• Journal of Chest Surgery
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• 제40권11호
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• pp.765-769
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• 2007

배경: 농흉의 근치적 치료 방법은 흉막박피술이 우선적으로 시도된다. 그러나 근치적 치료가 힘든 고 위험군 환자의 경우는 위험성이 높다. 과거에는 만성 농흉 치료의 최종 단계로서 개방식 배농술을 선택했으나, 일차적인 근치적 치료가 힘든 경우 개방식 배농술과 근육이식술(일시적 혹은 단계적)시행 후, 최종적으로 개방창 폐쇄술을 시도함으로써 비교적 안전하게 농흉의 치료를 꾀할 수 있다. 대상 및 방법: 1995년 1월 1일부터 2004년 12월 31일까지 농흉으로 개방식 배농술을 시행한 21명의 환자를 대상으로 원인 질환과 치료 경과 및 최종 결과를 후향적으로 조사 분석하였다. 결과: 평균연령은 $57.5{\pm}15.5$세($25{\sim}78$세)였으며, 남자 16명(76.2%), 여자 5명(23.8%)이었다. 폐기능 검사결과는 평균 FEV1이 $1.58{\pm}0.49 L$였다. 농흉의 원인으로는 결핵성 농흉이 13예(61.9%), 폐국균증이 3예(14.3%), 폐렴성 농흉이 3예(14.3%), 폐절제 후 농흉이 2예(10%)이었다. 이들 중 14예에서 기관지 흉막루가 있었고, 8예에서 흉막의 석회화가 동반되어 있었다. 기관지 흉막루가 존재한 환자들 중에서 4예는 첫 수술시 전거근으로 기관지 흉막루를 덮었다. 절제된 늑골의 개수는 평균 $4{\pm}1$개였다. 12예에서 개방창 폐쇄가 가능하였으며 개방식 배농술 후 개방창 폐쇄까지 평균적으로 걸린 기간은 $10.22{\pm}3.11$개월이었고, 최종 수술 전 남아 있는 흉막강 결손의 평균은 $330{\pm}110 cc$였다. 12예 중 자연적으로 개방창 폐쇄가 이루어진 경우가 2예, 술 중 접어 두었던 피부만으로 폐쇄 가능했던 경우가 2예, 근육피판치환술 시행이 7예(광배근 4예, 대흉근 3예), 연조직 이용이 1예였다. 합병증으로는 연조직만으로 개방창폐쇄를 꾀했던 1예에서 조직 괴사가 생겨 폐쇄에 실패하였고, 복직근을 사용한 환자에서 복부 탈장이 생긴 경우가 1예 있었으며, 수술 후 30일내 사망한 예가 1예였고 다른 1예는 전이성 암으로 사망하였다. 걸론: 근치적 방법으로 치료가 힘든 경우의 만성 농흉 환자들에게 있어 개방식 배농술과 근육이식술, 근육피판을 이용한 최종적인 개방창 폐쇄술까지의 단계적인 접근 방법이 안전하고 효과적인 대안이 될 수 있을 것으로 생각한다.

• 성인간호학회지
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• 제27권4호
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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.

• 성인간호학회지
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• 제23권4호
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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.

• 근관절건강학회지
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• 제23권3호
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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.

• 대한간호학회지
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• 제33권1호
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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.

• 대한간호학회지
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• 제53권2호
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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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• 제34권4호
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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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• 제41권1호
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• pp.120-123
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• 2008

40년 전 군복무 중 우측 서혜부에 총상을 입은 과거력을 가진 60세 남자 환자로 파행과 운동 시 호흡 곤란을 주소로 내원하였다. 총상 교정술 후 지속된 만성 외상성 대퇴동정맥루로 진단되었고 수술은 소심낭을 이용한 누공 폐쇄와 대복재정맥을 이용한 대퇴동맥-슬와동맥 우회술이 이루어 졌다. 술 후 결과는 양호하였으며 문헌고찰과 함께 보고한다.

• 한국콘텐츠학회논문지
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• 제22권8호
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• pp.347-357
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• 2022

본 연구는 Health-related quality of life instrument with 8 items (HINT-8)을 중심으로 만성폐쇄성폐질환 (Chronic Obstructive Pulmonary Disease, COPD) 환자의 건강관련 삶의 질 정도와 영향요인을 파악하기 위해 2019년 국민건강영양조사에서 폐기능 검사를 수행한 만 40세 이상의 성인 중 1초간 노력성 호기량(forced respiratory volume in 1 second, FEV₁) 대 노력성 폐활량(forced vital capacity)을 측정하여 비율이 0.7 미만인 자 중 건강관련 삶의 질 측정도구인 HINT-8에 누락이 있는 3명을 제외한 총 451명을 대상으로 하였다. SAS program을 이용하여 실수와 가중백분율, 평균과 표준편차, 일반선형모델을 이용하여 분석한 결과, HINT-8 index와 EuroQol five-dimensions 3-level version (EQ-5D-3L) index 두 도구 모두 COPD 환자에게서 건강관련 삶의 질을 측정하는 도구로서 적절하였다. HINT-8을 중심으로 COPD 환자의 건강관련 삶의 질 영향요인은 연령, 성별, 소득, 흡연상태, 동반질환, 스트레스, 주관적 건강상태이었다. COPD 환자의 건강관련 삶의 질을 개선하기 위해서는 금연교육 및 스트레스 관리 등이 포함되어야 하며, 고령, 저소득층 등 대상자의 특성에 맞는 개별화된 관리프로그램이 개발되고 적용되어야 할 것이다.

• 성인간호학회지
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• 제23권6호
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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.