• Journal of Chest Surgery
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• v.40 no.11
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• pp.765-769
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• 2007

Background: The curative treatment of choice for empyema is decortication of the pleura. The risks of this treatment however are increased for the patient with reduced pulmonary function, complicated calcification or septic shock. In the past, open window thoracostomy was a final stage treatment for chronic empyema. Relatively safe treatment of empyema could be achieved in difficult cases with a closure of the open window after open drainage and use of a myocutaneous flap (one stage or staged). Material and Method: A retrospective study of the cause, progression and final outcome of empyema patients who received open window thoracostomy was performed. 21 patients were followed from 1995 to 2004 in the department of Thoracic and Cardiovascular Surgery in the College of Medicine, Pusan National University. Result: The average age of the patients was $57.5{\pm}15.5$ years (range $25{\sim}78$ years), of whom 16 (76.2%) were men and five (23.8%) were women. Pulmonary function test results showed an average FEV1 of $1.58{\pm}0.49 L$. The type of empyema was tuberculous empyema in 13 cases (61.9%), aspergillosis in three cases (14.3%), parapneumonic empyema in three cases (14.3%) and post-resectional empyema in two cases (10%). Bronchopulmonary fistula was seen in 14 cases. Eight cases were complicated by severe calcification of the pleura. For the four cases of bronchopulmonary fistula, the patients' serratus anterior muscle was covered in their first operation. The average number of ribs resected was $4{\pm}1$. Closure of the open window thoracostomy was performed in 12 cases. The average time to closure after open drainage was $10.22{\pm}3.11$ months and the average defect of the empyemal cavity before the final operation was $330{\pm}110 cc$. Among the 12 cases, there were two cases of spontaneous closure. In two cases closure was only achieved by using the reserved skin fold during the first surgery. Of the remaining eight cases, in seven we used the myocutaneous flap (four cases of lattisimus dorsi muscle and three cases of pectoralis major muscle), and in one case we used soft tissue. As regards complications of the closure, tissue necrosis occurred in one case, which led to failed closure, and there was one case of abdominal hernia in the rectus abdominis muscle flap. One patient died within 30 days of the surgery and one patient died of metastatic cancer. Conclusion: A staged operation with a final closure using open window thoracostomy, which consists of open drainage, transposition of the muscle and a myocutaneous flap, can be a safe and effective option for the chronic empyema patient who is difficult to cure with traditional surgical methods.

• Korean Journal of Adult Nursing
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• v.27 no.4
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• pp.375-383
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• 2015

Purpose: The purpose of this study was to identify the relationship of resiliency and symptom experience and depression. Subjects (N=152) were patients with chronic obstructive pulmonary disease (COPD).admitted to D University Medical Center in B City. Methods: Data collection was conducted from July 20 to August 25, 2013. The levels of symptom, resilience, and depression were measured using a seven question symptom experience measuring instrument, a 25-question resilience instrument, and a 15-question Short Geriatric Depression Scale (SGDS). The collected data were analyzed by descriptive analysis, Pearson's correlation coefficients, and path analysis using SPSS/Win 19.0 and AMOS 5.0. Results: There was a significant negative correlation between symptom and resilience, a significant positive correlation between symptom and depression, and a significant negative correlation between resilience and depression. Symptom showed a direct effect on depression and an indirect effect on depression scores through resilience as a mediating variable. Conclusion: It is necessary to develop nursing intervention programs to relieve symptom in COPD patients, and to develop appropriate resilience enhancement programs to reduce their depression.

