• Title/Summary/Keyword: 만성간호

Search Result 403, Processing Time 0.04 seconds

Adult Physical Activity and Health Related Quality of Life : National Big Data Utilization (7th National Health and Nutrition Survey) (성인의 신체활동과 건강관련 삶의 질 : 국가빅데이터를 중심으로)

  • Kim, Seung-Ju;Jeon, Min-Ju
    • Journal of Korea Entertainment Industry Association
    • /
    • v.14 no.8
    • /
    • pp.455-465
    • /
    • 2020
  • The purpose of this study was to investigate the relationship between physical activity and health-related quality of life of adults using the 7th National Health and Nutrition Survey. The study was conducted with 11,211 adults, and the health-related quality of life was defined using the EuroQol group's EQ-5D and physical activity using GPAQ. Data analysis was performed using the SAS 9.4 program, the general characteristics and degree of physical activity of the subject, Chi-square for KEQ-5D index, and Logistic Regression Analysis for the relationship between physical activity and quality of life. As a result of the study, the general characteristics of the subjects were marital status, educational status, occupation, smoking, alcohol consumption, economic status, stress, chronic disease, chronic disease treatment, physical activity due to leisure and physical activity due to occupation, depending on gender. There was a difference (p<0.05). As for the quality of life related to physical activity and health, the quality of life was significantly lower by 37% in the 'minimum physical activity group' of occupational physical activity (p<0.05). The results of this study are expected to be provided as basic data for physical activity-related health policy establishment and physical activity programs.

The Study on the Relationship Between the Duration of Chest Vibration prior to Endotracheal Suctioning and the Changes in Oxygen Saturation in Low-Birth-Weight Infants (저체중아에 있어 기관내 흡인전 흉부진동법의 기관과 산소포화 변화간의 관계 연구)

