• Title/Summary/Keyword: 결장루

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Model Construction of Sexual Satisfaction in Patients with a Colostomy (결장루 보유자의 성만족 구조모형)

  • Park, Seung-Mi;Kim, Keum-Soon
    • Journal of Korean Academy of Nursing
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    • v.39 no.4
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    • pp.539-548
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    • 2009
  • Purpose: This study was designed to construct and test the structural equation model on sexual satisfaction in patients with a colostomy. Methods: The model construction was based upon Roy's adaptation model. Stoma-related discomfort (SRD), age, frequency of sexual intercourse, treatment modality, and gender affect sexual satisfaction and are mediated by physical, psychosocial, and interdependence modes. Each mode was conceptualized as sexual function, body image/ depression, and marital intimacy. The patients were 112 colostomates with colorectal cancer who were asked to complete a mail-back survey on their demographic data, SRD, body image, depression, marital intimacy, sexual function, and sexual satisfaction. Data were analyzed using SPSS WIN 15.0 and AMOS WIN 7.0. Results: Significant variables for sexual satisfaction in the final model were body image affected by SRD, depression affected by body image and SRD, marital intimacy affected by depression, and sexual function affected by marital intimacy. Conclusion: The results of this study suggest that specific guidelines for SRD are necessary to improve sexual satisfaction among colostomates. Nurses should be vigilant in monitoring depression and body image disturbance, and providing appropriate interventions to increase marital intimacy. Treatment modality, gender, and age should be considered in developing education programs pertaining to sexuality.

Psychosocial Adaptation and Related Factors in Patients with a Permanent Colostomy (영구적 결장루 보유자의 심리사회적 적응과 관련 요인에 관한 연구)

  • Cha, Bo-Kyoung;Baek, Eun-Seon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.16 no.4
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    • pp.506-514
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    • 2009
  • Purpose: This study was conducted to define factors influencing psychosocial adaptation of patients with a permanent colostomy. Independent variables including perceived stress, stoma care self-efficacy, self-care behavior, self-esteem and family support were used to predict psychosocial adaptation. Method: The data was analyzed using the SPSS pc program window version 12.0 for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. Ninety patients with a permanent colostomy were recruited between September 2007 and May 2008. The reliability of the instruments was tested with Cronbach's alpha which ranged from .78 to .92. Result: The results were as follows: The mean psychosocial adaptation score was 3.05. There were significant correlations between all the predictive variables and psychosocial adaptation (r= .63~ -.43, p<.001). Stepwise multiple regression analysis showed that self-esteem (40%), stoma care self-efficacy (7%), perceived stress (2%), and self-care behavior (2%) accounted for 51% of the variance in psychosocial adaptation. Conclusion: These findings indicate that to improve psychosocial adaptation of patients with permanent colostomy, the major related factors identified in this study should be considered.

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Affecting Factors of End Colostomy-Related Complications (말단결장루의 합병증 발생 영향 요인)

  • Park, Seung Mi;Kim, Keum Soon
    • Korean Journal of Adult Nursing
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    • v.19 no.4
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    • pp.634-643
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    • 2007
  • Purpose: This study was performed to investigate the type and frequency of end colostomy-related complications and to identify the risk factors for those complications. Methods: Retrospective analysis of medical records was made in 708 patients who underwent end colostomy in Samsung Medical Center between October 1994 and February 2005. The type was divided into stomal and peristomal complications: stomal complications included bleeding, necrosis, mucocutaneous separation, prolapsed stoma, retraced stoma, stenosis, and hyperplasia; peristomal complications did peristomal varix, peristomal hernia, irritant contact dermatitis, allergic contact dermatitis, maceration, folliculitis, hyperplasia, bacterial infection, candidal infection, malignancy in the peristomal area, mechanical damage and pyoderma gangrenosum. Results: For stomal complications, hyperplasia was most common(9.0%). For peristomal complications, irritant contact dermatitis was developed in 17.4%. Sex and BMI were risk factors for irritant contact dermatitis, hyperplasia, peristomal hernia, flat stoma, and retracted stoma. Conclusion: Teaching for preventing irritant contact dermatitis such as proper pouching and peristomal skin protection, and for comprehensive weight control should be emphasized on self care program for ostomates, while ostomy care nurse should take a careful consideration of preoperative ostomy site marking in female obese patients.

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The relationship between hardiness and psychosocial adjustment of persons with a colostomy (결장루 보유자의 강인성과 사회심리적 적응과의 관계)

  • 이은남
    • Journal of Korean Academy of Nursing
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    • v.21 no.2
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    • pp.218-229
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    • 1991
  • The problem addressed by this study were to explore the effect of hardiness on psychosocial adjustment of persons with a colostomy and to identify factors which influence that psychosocial adjustment. The purpose was to suggest a theoretical base for the planning of supportive nursing interventions to increase the level of adjustment. Among members of the Korea Ostomy Association, 34 subjects who had undergone colostomy from March, 1990 to March, 1991 were selected as the sample. Data were collected from April 8 to May 8, 1991 using a mailed questionnaire. The instruments used for this study were the Health -Related Hardiness Scale(Pollock, 1984) and the Psychosocial Adjustment to illness Scale (Derogatis, 1975). ANOVA, Pearson correlation coefficient and Stepswise Multiple Regression were used for data analysis. The results of the study are summarized as follows. 1. Hardiness was significantly related to psychosocial adjustment(p=0.009). That is, the higher the hardiness, the higher the level of psychosocial adjustment. 2. Among the demographic variables, only economic level was significantly related to the level of psychosocial adjustment. (p=0.005). 3. The important factors influencing the level of psychosocial adjustment of persons with a colostomy were economic level, commitment, challenge (subconcepts of hardiness). Therefore, in order to increase the level of the psychosocial adjustment, it might be helpful to provide them with hardiness training to strengthen their commitment and their challenge.