• Korean Journal of Adult Nursing
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• v.23 no.4
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• pp.309-320
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• 2011

Purpose: The purpose of the study was to examine the related factors of quality of life (QOL) among patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: Patients diagnosed with COPD (N=230) were recruited from four hospitals in Kyeong-Nam province, from March 2 to November 30, 2010. The data collection instruments were the Short Form 36, perceived dyspnea measure by Modified Medical Research Council, COPD and Asthma Sleep Impact Scale, COPD Self-efficacy Scale, and Center for Epidemiologic Studies Depression Scale were used. Following the completion of the data collection instruments Pulmonary function was tested. Data were analyzed with descriptive statistics, Pearson correlation and simultaneous multiple regression using SPSS/WIN. Results: The mean QOL of this study was 68.24. Using a multivariate approach, the significant correlates of QOL were depression (${\beta}$=-.37), dyspnea (${\beta}$=-.28), self-efficacy (${\beta}$=.20), and a sufficient degree of household income (${\beta}$=.16). These variables explained 49% of variance in QOL. Conclusion: The study suggests that psychological aspects are an important factor in explaining QOL of the patients. Screening and minimizing depression could be effective strategies in enhancing QOL of patients with COPD and further investigation to reduce depression could warrant the improvement of QOL in patients with COPD.

• Journal of muscle and joint health
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• v.23 no.3
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• pp.159-168
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• 2016

Purpose: The purpose of this study was to identify the factors influencing health-related quality of life (HRQOL) of patients with chronic obstructive pulmonary disease (COPD). Methods: A sample of 108 Patients diagnosed with COPD was recruited from outpatients, at a university hospital. Data were collected from February to April in 2016 using the St. George's Respiratory Questionnaire, the Hospital Anxiety-Depression Scale, and the COPD Self-efficacy scale. Results: The average score of HRQOL was 47.56 in patients with COPD. Results of the regression analysis showed that dyspnea phase (${\beta}$=.34, p<.001) and presence or absence of oxygen (${\beta}$=.20, p=.009), anxiety (${\beta}$=.29, p<.001), $FEV_1$ % predicted (${\beta}$=-.15, p=.014) were statistically significant in patients' HRQOL. Conclusion: The research findings show that dyspnea phase and anxiety among psychological factors were the most powerful factors that explain the HRQOL of COPD patients when the demographic and disease characteristics were controlled. Identification of quality of life-related factors should be used to inform targeted interventions, in order to improve HRQOL and help patients' cope.

• Journal of Korean Academy of Nursing
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• v.33 no.1
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• pp.9-16
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• 2003

Purpose : The objective of this study was the development and validation of a scale to measure the self-care of patients with chronic obstructive pulmonary disease(COPD) in Korea. Method: Self-care scale was developed based on the self-care activities patients had to carry out in order to manage their COPD. The original scale contained 34 items rated along a five-point Likert scale and was reviewed by 18 professional nurses and 10 Korean patients with COPD for content validity. Subsequently, patients with COPD were asked to complete this 23-item scale and further tests were done with the 125 useable responses. Result: Factor analysis identified eight factors-'maintaining a clean air way', 'taking medication', 'support from family', 'preventing infection', 'managing symptoms', 'breathing exercising', and 'taking in nutrition'. The internal consistency of the total scale was Cronbach's α=0.7226. These eight factors explained 60.8% of total variance. There was correlation among Korean Self-Care Scale score, administration level, and knowledge level but there was no correlation to patients' satisfaction with medical services. Conclusion: The 23 item questionnaire positively identified 8 areas defined important for COPD patients. Further studies are required to see how these can be integrated into patient education.

• Journal of Korean Academy of Nursing
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• v.53 no.2
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• pp.191-207
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• 2023

Purpose: This study aimed to develop a motivational interviewing pulmonary rehabilitation program based on self-determination theory to maintain pulmonary rehabilitation-related health behaviors in patients with chronic obstructive pulmonary disease. The program was developed by reviewing the literature on pulmonary rehabilitation guidelines, drawing on the self-determinism theory to establish its contents, recruiting experts to test its validity, and conducting a preliminary survey. Methods: A quasi-experimental design was used to confirm the effect of the program. The participants were outpatients diagnosed with chronic obstructive pulmonary disease at three general hospitals in Busan. There were 33 subjects: 15 in the experimental group and 18 in the control group. The experimental group performed a motivational interviewing pulmonary rehabilitation program which comprised 11 sessions delivered over 10 weeks. The outcomes were measured using basic psychological needs, dyspnea, 6-minute walking distance, and functional status. Intervention effects were analyzed using repeated-measures ANOVA. Results: The analysis revealed significant differences between the experimental and control groups in competence among the subdomains of basic psychological needs, dyspnea during exercise, and functional status. Conclusion: The developed program affects physical conditions and can be applied as an effective clinical nursing intervention to continuously improve the pulmonary rehabilitation behavior of patients with chronic obstructive pulmonary disease.

