal cancer; therefore, it is necessary to improve dietary habits to prevent recurrence during treatment after diagnosis. In this study, a clinical nutritionist conducted 4 interviews for patients diagnosed with colorectal cancer and scheduled for colectomy: before surgery, after surgery, 1st chemotherapy, and 2nd chemotherapy, and provided nutrition care for each treatment course to determine its effects on nutrition status and disease prognosis. Significant weight loss but no decrease in muscle mass was observed during treatment. Body fat mass, although not statistically significant, showed a decreasing tendency. The percentage of people who responded 'yes' to the below items increased after compared to before receiving nutrition education: 'I eat meat or eggs more than 5 times a week,' 'I eat seafood at least three times a week,' 'I eat vegetables at every meal,' 'I eat fruits every day,' and 'I eat milk or dairy products every day.' These results indicate that the patients changed their dietary habit from a monotonous eating pattern to a pattern of consuming various food groups after receiving nutrition education. These results suggest that continuous nutrition care by clinical dietitians, according to the patient's treatment process, can help improve the patient's nutritional status and establish healthy eating habits.