  • Ahn, Young-Mee
    • Journal of Korean Academy of Nursing
    • /
    • v.25 no.3
    • /
    • pp.597-607
    • /
    • 1995
  • 1960년대 이후 인공호흡기(mechanical ventilator)의 보급과 최근 의료과학의 발달, 간호의 질적 향상의 결과로 저체중출생아를 포함한 고위험 신생아의 생존율이 높아져왔다. 호흡장애증후군(RDS)은 일차적으로 폐포의 완전한 확장을 위해 필요한 계면활성물질(surfactant)의 부족, 미발달된 심폐기능에 의한 병리적 현상으로 저체중아의 가장 큰 원인이 되어왔다. RDS로 인해 인공호흡기에 의존해 있는 저체중아의 경우 적절한 산소공급과 이를 위한 호흡의 유지는 치료의 가장 큰 핵심이 되며, 이를 위한 기관내 흑은 비인두 흡인 (nasopharyngeal suction)은 신생아 중환자실(NICU)의 가장 중요한 간호행위가 되어왔다. 인공호흡기를 위한 기관삽관은 그 자체가 기도의 성모운동을 방해하고 기침반사를 억제시켜 폐 분비물의 효과적 배출을 억제하며, 특히 저체중아의 경우 조산과 관련하여 미발달된 흥곽운등과 심폐기능은 폐분비물의 이동을 저해하는 요소이다. 따라서 기도내의 분비물의 이동을 효과적으로 하여 흡인 시에 최대한의 효과를 돕기 위해 흥곽 물리요법(chest physiotheraphy : CPT)의 한 형태인 흉곽진동법 (Chest Vibration : CV)가 행해져 왔다. 그러나 저체중아를 위한CV의 임상적 적용은 그 대상의 생리적 특성, CV의 적용부위(site)와 기간(duration)에 대한 과학적 근거 없이 만성감염이나 폐질환을 가진 성인이나 cystic fibrosis환자를 위한 CV protocol을 무분별하게 채택하여 저체중아에게 행하여져 왔다 이에 본 연구자는 저체중아에 대한 CV의 안전성을 평가하고, 이에 기초하여 저체중아에게 바람직한CV의 형태를 알아보고자 본 연구를 시작하였다. 연구설계는 CV의 안전성을 평가하기 위한 실험연구이다. CV의 안전성은 RDS치료의 가장 일차적 목표인 oxygenation변화에 의해 평가될 수 있으므로, 본 실험 연구에서는 Pulse oximeter에 의해 계속적으로 측정된 산소포화 변화(oxygen saturation change)를 측정하였다. 실험대상은 미국동부에 위치한 대학병원의 NICU에 입원하여 RDS와 관련된 호흡장애로 인공호흡기에 의존해 있는 10명의 저체중아였다. 인공호흡기에 의존된 모든 저체중아는 Pulse oximeter와 심폐기능 측정기(cardiopulmonary monitor)에 의해 산소공급과 호흡상태가 계속 측정되고 있었다. 실험대상의 평균 출생시 몸무게는 평균 1,3050gm(SD=580.6)이었고, 임신월령 은 평균 28.6주(SD=3.1)였다. RDS가 그들의 일차적 진단명이었고, 그중 4명은 pneumonia, atelectasis의 합병증을 가지고 있었다. 10명중 6명은 intermittent mandatory ventilation(IMV)의 형태로, 4명은 continuous positive airway pressure(CPAP)의 형태로 인공호흡기에 의존되어 있었고 CV시의 FiO2는 평균 42.3(SD=21.2)였다. CV는 중환아용 소형진동기 (minivibrator)를 이용해 가각 10명 의 간호사에 의해 행하여 졌고, 최소 22초에서 최대 100초 동안 실시되었다. 50%의 간호사는 30초에서 40초간 CV를 실시하였으며, CV의 적용부위도, 전후 흉곽부위, 혹은 병변이 있는 좌 우측, 흑은 양쪽 흉벽 등으로 다양했고, 적용방법도 원형으로 돌려가며(circular motion), 혹은 아래에서 위로, 혹은 아무런 기준없이 간호사의 기호에 따라 다양하게 적용되었다. 산소포화의 변화는 CV가 행해지기 전.후로 5초동안 관찰되었다. 연구의 결과, 산소포화 변화는 비 모수통계(non parametric statistics)의 일종인 Matched Paired Wilcoxon test로 분석 한 결과 CV후에 3%의 감소를 보였다(P<.05). 저체중아에 있어 산소포화의 3%감소는 임상적으로 중요한 의미가 없다고 사료되어지며, 실제 흡인전의 과도호흡에 의해 CV를 행하기 이전의 산소공급수준으로 돌아 왔다. CV실시 기간과 산소포화와의 상관관계는 비 모수통계인 Spearman rho correlation coefficient를 이용하여 분석하였는데, 이 두 변수는 서로 관계가 없는 것으로 나타났다(P>.05) 또한 CV와 흡인 후에 각각의 간호사들에게 CV를 필요로 한 저체중아의 기준, 적용부위, 기간, 방법등에 대한 기준을 물었으나 대상의 특성에 따른 간호사정에 의존하기보다는 간호사 각자의 선호하는 방법이나 습관에 라 행하는 것으로 나타났다. 결론적으로 CV와 산소포화 변화와의 관계, NICU에서 관찰된 CV의 임상적 적용을 기초로 저체중아에게 안전한 CV protocol은 신생아용 소형 진동기를 이용하여, 양쪽 흉곽의 늑골하측 변연 부위(low lateral costal margin)에서 시작하여 흉골 중앙부위 방향으로 30초 동안 진동기를 적용하는 것이 좋은 것으로 나타났다. 이에 CV의 효과를 평가하기 위한 보다 과학적인 접근방법으로, CV와 흡인의 결과인 가래(sputum)에 대한 연구를 제언하는 바이다.

  • PDF

Difference of Pain Description According to Gender in the Elderly (노인의 성별 만성동통 호소의 차이에 대한 조사연구)

  • 김명애;박경민;김효정
    • Journal of Korean Academy of Nursing
    • /
    • v.28 no.2
    • /
    • pp.369-379
    • /
    • 1998
  • Despite acknowledgment that pain is likely to be a major problem for many older adults, it is difficult to estimate the frequency of pain problems for this population. The main purpose of this study was to identify the various characteristics of chronic pain in the elderly by gender. It examines by gender, pain frequency, pain intensity, number of chronic pain sites, localization of pain, impact on activities, methods of pain management, and effects of chronic pain management. The subjects were 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes. They were surveyed by interview using a closed-ended questionnaire. The survey was done from Nov. 6th. to Dec. 6th. 1997. Descriptive statistics were used to determine all of the reported pain variables. Chi-square tests were used to determine crude differences between pain intensity and gender. T-test was used to determine differences in number of pain sites between men and women. The findings are as follows ; Of the 189 subjects, 83.6% reported experiencing pain, and men reported a lower prevalence (69.5%) than women(89.2%). Women had significantly more severe pain than did men(p=.001). Lower back pain(20.2%) and leg pain(20.2%) were the most prevalent, followed by knee pain(17.4%), arm pain(13.3%), neck and shoulder pain(11.6%), and headache(9.9%). Women experienced more multiple localizations of pain(p=.0001), the greatest impact was on movement (83.5%) , followed by usual activities(60.8%), sleep(49.4%), visiting(29.1%), and hobbies and recreations(50.0%). No differences were observed between men and women in the proportion of subjects reporting a negative impact on each of these activities. The methods of pain management were hospital visit(70.9%), drug store medication(46.7%), oriental medicine clinic(32.9%), endurance(13.3%), self-management(6.3%). Drug therapy was the most effective pain management strategy(94%), followed by physical therapy(63%) and accupuncture.byssocausis(55%). The conclusion : Pain is a symptom of great clinical importance that is often associated with disability, loss of independence, and reduced quality of life. In this study chronic pain symptoms were common but unevenly distributed in men and women. The results further advance understanding of the experience and impact of pain by gender. Future studies should incorporate questions that gather systemic and more detailed information on the characteristics of pain, especially by gender and by age.

