An acute pain is the common experience following surgery. Pain is a most miserable experience in person and most preoperative patients have fear o! postoperative pain. In nursing, it is very important to understand and relieve the pain of post oprative patients as much as possible. This study was designed to compare the descriptive patterns of pain between group of Patient Controlled Analgesia and group of traditional Muscular Injection in surgcal patients. This information can be utilited as data of understanding nursing care and treatment planning for pain in surgical patients. The subjects in this study were 45 post-hysterectomy patients in Gynecology ward in C. N. U. H., in Taejon. Data was collected from May 12 to June 27. 1996. The instrumants used for this study were subjective Visual Analog Scale, Objedive nonverbal pain scale composed of Facial Apperance. Vocal Sound Change, and Sweating score. and the Melzack's Mcgill pain Qusetionaire. nine Items of Developmental Pain Intensity Scale by Lee En Ok. Analysis of data was done by using S. P. S. S. percentage, t-test, x²-test. ANOVA, and Repeated measure ANOVA. Results were obtained as follows. 1. Hypothesis 1 : There was very highly statistically significant difference in subjective self-report pain score(Visual Analog Scale) between PCA Group and IM Group(P=0.0001). 2. Hypothesis 2 : There was very highly statistically significant difference in muscle strength score (Visual Analog Scale) between PCA Group and IM group(P0.0001). 3. Hypothesis 3 : There was very highly statistically significant difference in facial appearance score between PCA Group and IM group(P=0.0001). 4. Hypothesis 4 : There was very highly statistically significance difference in vocal sound change score between PCA Group and IM group(P=0.0001). 5. Hypothesis 5 : There was no statistically significant difference sweating scores between PCA group and IM group(F=2.50, P=0.1220). But, postoperation time of 12, 24 was statistically difference between two groups(P=0.0001). So, it was partially supported. 6. Hypothesis 6 : There was very highly statistically significant difference in vocabulary pain score between PCA Group and IM group. 7. Hypothesis 7 : There was very highly statistically significant difference in amounts of total analgesic between PCA Group and IM group. There was very highly statistically significant difference in Visual Analog Pain Score, Facial Appearance Score, Vocal Sound Change Score, Vocabulary Score, amounts of total analgesic between PCA group and IM group. So, It is verified to asses of postoperative pain with VAS, Checklist of facia appearance, vocal sound change, and sweating, and Vocabulary Scale.
Malnutrition is a common problem in cancer patients. In addition anticancer drugs used in chemotherapy as a major therapeutic mode are famous as the side effect like nausea, vomiting, which lead the patients to malnourished state. This study was to determine the relationship of anorexia, nausea, vomiting and oral intake and identify the influence these side effects on the nutritional status in patients receiving chemotherapy. To assess the nutritional status, anthropometry such as weight, height, body mass index(BMI), body fat proportion, and triceps skinfold thickness, and biochemistry test such as hemoglobin and lymphocyte were measured at the pre- and post- chemotherapy and the readmission time, all three times. During chemotherapy, anorexia, nausea, and vomiting using a VAS or 5-point scale and 24 hour oral intake using a food record were measured daily. Forty-nine patients knowing their diagnosis and receiving chemotherapy were recruited from an oncological ward in a general hospital for 5 months and they were reduced 31 at readmission time for a next chemotherapy. The results were as follows. Most subjects (93.6%) were in the 4th stage of cancer and 57.1% of subjects were in the first or the second chemotherapy. In most subjects(82.6%), their weight was decreased 10.7% than as usual. The degree of anorexia, nausea, and vomiting was significantly higher and the amount of oral intake was significantly less during the chemotherapy than at the pre-chemotherapy. Weight, BMI, triceps skinfold were reduced more at the post- chemotherapy than the pre-chemotherapy and were recovered the nearly same but less level at the readmission time. Body fat proportion was increased at the post chemotherapy and then decreased at the readmission phase. Hemoglobin and the number of lymphocyte were below normal at the pre-chemotherapy and more reduced at the readmission time. Anorexia, nausea, and vomiting were related positively and oral intake was negatively related with nausea and vomiting. The nutritional status at the post- chemotherapy and the readmission time was explained 20% over by the side effect like anorexia, nausea, vomiting and oral intake during the chemotherapy. The significant nutrition predictors at the post- chemotherapy were vomiting and the significant predictors at the readmission time were anorexia, vomiting, and oral intake. These results indicated the patients receiving chemotherapy were continued to deteriorate the nutritional status. Therefore nurse should have knowledge how much the nutritional status can be affected and assess the nutritional status periodically and try to find out the intervention for side effects from the series of chemotherapies.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.12
