• 제목/요약/키워드: ward

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동종 조혈모세포 이식환자의 이식 전 처치 형태에 따른 영양상태 (Nutritional Status of Recipients of Allogeneic Hemopoietic Stem Cell Transplantation by Types of Conditioning Regimen)

  • 김남초;김희승;최소은;박현정
    • 한국보건간호학회지
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    • 제14권2호
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    • pp.191-202
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    • 2000
  • This study was conducted for 39 patients who are recipients of allogeneic hemopoietic stem cell transplantation at BMT ward of St. Mary's hospital affiliated to Catholic University of Korea from April to September 1999. The subjects were devided into two groups; those who received both TEl and chemo therapy as conditioning regimen (TEl group). and those who used chemo agents as singular conditioning regimen (chemo group). The oral intake status of the two groups were compared through physical assessment and blood chemistry exam of the subjects, and factors influencing their nutritional change and oral intake were explored in each stage of the transplantation (six stages: admission, conditional stage, date of transplantation, one week after transplantation, two weeks after transplantation, and three weeks after transplantation). The prior aim of the study was to provide baseline data to minimize delayed treatment from nutritional deficiency of the subjects. The results were as follows: 1. TBI group was significantly decreased of oral calorie intake in two weeks after transplantation compared to admission and conditioning stage while that of chemo group was significantly decreased on the date of transplantation. 2. TBI group was significantly decreased of protein intake in two weeks after transplantation compared to admission and conditioning stage. In chemo group, protein intake was significantly decreased on the date of transplantation compared to admission. It was remarkable that TBI group showed lesser protein intake than chemo group. 3. Both group were significantly decreased of BMI in one week and three weeks after transplantation compared to admission. TBI group showed significantly higher BMI than chemo group. 4. Both group were significantly decreased of Triceps Skinfold Thickness (TST)on the date of transplantation compared to admission stage. 5. TBI group was significantly decreased of mid-arm muscle circumference (MAMC) in two weeks after transplantation compared to admission, conditioning, date of transplantation. 6. TBI group was significantly decreased of albumin level in two weeks after transplantation compared admission stage. In chemo group, it was significantly decreased on the date of transplantation compared to admission, three weeks after the transplantation. 7. TBI group was significantly decreased of transferrin level in two weeks after transplantation compared admission, conditioning, date of transplantation and one week after transplantation. In chemo group, it was decreased of transferrin level in 3 weeks after transplantation. 8. Oral intake of TEl group was impacted by vomiting before transplantation and gingivitis after transplantation. In chemo group, it was impacted by vomiting before transplantation and by two factors, gingivitis and nausea, after transplantation. The results showed oral calorie intake was not different between the two groups while protein intake was significantly lower in TBI group than chemo group. Oral intake was significantly impacted by vomiting before transplantation in both groups, but affected by oral gingivitis in TBI group and gingivitis and nausea in chemo group after transplantation. This findings present that standardized strategies to manage nutrition and gingivitis more effectively are desperately needed to enhance oral intake and protein intake of patients who receive TBI as conditioning regimen.

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교대근무간호사의 피로경험 (The Fatigue Experience of Shift Work Nurses)

  • 고효정;김명애;권영숙;김정남;박경민;박정숙;박영숙;박청자;신영희;이경희;이병숙;이은주
    • 한국보건간호학회지
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    • 제18권1호
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    • pp.103-118
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    • 2004
  • The purpose of this study was to understand the process and investigate basic theory of fatigue experience of shift work nurses. The present study adopted grounded theory methodology on fatigue of shift work nurses. The participants for this study were 15 shift work nurses who were in the age of 25 to 35, the clinical experience of 2 to 14 years and the work department of ICU. ER. ward and delivery room. The data were collected from 2000 to 2003 by using interviews and observations. The contents of the interviews were tape-recorded and were drawn through repeated method. And then were analyzed into the concept, subcategories, and categories with the open coding process and axial coding was done to identify the relationships of the concepts and categories according to the paradigm models. The core category generated, which was a central phenomena of the exhaustion process. The causal condition is change events. The central condition of exhaustion were sorted as physical discomfort, decreasing vigor, psychological instability, feeling of sleeping desire, changing face impression and being heavy body. The intervening condition were discovered as social$\cdot$ psychology$\cdot$physical resist and positive$\cdot$negative interaction strategies. The consequences of the fatigue process is the short term exhaustion relief and long term residual exhaustion. The fatigue process of this study was 'break through exhaustion' of change event-exhaustion-resist-resolve intervention-adaptation. This study offers better understanding on fatigue process of shift work nurses and may facilitate more appropriate interventive strategies to support, information and knowledges according to fatigue process.