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Surgical Treatment for a Primary Arterioenteric Fistula between a Common Iliac Artery Aneurysm and the Terminal Ileum with Massive Bleeding (대량출혈을 동반한 총장골동맥류와 회장 사이에 생긴 일차성 동맥-장관루의 치험)

  • Lee, Hyung-Chae;Jun, Hee-Jae;Choi, Kwang-Ho;Lee, Yang-Haeng;Hwang, Youn-Ho;Lee, Seong-Kwang
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.635-638
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    • 2009
  • A 72-year-old man with progressive, unexplained lower gastrointestinal bleeding presented to the emergency department with abdominal pain and shock. Computed tomography of the abdomen showed a fistula between a right common iliac artery aneurysm and the small intestine. Laparotomy demonstrated a saccular aneurysm of the common iliac artery with a fistulous communication to the terminal ileum. Aneurysmectomy, aortoiliac graft replacement and segmental ileocecal resection with end-to-side anastomosis were all successfully performed. For a patient having an arterioenteric fistula along with lower gastrointestinal bleeding, making an early diagnosis using computed tomography and then performing immediate surgery can be expected to save the patient's life.

Effects of Self Efficacy Promoting Programs on Self Efficacy, Self Care Behavior and Psychosocial Adaptation in Patients with a Colostomy (자기효능 증진 프로그램이 결장루 형성술 환자의 자기효능, 자가 간호 행위 및 심리사회적 적응에 미치는 효과)

  • Kim, Kyoung-Mi;Baek, Eun-Seon;Kang, Nam-Hee;Yoon, Kyung-Eun;Bae, Na-Young;Cha, Bo-Kyoung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.3
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    • pp.288-296
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    • 2007
  • Purpose: This study was conducted to investigate the effects of self-efficacy promoting program on self-efficacy, self-care behavior and psychosocial adaptation in patients with a colostomy. Method: A non-equivalent control group pre test post test design was used. The self efficacy promoting programs was composed of a CD image program based on varicaious experience, education and telephone coaching program based on verbal persuasion, and Stoma care practice, and Self care performance based on performance accomplishment. This study was carried out from July 2, 2005 to April 20, 2006 and 21 patients with a colostomy at one of 2 hospitals participated. Descriptive statistics, ${\chi}^2-test$, and Mann-whitney U test were used to analyze the data. Results: There were significantly different for specific self efficacy, self care and psychosocial adaptation between the experimental group and control group. Conclusion: The self efficacy promoting program for patients with stomas was effective in improving degree of specific self efficacy, self care and psychosocial adaptation.

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Clinical and Experimental Studies on Colon Fistulation in Ruminant (반추수의 결장루 조성술에 관한 실험적 및 임상적 연구)

  • Jang Kwang-Ho;Kweon Oh-Kyeong;Nam Tchi-Chou
    • Journal of Veterinary Clinics
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    • v.11 no.1
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    • pp.437-470
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    • 1994
  • These studies were performed to establish more effective surgical method for correcting congenital atresia coli in calves. Distal colon fistulation, proximal colon fistulation and colon anastomosis which could be applied for surgical repair of intestinal obstruction were carried out in goatlings experimentally and in calves with atresia coli clinically. After treatment of the animals clinical signs, blood component values, body weight gain, survival and necropsy findings were observed. In goatlings, clinical signs after colon fistulation were diarrhea, anorexia and vitality loss, and those of proximal colon fistulation group were severer than those of distal colon fistulation group. Surviviability after operation was 9~16 weeks in distal colon fistulation group, 2~8 weeks in proximal colon fistulation group, and 2-3 days in colocolic anastomosis group, respectively. There were no alterations in blood component values among experimental groups. Weight gain rates were 54.6% in distal colon fistulation group and 42.9% in proximal colon fistulation group compared with those of control. Necropsy findings observed in experimental groups were distension of intestine and excessive fluid in abomasum and intestine. Two calves with atresia coli died 1 day and 6 days after operation but one with colon fistulation survived more than two months. Preoperative clinical signs in calves with atresia coli were abdominal distension, progressive anorexia, no defecation and postoperative clinical signs wert diarrhea and periodic abdominal distension. After operation there were no alterations in blood component values between the calf with atresia coli and control calf. Weight gain rate of calf with atresia coli was similar to that of control but revealed the tendency to decrease from the 2nd month after operation. Necropsy findings observed in two calves with atresia coli were intestinal distension. intraluminal excessive fluid, blind atretic sac and absence of intrarectal content. It was concluded that proximal or distal colon fistulation could be available for surgical correction of congenital atresla coli and prognosis of distal colon fistulation was better than of proximal colon fistulation, but that extensive colocolic anastomosis could not be compatible with life in ruminants.

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결장루형성술 환자 간호를 위한 일 연구

  • 모경빈
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.27-43
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    • 1970
  • This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

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