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pp.398-409
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2019
As the prevention of patient safety accidents has been strengthened in the accreditation process of medical institutions, patient safety, which is the maintenance of patient safety by managing medical accidents around the patients, is considered a subject that is important as a disease cure. The purpose of this study is to develop a Patient Safety Program using simulated situations for inpatients at a general hospital ward and to understand the effects on knowledge, performance, and perception of patient safety before and after the programs. In addition, the satisfaction of patient safety education is verified after application of the program. The participants were 30 inpatients at a general hospital. Data were collected from April 15 to 30, 2019 and analyzed using IBM SPSS Version 23.0. The results of the preand post-education revealed a statistically significantly improvement of patient safety knowledge, performance, perception and educational satisfaction. The Patient Safety Education Program using simulated situation was an effective educational program for the inpatients to improve patient safety knowledge, performance, perception, and educational satisfaction. Therefore, this program demonstrated a positive effect of patient safety and it is expected that it can be used as the basis of an education program in patient safety education in a clinical setting.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.12
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pp.212-223
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2019
The purpose of this study was to investigate how attitude, subjective norm, and perceived behavioral control affect nurses' pressure ulcer (PU) prevention behavior among general hospital nurses based on the theory of planned behavior. A total of 111 nurses in four general hospitals in Korea participated in this study and replied to a survey on attitude, subjective norm, perceived behavioral control, and behavior regarding PU prevention. Data were analyzed with multiple regressions by all participants, education level, working department, and hospital size group. In all participants, the more positive attitude and the higher subjective norm, the more PU prevention behavior. However, in the group of 'more than bachelor degree' and 'tertiary hospital', the more clinical experience, the more behavior. In the group of 'surgical ward & intensive care unit', the higher attitude, the more behavior. In the group of 'more than bachelor degree', the higher subjective norm, the more behavior. Therefore, personalized and tailored intervention for nurses may be provided depending on nurses' education level, work department, and hospital size to enhance PU prevention behavior by means of improving nurses' attitude, subjective norm toward PU prevention.
The distribution characteristics of incised meander river are analysed concerning topography, geology, stream order and altitude. Additionally geomorphological development of the Korean peninsular is considered with incised meander. The main findings are as follows: 1. The incised meander is intensively distributed on the west and north slope of T'aebak and Sobaek mountain range, but sparsely distributed on the opposite slopes. 2. Geologically, the occurrence rate of incised meander is high orderly as follows: Joseon supergroup, Pyeongan supergroup, Daedong supergroup metamorphic rock, Gyeongsang supergroup, and granite. The incised meander is developed well on the following conditions: hard rocks against weathering, stratified structure, geologic arrange across the river channel and contacting zone of geological formations. 3. The higher stream orders are, the higher occurrence of incised meander is. 4. Comparing the altitude of present river bed with the summit level of restored map, it is supposed that the incised meander rivers have been dissected about 300-500m down ward. 5. Considering the distribution characteristic of incised meander, it is suggested that not only T'aebak mountain range but Sobaek mountain range is the axis of asymmetrical up-warping in the Korean peninsular. 6. Considering the distribution characteristic of incised meander on the restored map and the stream order, it seems that present incised meander channel was inherited from antecedent meander river that had flowed on High and Middle level erosion surface. But the channel pattern has been modified.
