• Title/Summary/Keyword: 성인간호학

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Risk Factors and Clinical Outcomes of Unplanned Reintubation after Planned Extubation in Adult Patients admitted to the Intensive Care Unit after Cardiac Surgery (성인 심장수술 후 중환자실에 입실한 환자의 계획된 발관 후 비계획적 기관 재삽관 위험요인과 임상결과)

  • Lee, Ju-Hee;Choi, Hye-Ran
    • Journal of Korean Critical Care Nursing
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    • v.15 no.3
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    • pp.88-100
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    • 2022
  • Purpose : This study aimed to identify risk factors for unplanned reintubation after planned extubation and to analyze the clinical outcomes in patients admitted to the intensive care unit after cardiac surgery. Methods : The study examined patients who underwent intubation and planned extubation admitted to the intensive care unit after cardiac surgery between January 1, 2017, and December 31, 2021. The reintubation group comprised 58 patients underwent unplanned reintubation within 7 days of planned extubation. The maintenance group comprised 116 patients who did not undergo reintubation and were matched with the reintubation group using the rational for matching criteria. Data were collected retrospectively from electronic medical records. We used the independent t-test, Mann-Whitney U test, 𝑥2-test, Fisher's exact test, and logistic regression analysis with SPSS/WIN 27.0. Results : The multivariate logistic regression analysis demonstrated that albumin (odds ratio [OR]=0.38, 95% confidence interval [CI]=0.20-0.72), surgery time (OR=1.54, 95% CI=1.20-1.97), PaO2 before extubation (OR=0.85 per 10 mmHg, 95% CI=0.75-0.97), postoperative arrhythmia (OR=2.82, 95% CI=1.22-6.51), reoperation due to bleeding (OR=4.65, 95% CI=1.27-17.07), and postoperative acute renal failure (OR=2.97, 95% CI=1.09-8.04) were risk factors for unplanned reintubation. The reintubation group had a higher in-hospital mortality rate (𝑥2=33.74, p<.001), longer intensive care unit stay (Z=-7.81, p<.001), and longer hospital stay than the maintenance group (Z=-8.29, p<.001). Conclusion : These results identified risk factors and clinical outcomes of unplanned reintubation after planned extubation after cardiac surgery. These findings should be considered when developing and managing an intervention program to prevent and reduce the incidence of unplanned reintubation.

Effects of Auricular Acupressure on Insomnia in Korean Adults (귀 지압이 한국 성인의 불면증에 미치는 영향)

  • Jang, Yun-Jeong;Shin, Hye-Yeon;Jo, Ha-Yeon;Park, Min-Ji;Lee, Eun-Jin
    • Journal of muscle and joint health
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    • v.30 no.2
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    • pp.129-137
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    • 2023
  • Purpose: The purpose of this study was to investigate the effect of auricular acupressure on insomnia. Methods: Forty-four adults with insomnia for >1 month were recruited and randomly assigned to either the experimental or control group. In the experimental group, acupressure stickers were attached to the areas of Pineal Gland (TG1), Aggressivity point (LO2), Point Zero (HX1), and Occiput (AT3) for 1 week. Sleep hygiene education materials were provided to the control group, but acupressure was not provided. The collected data were analyzed using the SPSS ver. 26 program. Results: As a result of controlling for the severity of insomnia (F=5.40, p=.025) and headache (F=4.60, p=.038), which showed a significant difference in the homogeneity test as covariates, the Pittsburgh Sleep Quality Index score in the experimental group decreased compared to that in the control group . Conclusion: The result of this study showed that auricular acupressure was helpful in improving insomnia.

