• Hip & pelvis
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• 제34권4호
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• pp.227-235
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• 2022

Purpose: Outpatient classified total hip arthroplasty (THA) is a safe option for a select group of patients. An analysis of a national database was conducted to understand the risk factors for unplanned discharge to a skilled nursing facility (SNF) or acute rehabilitation (rehab) after outpatient classified THA. Materials and Methods: A query of the National Surgical Quality Improvement Program (NSQIP) database for THA (Current Procedural Terminology [CPT] 27130) performed from 2015 to 2018 was conducted. Patient demographics, American Society of Anesthesiologists (ASA) classification, functional status, NSQIP morbidity probability, operative time, length of stay (LOS), 30-day reoperation rate, readmission rate, and associated complications were collected. Results: A total of 2,896 patients underwent outpatient classified THA. The mean age of patients was 61.2 years. The mean body mass index (BMI) was 29.6 kg/m² with median ASA 2. The results of univariate comparison of SNF/rehab versus home discharge showed that a significantly higher percentage of females (58.7% vs. 46.8%), age >70 years (49.3% vs. 20.9%), ASA ≥3 (58.0% vs. 25.8%), BMI >35 kg/m² (23.3% vs. 16.2%), and hypoalbuminemia (8.0% vs. 1.5%) (P<0.0001) were discharged to SNF/rehab. The results of multivariable logistic regression showed that female sex (odds ratio [OR] 1.47; P=0.03), age >70 years (OR 3.08; P=0.001), ASA≥3 (OR 2.56; P=0.001), and preoperative hypoalbuminemia (<3.5 g/dL) (OR 3.76; P=0.001) were independent risk factors for SNF/rehab discharge. Conclusion: Risk factors associated with discharge to a SNF/rehab after outpatient classified THA were identified. Surgeons will be able to perform better risk stratification for patients who may require additional postoperative intervention.

• 한국응용과학기술학회지
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• 제39권6호
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• pp.892-905
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• 2022

본 연구는 한국청소년정책연구원에서 실시한 한국아동·청소년 패널조사의 초등학교 4학년 패널의 7차년도 자료인 고등학교 1학년에 재학중인 청소년을 대상으로 의사결정나무분석을 통하여 청소년 지위비행의 고위험군의 특성을 파악하고, 그 영향요인을 확인하였다. 본 연구의 대상자 1,979명 중 지위비행 집단은 264명으로 전체의 13.3%로 나타났다. 청소년 지위비행의 고위험군은 남자이면서 긍정적 양육방식을 낮게 인식하는 군이었다. 긍정적 양육방식이 가장 중요한 영향요인으로 나타났으며, 그 다음으로 성별, 정서문제, 교사관계, 성취가치 순이었다. 청소년 지위비행을 예방하기 위해 양육방식에 대한 부모교육 프로그램, 남자 청소년에게 특화된 중재 프로그램의 개발이 필요하다. 또한 공격성에 초점을 두었던 그 동안의 중재에서 더 나아가, 우울, 사회적 위축 등의 정서문제를 포괄적으로 다루는 중재가 요구된다. 특히 청소년에게 중요한 학교환경에서 교사관계가 가장 중요한 영향요인으로 밝혀진 바, 청소년 지위비행의 원인과 결과에 대한 교육, 상담기법에 대한 훈련을 통한 교사와의 관계 증진이 청소년 지위비행을 예방하는 보호요인으로 작용할 것이다.

• 한국보건간호학회지
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• 제15권1호
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• pp.157-171
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• 2001

The study was designed to provide the fundamental information for understanding discomfort of bone marrow donors and for promoting an individual comfort by comparing the difference on discomfort between unrelated donors and related donors. The subject of the study was fifty related donors and thirty unrelated donors who was in the C University Hospital. This survey had been carried out and collected from October, 1998 to March, 1999. The scale of discomfort of donors associated with bone marrow donation were assessed by the questionnaire deviced by Kim Sang Dol and amended by the researcher. Data was analyzed by $x^2-test$, t-test, two-way ANOVA, and Pearson Correlation Coefficients. The results were as follows. 1. Considering the general characteristics of bone marrow donors according to gender, male was consisted of $60\%$ and female was consisted of $40\%$. Of those related donors are consisted for $62.5\%$ and accounted for $37.5\%$ of those unrelated donors. Considering the classification to the job, employee of company were major donors which was $35\%$, and next order was student, individual businessman, and housewife. Considering the education level. college students were $48.7\%$ and students who have less than high school level were $42.5\%$. 2. According to the above the results regarding discomfort of bone marrow donation, it is especially shown that the major cause for discomfort of bone marrow donors is on physical factor. The concrete examples for physical factor are pain in the region of bone marrow harvest and pain in the injection part by fluid therapy and blood-sampling, an immovability of the body after bone marrow harvest, and difficulties on walking. Considering physiological factor, there are an uneasiness about leading to injure their health, vague fear about the hospital. and a tedium at hospital. Environmental factors for discomfort of bone marrow donors are insufficient explanation for needle gauge and procedure of bone marrow donation and difficulty on following medical schedule. Therefore. it is necessary to establish more effective and systematically organized program for nursing intervention based on the research results. An effective program is only useful in getting rid of discomfort of bone marrow donors.