The purpose of this experiment was to investigate the effects of adrenalectomy and PMSG treatment on reproductive organs and serum steroid hormone level in immature female rats. The animals used in this experiment were 25 days old female rats weighing a, pp.oximately 70g. They were randomly divided into two groups of intact rat group (Int-) and adrenalectomized rat group (Adx-) and each group were subdivided into two groups of Non-PMSG (-Cont) and PMSG treated (-PMSG) group. The rat of PMSG-treated group (-PMSG) was administered subcutaneously with 25 IU PMSG on first day (9 a.m.) after adrenalectomy. The adrenalectomized rat groups were su, pp.ied with saline solution through the experiment period. The rate of ovulation and vaginal opening and reproductive organ weights were observed at 8, 32, 56, 80 and 104 hours after PMSG treatment. At the same time, the serum level of estradiol-17${\beta}$ and progesterone were measured by the radioimmunoassay. The results obtained were as follows: 1. Ovulation was shown at 56 hours after treatment in Int-PMSG group and Adx-PMSG group and Adx-PMSG group. The rate of ovulation was very low in PMSG-treated groups, but it was increased in 80 to 90% at 104 hours after treatment. However, there was no ovulation in Int-Cont group and Adx-Cont group. 2. Vaginal opening was shown at 56 hours after treatment in Int-PMSG group and Adx-PMSG group and a, pp.ared in 80% at 104 hours after treatment. The rate of vaginal opening in PMSG-treated groups was very low, but Int-Cont group and Adx-Cont group had no vaginal opening. 3. The weight of ovary and uterus in two PMSG-treated groups were increased with the elapse of time after treatment and were significantly heavy in all observation time, but changes in Int-Cont group and Adx-Cont group were not recognized. The weights of ovaries and utera in Adx-Cont group were increased with the elapse of time. 4. The level of serum estradiol-17${\beta}$ was remarkably increased in PMSG-treated groups (Int-PMSG and Adx-PMSG groups) compared with Int-Cont and Adx-Cont group, and significant difference was recognized between Non-PMSG group and PMSG-treated group in the experimental period. Especially, the highest levels of Int-PMSG groups and Adx-PMSG groups were shown at 80 and 56 hours after treatment and after ward estradiol-17${\beta}$ levels of PMSG-treated groups were decreased. However, changes of the levels did not a, pp.ared in Non-PMSG groups at 104 hours after treatment. 5. The level of serum progesterone in PMSG-treated groups was significantly increased between 80 and 104 hours after treatment. With the elapse of time, the level was increased in all observed groups except for Int-Cont and Adx-Conx group. And the order from the highest level at 104 hours after treatment was Int-PMSG, Adx-PMSG, Int-Cont and Adx-Cont group.
The purpose of this study was to investigate effect of psychotic patient after applying anger management video and tea gathering program to psychotic patient. This study was an experimental research and used nonequivalent control-group pretest-posttest design. Study subjects were 16 patients for an experimental group and 16 for a control group-32 in total- who were psychotic patients hospitalized in a closed ward in H mental hospital. The measurement variable is an aggressiveness scale, and the effect of the program was measured once after the video program and once after eight tea gathering. Data Analysis methods were real number and percentage, average and standard deviation, χ2 test, t-test, paired t-test, and Repeated measure ANOVA. The aggression of an experiment group was significantly lower than the control group(F=14.38, p< .001). Aggressive sub-item, hostility (F=8.53, p< .001), anger (F=6.10, p=.004), verbal aggression(F=7.58, p< .001), physical aggression(F=13.92, p< .001) all of tte experiment group was significantly lower than control group. Based on these results, anger management programs can be used as basic data for anger control in psychotic patient or in various groups.
Kim, Kyoung-Ok;Park, Mi-Jung;Lee, In-Kwang;Park, Kyung-Soon;Shon, Ho-Sun;Kim, Kyung-Ah;Seo, Chang-Jin;Cha, Eun-Jong
Journal of Biomedical Engineering Research
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v.37
no.2
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pp.75-83
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2016
Nursing staffing is of major interest in hospital management, however, no practical method has been developed. The present study proposed a mathematical model based on the patient classification system for nursing staffing optimization. A few characteristic parameters possibly determined experimentally and/or empirically were introduced followed by systematic calculation of the required number of nurses. An essential concept of the model is the unit work load defined as the amount of nursing work performed on single patient per unit time, where the work load is defined as the number of nursing staffs multiplied by the working hours. The unit work load was considered to vary with the patient classification level as well as the working time during a day, both of which were represented by corresponding parameter values. The number of patients for each class and the number of working hours were multiplied to the unit work load, and added up to obtain the total required work load. As the next step, the averaged number of hours that a nurse could provide per day was formulated considering the degree of nursing practice experience into 3 levels. Finally, the appropriate number of nursing staffs was calculated as the total work load divided by the average working hours per nurse. The present technique has a great advantage that the number of nursing staffs to fulfill the required work load is systematically calculated once the characteristic parameters are appropriately determined, leading to instant and fast evaluation. A practical PC program was also developed to apply the present model to nursing practice.