  • PDF

A Study of the Influence of illness on Body Image and Self Concept -Specifically in Children with Asthma- (만성 질환이 자아개념 (Self Concept)과 신체상(Body Image)에 미치는 영향 -천식 환아를 중심으로-)

  • 장효순
    • Journal of Korean Academy of Nursing
    • /
    • v.12 no.2
    • /
    • pp.80-90
    • /
    • 1982
  • This study was undertaken to determine the influence of a chronic disease on body image, and to show that body image is directly related to one's self concept. Body image is the concept of one's own body based on present and past perception, and is elated to one's self concept. Body image is a dynamic concept constantly changing throughout the life cycle but it changes greatly in illness, surgery, and accident. The child with a chronic disease experiences pain and immobilization due to illness and he/she experiences a strange environment in the hospital. illness often brings feeling of frustration and loss of self-esteem. Therefore this study was done to compare the body image of a child with a chronic disease(Asthma), with that of a normal healthy child, and to determine the relationship between the body image and self concept. The subjects in this study were 36 children being treated for asthma at the allergy clinic of Y University Hospital in Seoul (patient group) and 44 children attending elementary school in Kwanak Ku Seoul (normal healthy group). For the measurement of the body image, the researcher used Secord & Jourard's Body Cathexis Scale, and another scale which was constructed after reading about Osgood's Semantic Differential Method. For the measurement of the self concept, the researcher used Jacox & Stewart's Health Self Concept. The period for data collection was from October 7th to October 27th, 1982. The analysis of data was done by use of Percentage, t-test, Chi-square test, Pearson Correlation Coefficient and ANOVA, The results of the study were as follows: 1. The first hypothesis,“That the chronically ill (Asthma) child will have a more negative body image than the normal healthy child.”was supported. 2. The second hypothesis,“The more negative the body image, the lower the self concept.”was also supported. 3. The researcher failed to obtain statistically significant results in the analysis of the general characteristics which affect the body image except in the case of the older child as compare to the younger Child having a mole positive body image (r=.2751, r=.2481, p<.05). However it was found that, 1) Boy's have a more positive body image than girls (Mean=〔37.81, 141.09〕,〔37.00, 126.54〕), 2) The child who has been hospitalized has a more negative body image than the child who has never been hospitalized (Mean=〔33.25, 122.45〕,〔35.68, 129.93〕). 3) The younger the child when the disease is discovered and diagnosed, the more negative the body image (Onset of illness: Mean=〔31.44, 117.33〕,〔34.00, 103.50〕, 〔35.75, 140.38〕,〔36.33, 130.00〕, Time of Diagnosis: Mean=〔29.00, 117.33〕,〔33.89, 115.00〕,〔33.36, 124.93〕,〔37.10, 139. 20〕). In conclusion the chronically ill(.Asthma) child has a more negative body image than the normal healthy child, and the more negative the body image the lower the self concept. Therefore the concept of body image is useful in understanding the influences of chronic disease on body' image and self concept.

  • PDF

A Study on Type A Behavior Pattern(TABP), Stress, Depression and HIT-6 in the Patients with Chronic Headache (만성두통 환자의 성격유형 A 행태, 스트레스, 우울 및 두통영향정도의 관계 연구)