• 근관절건강학회지
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• 제19권2호
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• pp.152-160
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• 2012

Purpose: The purpose of this study was to test the effects of the Tai Chi exercise on metabolic syndrome and health-related quality of life in middle-aged women. Methods: A quasi-experimental design was used. Subjects were sixty middle-aged women with metabolic syndrome. All of the subjects were met the criteria of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). The subjects were divided into the experiment group (n=33) trained the Tai Chi for 12 weeks and the control group (n=27). Metabolic syndrome risk factors including blood pressure, waist circumference, glucose, triglyceride (TG), and high density lipoprotein cholesterol (HDL-C) were measured before and after the 12-week period. Euro Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D) was used to evaluate the health-related quality of life. Results: The experiment group showed significant decreases in diastolic blood pressure, waist circumference, glucose, and TG; and increase in HDL-C compared to the control group. For the health-related quality of life evaluation, the experiment group showed significant improvement more than the control group. Conclusion: The Tai Chi exercise may be effective intervention in preventing cardiovascular disease caused by metabolic syndrome in middle-aged women.

• 보건교육건강증진학회지
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• 제30권5호
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• pp.139-151
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• 2013

Objectives: This study investigated how income, duration of illness, social stigma, quality of sleeping, ADL and social participation related to Parkinson's disease(PD) predict depression in a conceptual model based on the International Classification of Functioning(ICF) model. Methods: The sample included 206 adults with idiopathic Parkinson's disease(IPD) attending D university hospital in B Metro-politan City. A structured questionnaire was used and conducted face-to-face interviews. The collected data were analyzed for fitness, using the AMOS 18.0 program. Results: A path analysis showed that the overall model provided empirical evidence for linkages in the ICF model. Depression was manifested by significant direct effects of social stigma(${\beta}=.20$, p<.001), quality of sleeping(${\beta}=-.40$, p<.001), ADL(${\beta}=-.20$, p<.01), and social participation(${\beta}=-.12$, p<.05), indirect effects including income(p<.05), duration of illness(p<.05). These variables explained 45.9% of variance in the prediction model. Conclusions: This model may help nurses to collect and assess information to develop intervention program for depression.

• 대한지역사회영양학회지
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• 제21권2호
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• pp.190-199
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• 2016

Objectives: The purpose of this study was to identify the differences in nutrient intake according to using diuretics, symptom severity and degree of physical functioning in heart failure patients. Methods: A secondary data analysis was conducted by using baseline data of an intervention study for heart failure patients. In this study, 131 heart failure patients were included. Data were collected using medical records, NYHA (New York Heart Association functional classification) class, and 6-minute-walking test and 24-hour diet recall. Data were analyzed using descriptive statistics and Chi-square test by SPSS 21.0. Nutrient intake was assessed using CAN-pro 2.0. Results: Majority of the participants consumed total calorie less than Estimated Energy Requirement (EER) and consumed carbohydrates more than 65% of their total calorie intakes. 24.4% of the participants consumed fat more than 30% of their total calorie intakes and 23.7% consumed saturated fat more than 7% of their total calorie intakes. 100.0% of the participants consumed protein less than 7% of their total calorie intakes and 73.3% of the participants consumed more than recommended intakes of sodium. More than 90.0% of the participants consumed less than adequate intakes of potassium (90.1%) and Vitamin D (91.6%), respectively. 100% and 62.6% of the participants consumed less than Estimated Average Requirement (EAR) of magnesium and Vitamin $B_1$, respectively. Nutrient intakes in heart failure patients were different for potassium intake according to the usage of diuretics. The participants with symptom severity tended to intake protein less properly and the participants walking more than 300.0 m tended to intake sodium improperly high. Conclusions: The findings of this study indicated the need for screening nutrient intakes of heart failure patients. It is necessary to increase the intake of total calories and most nutrients and to restrict sodium intakes among heart failure patients.

• Journal of Korean Neurosurgical Society
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• 제59권1호
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• pp.37-43
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• 2016

Objective : The aim of this multicenter, matched-pair study was to compare the outcomes of stereotactic radiosurgery (SRS) and conventional external radiation therapy (RT) when used as a primary treatment in spine metastasis from hepatocellular carcinoma (HCC). Methods : From 2005 to 2012, 28 patients underwent SRS as the primary treatment in spine metastasis from HCC. Based on sex, age, number of spine metastasis, Child-Pugh classification, interval from original tumor to spine metastasis, and year of treatment, 28 patients who underwent RT were paired. Outcomes of interest were pain relief, progression free survival, toxicities, and further treatment. Results : The perioperative visual analog scale (VAS) decrease was larger in SRS group than in RT group, but the difference was not significant (3.7 vs. 2.8, p=0.13). When pain medication was adjusted, the number of patients with complete (n=6 vs.3) or partial (n=12 vs.13) relief was larger in SRS group than in RT group; however, the difference was not significant (p=0.83). There was no significant difference in progression free survival (p=0.48). In SRS group, 32.1% of patients had 1 or more toxicities whereas the percentage in RT group was 63.0%, a significant difference (p=0.04). Six SRS patients and 7 RT patients received further intervention at the treated segment. Conclusion : Clinical and radiological outcome were not significantly different between the two treatments. Toxicities, however, were more prevalent in the RT group.