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간호활동의 유형과 요통 발생에 관한 일 조사연구 (A Survey on Back Pain of Nurses)

  • 한윤복
    • 대한간호학회지
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    • 제7권1호
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    • pp.39-46
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    • 1977
  • Despite the fact that it is not a fatal symptom. the lower back pain of human species is considered a health problem of modern society: 80% of world population experience it and the distress and dysfunction caused by interferes daily life as well as the general productivity. This study was performed to investigate the general tendency of lower back Pain on nurses: influence of nursing activities, working condition and the physical characteristics of nurses on the pain in order to provide data for prevention and treatment. 386 nurses working at 16 general hospitals throughout the country were sampled. Questionaries developed by the researcher was used for data gathering. Results are as follows : 1. Lower back pain was experienced by most(72.3%) of the nurses: the highest rate of -Pain experience was revealed to be the a9e group of 35-39 (80.8%) followed by 25-29 group (74.2%). 2. In almost all instances (91.4%), the first pain attack occurred before the age of 29, and in 73.1%. the attack occurred between the age of 15-24. 3. In 10.1%, the pain was almost persistent or occurred every other day frequency. In 9%, the pain was relieved by the administration of analgesics or "unable to move". 4. More than 6 days′sick leave due to the pain revealed to be in 2.2%. No significant difference was revealed between specialities of service. 5. Pain experience and the over or under weight revealed not to have significant relations. (X$^2$=0.55224, p〉0.7587) 6. The length of working hour of I. C. U. and O. R, revealed to be longer than that of nurses general ward, however. no significant difference on the rate of pain occurrence apparent. (X$^2$=0.4952, p〉0.8239) No significant difference on the rate of pain occurrence between nurses working over 46 hours/week and under 45 hours/week. (X$^2$=3.86241, p〉0.078318) 7. The most frequent Pain related movement revealed to be "lifting patient or heavy object" (24. 7%, N=68) followed by "the sameness of position, either standing or sitting"(16.8%) 8. Regular physical exercise revealed to have no significant influence on the rate of Pain occurrence. 9. Higher raft of pain experience was revealed in the group of nurses wearing eye glasses. Uncomfortable shoes revealed to have influenced the pain. 10. The most frequent pain relieving treatment revealed to be "rest" (54.2%, N= 151) followed by "analgesics" (12.6%, N=35) and "hot compress/fomentation"(10.5%, N=29). In 13.7% (N=38) no special care was given.

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유청단백 함유 체중조절용 식사대체제를 이용한 4주 다이어트 프로그램이 과체중 및 비만 여성의 체중, 체지방 및 체성분에 미치는 영향 (Effects of Whey Protein-rich Meal Substitute in 4-Week Diet Trial on Body Weight, Body Fat, and Body Composition of Overweight or Obese Females)

  • 석매주;장이림;최영빈;정기희;김건우;박용우;이복희
    • 동아시아식생활학회지
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    • 제26권1호
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    • pp.25-33
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    • 2016
  • The study was performed to investigate the effects of whey protein-rich meal substitute added with vitamins, minerals, and lactobacillus powder probiotics on weight loss, body fat, and body composition in 24 female volunteers for 4 weeks. Whey protein-rich meal substitute was consumed with low-fat, high calcium milk (1% fat, 260 mg/200 mL) twice a day. Subjects submitted 3-day diet records and a life-style questionnaire before the study. During the study, subjects were required to turn in a diet record every day and consume the meal substitute formula in the metabolic ward at C university for 4 weeks. Anthropometric measurements were carried out weekly by Inbody 7.0. The dietary intake and anthropometric data were analyzed to compare changes before and after the study by paired t-test with SPSS version 23.0. The subjects were mostly early 20's and either overweight or obese and highly motivated to lose weight. Most of the subjects consumed three meals per day regularly and spent mostly 10~15 minutes for a meal. Their caloric intake was relatively low and decreased from 1,360 kcal at week 0 to 1,100 kcal after 4 weeks. However, total protein intake increased while carbohydrate and fat intakes decreased (p<0.05) after the trial. Nine vitamin intakes after the study improved compared to those before the study (p<0.05). After the study, subjects showed lower body weight (-1.8 kg), body fat (-0.94 kg), percent body fat (-0.86%), as well as waist circumference (-4.52 cm), hip circumference (-0.44 cm), waist hip ratio (-0.05), and triceps skinfold thickness (-2.39 mm) compared to those at week 0 (p<0.05). Muscle mass tended to be less compared to week 0, although there was no significant differences between weeks 0 and 4. In conclusion, diet trial with whey protein-rich meal substitute induced weight loss and positively changed body fat parameters and body composition.