Background : Because unplanned readmissions to intensive care unit(ICU)might be related with undesirable patient outcomes, we investigated the pattern of and reason for unplanned ICU readmission to provide baseline data for reducing unplanned returns to ICU. Methods : The subjects included all patients who readmitted to ICU during the same hospitalization at a tertiary referral hospital between January 1st and June 30th 2002. Quality improvement(QI) nurse collected the data through medical records and a medical director reviewed the data collected. Results : 1) The average unplanned ICU readmission rate was 5.6%(gastroenterology 14.6%, pediatrics 12.7%, pulmonology 11.9%, neurosurgery 6.3%, general surgery 5.3%, chest surgery 3.9%, and cardiology 3.3%). 2) Among the unplanned readmissions, more than 50% of cases were from patients older than 60 years, and the main categories of diagnose at hospital admission were neurologic disease(29.9%) and cardiovascular disease(27.6%). 3) Of unplanned ICU readmissions, 41.8% had recurrence of the initial problems, 44.8% had occurrence of new problems. And 9.7% required post-operative care after unplanned operations. 4) The most common cause responsible for unplanned ICU readmission were respiratory problem(38.3%) and cardiovascular problem(14.3%). 5) About 40% of unplanned ICU readmission occurred within 3 days after ICU discharge. 6) Average length of stay of the readmitted patients to ICUs were much longer than that of non-readmitted patients. 7) Hospital mortality rate was much higher for unplanned ICU readmitted patients(23.6%) than for non-readmitted patients(1.5%) (P<0.001). Conclusions : This study showed that the unplanned ICU readmitted patients had poor outcomes(high morality and increased length of stay). In addition study results suggest that more attention should be paid to patients in ICU with poor respiratory function or elderly patients, and careful clinical decisions are required at discharged from ICU to general ward.
Jung, Yooun Joong;Kim, Young Hwan;Kim, Tae Hyun;Keum, Min Ae;Ma, Dae Sung;Kyoung, Kyu Hyouck;Kim, Jung Jae;Hong, Suk-Kyung
Journal of Trauma and Injury
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v.25
no.4
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pp.254-260
/
2012
Purpose: Ongoing treatment and care, as well as initial stabilization, are required for trauma patients. With increasing number of sickest trauma patients and shortage of surgeons, the need for advanced practice nurse to provide and coordinate trauma care has been greater. The purpose of this study is to analyze the effect of hiring a trauma clinical nurse specialist and its influence on the treatment of trauma patients. Methods: Based on the employment of the clinical nurse specialist in December 2010, the patients were divided into two groups: patients admitted from January 1, 2010 to November 30, 2010 and patients admitted from December 1, 2010 to December 31, 2011. Retrospectively, data were collected using electronic medical records. The general characteristics, clinical courses, and ICU re-admission rates, collaboration (transfers to other departments and collaborative surgery) were compared. Results: To have a clinical nurse specialist on the trauma team resulted in a statistically significant reductions in the length of general ward hospital stay (p<0.05), the ICU re-admission rate, (p<0.03), the lead-time before transfer to other departments (p<0.05). Conclusion: The clinical nurse specialist, as a professional practitioner, improved the quality of treatment through early detection and management of problems. In addition, as a coordinator, the clinical nurse specialist maintained a cooperative relationship with multi-disciplinary medical personnel. The trauma clinical nurse specialist contributed to the treatment of trauma patients positively through a decrease in ICU re-admission rate and length of hospital stay.
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