  • Cha, Nam-Hyun;Lim, Sabina;Jung, In-Tae;Kim, Su-Young;An, Kyung-Ae;Kim, Keon-Sik;Lee, Jae-Dong;Lee, Sang-Hoon;Choi, Do-Young;Lee, Yun-Ho;Lee, Doo-Ik
    • Korean Journal of Adult Nursing
    • /
    • v.17 no.4
    • /
    • pp.539-547
    • /
    • 2005
  • Purpose: To examine an estimate factor and grasp the relation of difference for Type A Behavior Pattern(TABP), Perceived Stress Questionnaire, Depression and HIT-6 in the Chronic headache client. Method: Data collected by self-reported questionnaires from 38 client in S city who were selected by criteria of IHS, from the $19^{th}$ of October to 10th of December, 2004. Result: 1) Differences between biographical data by TABP was significant by SaSang constitutions, by Stress was significantly influenced by age, and by Depression were significantly influenced health status and SaSang constitutions. 2) Correlations Coefficients among Study Variables were Stress and Depression(r=.494, p=.002) and Depression and HIT-6(r=.432, p=.010). 3) In regression analysis, HIT-6 were significantly influenced by Depression and Type A Behavior Pattern(TABP).These variables explained 38% and 34% respectively. Conclusion: The result suggest that chronic headache management with psychological aspect, as well as physical aspect should be a focus to enhance the quality of life.

  • PDF

The Relationship between Pain Level and Perceived Family Support and Quality of Life in Musculoskeletal Patients with Chronic Pain (근골격계 만성통증 환자가 지각한 통증, 가족지지 및 삶의 질과의 관계)

  • Oh, Hyun-Ja
    • The Korean Journal of Rehabilitation Nursing
    • /
    • v.1 no.1
    • /
    • pp.93-109
    • /
    • 1998
  • The purpose of study is to identify the relation between pain level and perceived family support and quality of life in musculoskeletal patient with chronic pain. The subjects for the study consist of 155 patients with musculoskeletal pain that received medical treatment in hospital or by attending hospital in Chonju. The data were collected during the period from August 5 to August 14, 1998 by means of interviews with structured questionnaire. Data analysis was done by descriptive statistics. t-test, ANOVA, Pearson's correlation, Regression. Cronbach alpha using the SAS program. The result of this study were as follows : 1. The mean score of pain was 8.02, family support was 3.88 and quality of life was 3.07. 2. Hypothesis : The first hypothesis that 'The lower pain level is, the higher quality of life is' was accepted (r=-.2178, p= .0065). In addition, pain level of musculoskeletal patient with chronic pain provided predicted 4.7%(F=7.619, P= .0065) of quality of life. The second hypothesis that 'The higher perceived family support is, the lower pain level is' was rejected (r=-.0376, p= .6425). The third hypothesis that 'The higher perceived family support is, is higher quality of life is' was accepted (r= .3212, p= .0001). In addition, perceived family support of musculoskeletal patient with chronic pain provided predicted 10.31% (F=17.597, p= .0001) of quality of life. 3. General characteristics related pain were age(F=6.85, p= .0001),educational-level(F=9.29, p= .0001), occupation(F=5.81, p= .0037), marriage status(F=8.09, p= .0005), family numbers(F=5.73, p= .001), benefits of medical care(F=4.09, p= .0019), pain period(F=9.52, p= .0001), part of pain(F=2.33, p= .0352), pain period(F=3.08, p= .0181). 4. General characteristics related pain were sex(t=3.20, p= .0017), support sources(t=3.26, p= .0014), pain period(F-4.52, p= .0018). 5. General characteristics related pain were religion(t=3.11. p= .0022), benefits of medical care(F=3.61, p= .0293), pain duration(F=3.03, p= .0195). In conclusion, perceived family support in musculoskeletal patient with chronic pain is an important factor that can improve their quality of life. Therefore, nurses must establish nursing plan included patient's family when nurses carry out nursing intervention and education for patient so that a patient promote quality of life by maintaining optimal wellbeing.

  • PDF

The Relationship between Resilience, Social support and Caring burden of Middle-aged Caregivers caring for Chronic disease (만성질환자를 돌보는 중년기 주 돌봄 제공자의 회복탄력성, 사회적지지와 돌봄 부담감과의 관계)

  • Kim, Nam-Hee;Park, Sun-Young
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.20 no.2
    • /
    • pp.300-310
    • /
    • 2019
  • The purpose of this study was to investigate the relationship between resilience, social support and caring burden of middle-aged caregivers caring for chronic disease. The data were collected from 175 caregivers at one rehabilitation centers in B City from July 2 to 31, 2018 and analyzed SPSS Win 21.0. Factors influencing caring burden were time for caregiving(F=6.70, p<.001), activities of daily living(F=4.70, p<.001), patient disease(F=4.61, p<.001), relationship with patients(F=3.68, p<.013), Health Status(F=3.08, p=.018), Marital status(t=-2.12, p<.036), Period after diagnosis(F=2.92, p=.036). The caring burden had not an influence on resilience and social support. a positive correlation was found between resilience and socail support(r=.487, p<.001). Therefore, it is essential to develop burden intervention programs that can reduce the burden in middle-aged caregivers caring for chronic disease and taking all the factors affecting burden into consideration.