급성기 정신분열병의 치료로서 단기적인 안구운동 민감소실 및 재처리요법에 대한 예비연구 (A Pilot Study of Brief Eye Movement Desensitization and Reprocessing(EMDR) for Treatment of Acute Phase Schizophrenia)

  • 김대호;최준호;김석현;오동훈;박선철;이선혜
    • 생물정신의학
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    • 제17권2호
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    • pp.94-102
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    • 2010
  • Objectives : Eye movement desensitization and reprocessing(EMDR) is a novel, time-limited psychotherapy originally developed for treatment of psychological trauma. The effectiveness of this therapy has been validated only for posttraumatic stress disorder ; however, EMDR is often applied to other psychiatric illnesses, including other anxiety disorders and depression. This pilot study tested the efficacy of EMDR added to the routine treatment for individuals with acute stage schizophrenia. Methods : This study was conducted in the acute psychiatric care unit of a university-affiliated training hospital. Inpatients diagnosed with schizophrenia were randomly assigned to either three sessions of EMDR, three sessions of progressive muscle relaxation(PMR) therapy, or only treatment as usual(TAU). All the participants received concurrent typical treatments(TAU), including psychotropic medication, individual supportive psychotherapy and group activities in the psychiatric ward. The Positive and Negative Syndrome Scale(PANSS), the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale were administered by a clinical psychologist who was blinded to the patients' group assignment. Results : Forty-five patients enrolled and forty patients(89%) completed the post-treatment evaluation. There were no between-group differences in the withdrawal rates of patients during the treatment or at the three-month follow-up session. All three groups improved significantly across each of the symptomatic domains including schizophrenia, anxiety, and depressive symptoms. However, a repeated measures ANOVA revealed no significant differences among the groups over time. Effect size for change in total PANSS scores was also similar across treatment conditions, but effect size for negative symptoms was large for EMDR(0.60 for EMDR, 0.39 for PMR and 0.21 for TAU only). Conclusion : These findings supported the use of EMDR in treating the acute stage of schizophrenia but the results failed to confirm the effectiveness of the treatment over the two control conditions in three sessions. Further studies with longer courses of treatment, more focused target dimensions of treatment, and a sample of outpatients are necessary.

일상화된 회음절개술에 대한 여성의 지식, 교육요구, 불편감 및 통증정도에 관한 일 연구 (A Study on Women's Level of Educational Need & Knowledge about Routine Episiotomy and the Degree of Discomforts and Pain after Episiotomy)

  • 유은광;김진희
    • 여성건강간호학회지
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    • 제7권3호
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    • pp.393-406
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    • 2001
  • The purpose of this study was to find out women's need and level of knowledge about episiotomy, pain and discomfort related to episiotomy on a cross-sectional survey design. The subjects were 102 postpartal women agreed on oral consent. 34 postpartal women admitted at obstetric ward of H university hospital, 34 postpartal women admitted at 2 Sanhujoriwons, and 34 women within one year afterbirth. They were selected in Seoul, Korea. Data were collected from July, 1 to September 30, 2000, by a structured questionnaire. The instrument used for this study was a questionaire consisted of 5 items of general characteristics, 12 items of obstetric characteristics, 10 items of level of knowledge (Chronbach $\alpha$ .8176), 8 items of need of education(Chronbach $\alpha$ .8836), 3 items of pain (Chronbach $\alpha$ .9252), and 3 items of discomfort (Chronbach $\alpha$ .8092). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows; 1. 63.2% of respondents had right answer on 6-8 items among 10 items. Only 4.4% of women got right answer on 10 items all. 2. The need of education was high(4.45%) on all items and the range of score was $4.25{\sim}4.64$. 3. The strength of pain was the highest within one week afterbirth(5.93/10) and became lower in 8-14 days afterbirth(2.55). And after 15days of postpartum, the pain level became to the lowest level(1.08). However, pain was delayed until more than one month afterbirth. 4. The level of discomfort was the highest one week afterbirth(6.88/10) and became lower in 8-14 days afterbirth(4.20). And after 15days of postpartum, the discomfort level became to the lowest level(2.47). Universally, the degree of discomfort was higher than pain. 5. There was a strong positive correlation between discomforts and pain ($r=.752^{**}$) and weak positive correlation between discomforts and the level of educational need($r=.308^*$). In conclusion, women have a right to choose whether she will have episiotomy or not according to her decision making based on the comprehensive knowledge of episiotomy before they get episiotomy with consent process and explanation in detail. Women health care providers like nurses have a responsibility to do conscious raising and empowerment for women so that they could lead themselves to choose given medical treatments for women's health and wellbeing and the quality of life in her life cycle.