• Journal of Chest Surgery
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• v.34 no.4
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• pp.361-364
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• 2001

자가 폐동맥 판막을 이용한 대동맥 판막 치환술을 항응고제 복용이 필요없고 내구성이 어느정도 입증되어 늘어나고 있으나, 자가 폐동맥 판막을 이용한 승모판막 치환술은 국내에 보고된 예가 없다. 53세 여자 환자로 류마티스성 승모판막 협차가 및 폐쇄부전, 삼첨판막 폐쇄부전, 만성 심방 세동, 그리고 자회전 관상동맥의 폐색등으로 진단받은 환자에서 자가 폐동맥 판막을 이용한 승모판막 치환술 및 maze 술식, 삼천판막 성형술, 관상동맥 우회수술을 시해하였다. 수술후 특별한 문제없이 회복하였으며 술후 시행한 심초음파 검사상 자가 폐동맥 판막의 이상 소견없이 잘 기능하고 있으며 항응고제 복용없이 잘 지내고 있다.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.120-123
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• 2008

A 60-year-old man with a history of gunshot vascular injury on the right inguinal area, and this happened in the military service 40 years ago, was admitted to our hospital with claudication and dyspnea on exertion. The patient was diagnosed with a chronic traumatic femoral arteriovenous fistula. The patient underwent a successful operation for arteriovenous fistula closure with bovine pericardium and for femoropopliteal bypass with using a right greater saphenous vein graft. The patient is well at 14 months after the operation.

• The Journal of the Korea Contents Association
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• v.22 no.8
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• pp.347-357
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• 2022

This study was attempted to identify the health-related quality of life of Chronic Obstructive Pulmonary Disease (COPD) patients and factors influencing the quality of life, focusing on Health-related quality of life with 8 items (HINT-8). The subjects of this study were 451 adults aged 40 years or older who performed lung function tests and whose ratio is less than 0.7 by measuring forced respiratory volume in 1 second [FEV₁] to forced vital capacity in the 2019 National Health and Nutrition Examination Survey, It was analyzed using SAS program. As a result, both the HINT-8 index and EuroQol five-dimensions 3-level version (EQ-5D-3L) index were appropriate as tools to measure the health-related quality of life in COPD patients, and the factors affecting the health-related quality of life were age, gender, income, and smoking status, comorbidities, stress, and subjective health status. Therefore, in order to improve the health-related quality of life of COPD patients, an individualized management program suitable for the characteristics of subjects such as the low-income class and the elderly, including smoking cessation education and stress management, should be developed and applied.

• Korean Journal of Adult Nursing
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• v.23 no.6
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• pp.595-604
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• 2011

Purpose: This study was conducted to examine the effects of the nurse-led one-on-one discharge education on the levels of symptom experience and self-care compliance among patients with chronic obstructive pulmonary disease (COPD) who had not previously participated in an education or respiratory rehabilitation program. Methods: This study used a quasi-experimental pre-and post-test design with nonequivalent control group. Sixty seven hospitalized patients (34 for experimental and 33 for control groups) were recruited from in-patient units of a general hospital from August to November, 2010. The one-on-one education session of symptom management and daily self-care was administered to experimental group for 50 minutes along with a follow-up phone call. Self-administered questionnaire was administered at the pretest and at 1 month after discharge. Results: The subjects were 67.43(${\pm}10.24$)years old in average. The mean differences of symptom experience (t=3.39, p=.001) and self-care compliance (t=-38.13, p<.001) in the experimental group was significantly higher than those of the control group. Conclusion: Nurse-led one-on-one discharge education was effective in reducing the level of symptom experience and enhancing self-care compliance at home within one month after discharge. Therefore, this form of one-on-one education provided by nurses might be applicable effectively for COPD patients who do not have access to respiratory rehabilitation programs.