Depressive Symptoms of Caregiving Grandmothers in South Korea (손자녀를 돌보는 한국 조모들의 돌봄 특성에 따른 우울 증상)

  • Lee, Ja-kyung;Jang, Soong-nang
    • 한국노년학
    • /
    • v.36 no.3
    • /
    • pp.693-709
    • /
    • 2016
  • This study was to investigate depressive symptoms of caregiving grandmothers in South Korea and related factors focusing on caregiving characteristics. The data were drawn from the fourth wave of Korean Longitudinal Study on Ageing (KLoSA). The study participants were 3,291 grandmothers who had at least one grandchild, and we limited our analysis to 127 grandmothers who had provided care for their grandchild(ren) during the past one year. As for the depressive symptoms, Center for Epidemiological Survey-Depression 10(CES-D 10) short version were applied. Caregiving characteristics including caregiving duration by weeks per year, caregiving hours per week and the number of grandchildren who received grandmother care were examined. A multiple logistic regression was performed to detect association between caregiving characteristics and depressive symptoms while adjusting for general socioeconomic characteristics and health status of caregiving grandmothers. The longer duration of caregiving lowered the depressive symptoms and in contrast, those who spent more hours for providing care to their grandchildren were more exposed to the depressive symptoms. Physical pain significantly increased their depressive symptoms and low income level were more likely to induce depressive symptoms. More detailed studies on grandchild caregiving patterns among grandmothers were needed. Also, tailored support policy and services should be considered to alleviate their burden and depression in the future.

Classification of Clusters, Characteristics and Related Factors according to Drinking, Smoking, Exercising and Nutrition among Korean Adults (한국 성인의 음주, 흡연, 운동 및 영양행태에 대한 군집별 특성 및 관련요인)

  • Kim, Kkot-byeol;Eun, Sang Jun
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.20 no.5
    • /
    • pp.252-266
    • /
    • 2019
  • The purpose of this study was to identify the type of health behaviors in Korean adults and to identify related factors. The data used in the analysis was the Korea Health and Nutrition Examination Survey 2014., which was representative of the Korean population. Cluster analysis was used to find the pattern of clustering of smoking, drinking, exercising and nutrition. Differences in the pattern of clustering was examined, first by bivariate chi-square test, and then by multinomial logit regression. Lastly, the association between the clusters of health behaviors and other behavioral risk factors was tested by chi-square test and logistic regression. The distribution of the clusters varied not only across socioeconomic characteristics and local size, but also between individuals with certain chronic diseases and those without. The results of this study can be used as a basis for the usefulness of approaching the cluster rather than individually approaching the health behavior.

Factor affecting Unplanned Readmissions after Cardiac Valve Surgery: Analysis of Electric Medical Record (심장판막수술 환자의 비계획적 재입원 영향요인: 전자의무기록분석)

  • Lee, Jung Sun;Shin, Yong Soon
    • The Journal of the Korea Contents Association
    • /
    • v.22 no.2
    • /
    • pp.794-802
    • /
    • 2022
  • This retrospective study was to investigate the characteristics of unplanned readmission and factors affecting readmission within 30 days of discharge in patients who underwent heart valve surgery through electronic medical records. The participants were 423 unplanned re-hospitalization within 30 days after heart valve surgery at a tertiary hospital in Seoul from January 2018 to August 2019. A total of 48 patients (11.3%) were unplanned readmissions, and the most common causes were atrial fibrillation in 13 cases (27.1%) and pain at the surgical site in 13 cases (27.1%). Other causes were: 10 cases (20.8%) of warfarin inappropriate treatment concentration, 7 cases of general weakness (14.6%), 5 cases of hypotension (10.4%), 4 cases of pericardial effusion (8.3%), 3 cases of surgical wound infection (6.3%), 3 cases of hemorrhage (6.3%), 3 cases of high fever (6.3%), and 1 case of cerebral infarction (2.1%). Variables influencing readmission were history of cancer (OR = 2.60, 95% CI 1.13-6.03, p = .025) and the patients who went to a home rather than a hospital after discharge (OR = 2.91, 95% CI 1.33-6.36, p = .008), as a type of valve surgery, mitral valve valvuloplasty had a higher readmission rate than aortic valve replacement (OR = 1.21, 95% CI 1.21-4.98, p = .012). In order to reduce unplanned readmissions, an tailored education program is needed to enable patients and caregivers to manage their comorbid chronic diseases before discharge and assess risk factors for readmission in advance.