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경혈지압 간호중재가 수술후 장유동 회복에 미치는 영향 (An Effect on Recovery of Post-operative Bowel Movement on Nursing Intervention of Meridian Acupressure)

  • 이향련;김귀분;김광주;왕명자;김윤희;김일원;김호미
    • 동서간호학연구지
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    • 제6권1호
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    • pp.46-54
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    • 2001
  • This study was conducted to identify the effectiveness of meridian acupressure for enhancement of post operative bowel movement to the patient with absolute bed rest who having surgery under general anesthesia. This study used a qusai experimental, nonequivalent control group post test only design. This subject were 44 patients, 22 for the experimental and 22 for the control group, who were admitted at KyungHee University hospital, neurosurgical unit A and B ward, assigned by matched sample by the name of operation who having microvascular decompression and laminectomy. Date were collected from May 1, 2001 to June 30, 2001 by auscultation, self report and by using 7 point face scale. The recovery of bowel sound were measured every 4 hours until gas out for 1 minute auscultation on lower abdomen after 4 hours having surgery. The time of gas out were measured by self report, the severity of nausea were measured every 4 hours for 7 point face scale and also the degree of satisfaction of nursing care were measured after 2 days having surgery with same scale. Data were analyzed with $X^2$, t-test, repeated measures ANOVA and ANOVA. The result of this study were as follows; 1. The experimental group which were implemented with meridian acupressure showed shorter time the recovery of bowel sound after having surgery than control group(t=-5.112, p=.0001). 2. The experimental group which were implemented with meridian acupressure showed shorter time of gas after having surgery than control group(t=-4.010, p=.0001) 3. The experimental group which were implemented with meridian acupressure showed decreased level of nausea score according to time interval than control group(F=21.995, p=.0001). 4. The experimental group which were implemented with meridian acupressure showed higher the degree of satisfaction of nursing care than control group(t=-4.010, p=.0001). These finding indicate that a meridian acupressure could be a effective nursing intervention for enhancement of post operative bowel movement to the patient with absolute bed rest who having surgery under general anesthesia.

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신속대응팀의 활성화 시간에 영향을 주는 요인 (Factors Influencing the Activation Time of the Rapid Response Team)

  • 한미라;강은형;이용숙;장은주;이수정;허윤아;남궁서화;서서희
    • 임상간호연구
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    • 제26권2호
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    • pp.198-206
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    • 2020
  • Purpose: The rapid response team is a patient safety system that detects symptoms and signs of deteriorating inpatients and provides intervention and treatment. This study analyzed the factors influencing the activation time of the team. Methods: This is a descriptive correlation study that analyzed the electronic medical records of patients activated by the rapid response team. The collection period was from January 2014 to December 2017. We analyzed 278 pieces of data activated by the rapid response team for patients aged 16 years or older at C University S Hospital in Seoul. We employed the SPSS 23.0 program for data analysis. Results: The reasons for activation of the rapid response team were oxygen saturation of less than 90.0%, other causes, and change in consciousness. The most common diagnosis of activated patients was respiratory failure (32.4%). The average activation time was 153.43±286.05 min. The activation time was shortest during convulsions (13.29±7.32 min). For patients with a history of kidney disease (B=0.58, p=.008), in case of surgery (B=0.55, p<.001), if the first symptom is mediated by the physician (B=0.53, p=.007) the active time is often extended. On the other hand, activation time is reduced when consciousness changes (B=-0.51, p=.002), especially when oxygen saturation is below 90.0% (B=-0.64, p<.001). Conclusion: Based on the results of the study, it is expected that patients deteriorating in the general ward would be recognized early, which will help in the effective activation of the rapid response team.