Effects of the Rhy-Kwon Exercise with Motion Beat Music on Physical Fitness and Mood among Adult Women (모션비트 음악을 이용한 리권운동이 성인여성의 체력 및 기분에 미치는 영향)

  • Cho, Kyung-Sook;Kim, Woo-Won
    • Journal of muscle and joint health
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    • v.16 no.2
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    • pp.125-134
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    • 2009
  • Purpose: The purpose of the study was to compare the effects of the Rhy-Kwon exercise with motion beat music program to the Rhy-Kwon with ordinary beat music program on physical fitness and mood in employed women. Method: Total of 29 women who did not have any particular disease were randomly assigned either to a Rhy-Kwon with motion beat music group or to a Rhy-Kwon with ordinary beat music group. Nine subjects in each group completed posttest measures (physical fitness and mood) in 8 weeks. Results: After the 8 weeks of the study period, there were significant improvement in sargent jump and mood especially for the subscale of vigor in the Rhy-Kwon with motion beat music group compared to their counterparts. But no significant differences were found between the groups in other physical fitness measures. Conclusion: The results showed that Rhy-Kwon with motion beat music program would partially improve physical fitness and mood (vigor). Further studies are needed to confirm the effects of Rhy-Kwon with motion beat music program with various populations.

Factors Associated with Unawareness of Early Symptoms of Stroke and Myocardial Infarction in Adults with Hypertension and Diabetes: Focused on Management related to Disease (고혈압, 당뇨병 성인의 뇌졸중 및 심근경색증 조기 증상 비인지 관련 요인: 질병 관리 관련 특성을 중심으로)

  • Kwon, Young-Sook
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.1
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    • pp.60-74
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    • 2021
  • The purpose of this research was to determine the degree of awareness of early symptoms of stroke and myocardial infarction in adults diagnosed with hypertension and diabetes, and to analyze factors related to unawareness. Raw data from the 2017 Community Health Survey were utilized. A total 12,277 adults older than 40 years were included in analysis finally. The early symptom awareness rates of stroke and myocardial infarction were 53.6% and 46.8%, respectively. Logistic analysis was performed to assess factors associated with unawareness of early symptom of stroke and myocardial infarction. After correcting for socio-demographic variables, education for the management of hypertension, recognition of blood pressure level and HbA1c level were significantly related to stroke early symptom unawareness on multivariate analysis. (Education for the management of hypertension, recognition of blood pressure level and HbA1c level were significantly related to the unawareness of early stroke symptoms even after socio-demographic variables were corrected in multivariate analysis.) Recognition of blood pressure level and HbA1c level were also significantly associated with unawareness of early symptoms of myocardial infarction. Therefore, it is required to interventions and strategies to improve the level of awareness of early symptoms of cardio-cerebrovascular disease, such as accelerating promotion and strengthening education for high-risk groups who must manage both hypertension and diabetes.

A Study on Adult's Perception of Nursing Concept (간호 개념의 의미에 대한 조사연구(경인지역 성인을 대상으로))

  • Yang Kwang Hee
    • Journal of Korean Public Health Nursing
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    • v.4 no.1
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    • pp.5-16
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    • 1990
  • 'What is nursing' this question could always be arised and such a question could bring forth the new possibility to definete the nursing concept more clearly. At the middle of 19th Centry, Mrs. Nightingale defined the concept of nursing as follows; 'Nursing is a kind of treatment act to aid the patient so that the health of patients may be recovered naturally, as keeping the most comfortable circumstances.' But after then, the role and function of nurses about purpose and method of nursing has continuously been studied, as the social circumstance has been changed. The fact that care provider and client have the same concept about nursing is very important at the first step of assessment. But at the present time, the care provider and client have not same concept yet, so the difference of unrsing concept between care provider and client is analyzed in this study. This study would be belived to be helpful for the advance of nursing in the future. In this study, 20 questionare from nursing objectives developed by Abdellah(basic care needs, sustenal care needs, remedial care needs and restorative care needs) are used for adult. The data of this study by the 6 point rating scale are analyzed by SAS as follows; 1. Respondent's view is that nursing is necessary in case of group(school or company) rather than private and in case of abnormal conditions rather than normal conditions. 2. Every questionares of nursing objectives are divided into 4 points of view such as basic care needs, sustenal care needs, remedial care needs and restorative care needs are examined. The evaluation by 6 point rating scale revealed that $5.08\pm0.65$ point in basic care needs $4.93\pm0.68$ point in sustenal care needs $4.91\pm0.80$ point in remedial care needs and $4.61\pm0.91$ point in restorative care needs. While basic care needs and substenal care needs that need more physical care show high points, remedial care needs and restorative care needs that need more psychological, social and spiritual care show low points. 3. It was checked whether there is any significant difference between above 4 point of views in nursing objectives and qeneral characteristics or not. As a result, there is significant difference between 4 point of view and ages, educational level, marriage, composition of children. And also there is significant difference between religion and basic care needs, remedial care needs and restorative care needs. But there is no significant difference between any point of view and sex, occupation, experience of admission and experience of family admission. As this study is based on the data gethered from a restricted area, the result can not represent the opinion of all the clients. Therefore the same kind of study should be carried out on many areas repeatedly and also it should be tried to extract objective concept. And also periodical study is needed to observe the changing process of nursing concept.