간호업무 전산화를 위해 개발된 표준화된 간호계획서의 타당성 검정 (The Validation of Standardized Nursing Care Plans Developed for Computerized Use in Clinical Practice)

  • 김용순
    • 대한간호학회지
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    • 제21권3호
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    • pp.349-364
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    • 1991
  • Recognition of the usefulness and the importance of the nursing diagnosis is increasing. There is a prevailing opinion that nursing diagnosis should be used to improve the quality of nursing care. Developing standardized nursing care palns based on nursing diagnoses is therefore considered one of the most essential projects for professional growth and improvement in the nursing world of Korea. Consequently, in the first stage of this research project, the ten nursing diagnses used most frequently with patients on medical and surgical wards were determined and related nursing care plans were developed, implemented and evaluated. The application of the standardized nursing care plans raised the nurses' confidence and proved to be effective in enhancing the quality of nursing care. This study was initiated as the next stage, to develop, test, and determine the validity of nursing care plans for the remaining nursing diagnoses. Nineteen medical and surgical wards were selected for the study ; the 176 staff nurses working on those wards and 1211 patients hospitalized there (603 patients during the nursing care plan use) took part in the project. The following summarizes the results of the study : 1. After listing all the nursing diagnoses up to the 20th in frequency from each ward except the ten used in the first study, 22 nursing diagnoses were selected. Two related to ‘self care deficit’, were combined into one. Standardized nursing care plans were established for these 21 nursing diagnoses. 2. The first page of each nursing care plan lists the related factors and defining characteristics as supporting data. The application rate distribution revealed that the majority were recorded less than 50% of the time. For each nursing diagnosis, only one to three related factors were recorded more than 50% of the time regardless of the number of suggested related factors, and similarly, only one to five defining characteristics were recorded more than 50% of the time regardless of the number of suggested defining characteristics. Therefore, these factors and defining characteristics were proposed as the common related factors and the typical signs and symptoms for each nursing diagnosis. 3. The application rate distribution for the expected outcomes, and the nursing orders that were the main data of each nursing care plan occurred more than 50% of the time, unlike the related factors and the characteristics that occurred less frequently. These findings supported the clinical validity. 4. In an effort to evaluate indirectly the effect of the use of the standardized nursing care plans, nurses' job satisfaction and perceptions of their ability in the use of the nursing process were measured and compared. Scores after the use of the plans were significantly higher than those before. The experience in actually using the standardized nursing care plans with patients increased the nurses' professional and emotional satisfaction and their confidence in using the nursing process. Also when the nurses who actually used the nursing care plans were asked to rate their effectiveness, the highest score was given to ‘the ease of establishing the nursing goal’, followed by ‘improved professional advice and care for patients’, ‘the efficiency and systemization of charting’, ‘the definite recognition of the nursing problem’, and ‘the selection of effective and appropriate nursing interventions’ in descending order. The results indicate the nurses were very positive about the effect of the real clinical application of standardized nursing care plans, and that the objective of this study to utilize the nursing diagnosis to strengthen the nursing process was attained.

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남자 간호대학생의 임상실습의 경험 (Clinical Practice Experience of Men in Nursing as a Student)

  • 김미화;송미숙
    • 문화기술의 융합
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    • 제6권1호
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    • pp.223-229
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    • 2020
  • 본 연구는 임상실습을 경험한 남자 간호대학생의 임상경험을 심층적으로 살펴봄으로써 임상 실습의 의미와 본질을 이해하고 남자 간호대학생의 임상 실습이 진로설정에 어떠한 영향을 미치는지에 대한 기초자료를 얻고자 함이다. 본 연구의 참여자는 현재 H대학교 간호학과 재학 중인 남학생으로 임상 실습 경험이 있는 3학년 3명과 4학년 남학생 3명을 눈덩이 표집으로 선정하였으며, Colaizzi의 현상학적 연구방법에 따라 의미 있는 진술을 분석하여 남자 간호학생들의 임상 실습 경험의 의미를 파악하는 것이다. 연구결과 3개의 범주로 구분되며, 6개의 주제, 14개의 의미 있는 진술로 도출되었다. 이는 '병동실습에서 경험한 부정적인 간호이미지', '감당해야 할 스스로의 짊', '특수파트 실습경험에서 찾은 간호의 매력'으로 남자 간호학생들은 남자 간호대학생이라는 이유로 차별을 경험했으며, 그로 인해 직업에 대한 갈등과 혼란을 일으키고 있었다. 하지만, 그 속에서도 간호사의 전문성을 확인하고 배움의 즐거움을 찾아가고 있었다. 본 연구결과를 통해 남자 간호학생들의 임상 실습 경험에 대한 총체적인 시각을 제시할 수 있을 것으로 사료된다. 또한 남자 간호대학생의 학과 적응과 임상 실습 적응에 대한 상담과 지도에 유용한 기초자료로 활용 될 수 있으며, 남자 간호학생의 졸업 후 진로결정 상담에서도 유용한 자료로 활용되기를 기대한다.