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Time Resource Transfers of Married Couples to Their Parents on Decision-Making Power (배우자간 의사결정력에 따른 노부모로의 시간자원 이전)

  • Yoon, Won-Ah
    • Journal of the Korean Home Economics Association
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    • v.48 no.4
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    • pp.83-102
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    • 2010
  • This paper investigates whether intra-household bargaining power affects couples' caregiving decisions during instances of competing parental demands for assistance. The primary focus is on examining how partners' bargaining power influences the relative allocation of time resources between parents and parents-in-law, assuming that children prefer to transfer caregiving resources toward their own parents over their parents-in-law. The findings in this study reject the bargaining theory that couple's parental care behavior results from a bargaining process between the husband and the wife. More specifically, the results did not clearly show that children prefer to transfer caregiving resources toward their own parents over their parents-in-law. Decision-making power, measured by final decision-making authority, also failed to affect the relative care transfers.

Association between hyperuricemia and metabolic syndrome (고요산혈증과 대사증후군과의 연관성)

  • Park, Yun-jin
    • Journal of the Korean Applied Science and Technology
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    • v.39 no.5
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    • pp.674-682
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    • 2022
  • This study aims to examine the relationship between hyperuricemia and metabolic syndrome, which is a risk to health, and to analyze the effect of hyperuricemia on the body. The analysis data were downloaded and used for the 8th 2nd (2020) data of the National Health and Nutrition Survey, and in this study, 2,320 men and 2,893 women were finally analyzed. For the analysis of the data, Chi-square test and t-test were used for the difference values according to collected general characteristics and hyperuricemia, and the risk of eGFR rise was analyzed by regression analysis, and Pearson correlation was used to confirm the correlation with each variable. Through this study, it was found that hyperuricemia is significantly related to metabolic syndrome, and through this, preemptive management is needed to prevent metabolic syndrome from worsening into vascular diseases including kidney diseases. Therefore, it is proposed to develop a health program suitable for the patient's age through this study.

Developing the Sarcopenia Risk Assessment Model in Korean Adults (한국 성인의 근감소증 위험도 평가점수 모형 개발)

  • Eun-Jung, Bae;Il-Su, Park
    • The Journal of Korean Society for School & Community Health Education
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    • v.23 no.4
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    • pp.81-93
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    • 2022
  • Objectives: The purpose of this study was to develop a model for comprehensively evaluating the risk of sarcopenia in Korean adults and to generate the sarcopenia risk scorecard model based on the results. Methods: The participants of the study were 7,118 adults without sarcopenia in the first basic survey, and a longitudinal analysis was conducted using data from the 1st to 8th survey (2006-2020) of the Korean Longitudinal Study of Aging (KLoSA). The data were analyzed using Rao-Scott chi-square test and weighted Cox proportional hazards regression of complex sampling design. The sarcopenia risk scorecard model was developed by Cox proportional hazards regression using points to double the odds (PDO) method. Results: The findings show that the risk factors for sarcopenia in Korean adults were gender, age, marital status, socioeconomic status, body mass index (BMI), regular exercise, diabetes and arthritis diagnosis. In the scorecard results, the case of exposure to the highest risk level was 100 points. The highest score range were given in the order of age over 65, low BMI, and low socioeconomic status. Conclusions: The significance of this study is that the causal relationship between various factors and the occurrence of sarcopenia in Korean adults was identified. Also, the model developed in this study is expected to be useful in detecting participants with risk of sarcopenia in the community early and preventing and managing sarcopenia through appropriate health education.

Effect of Serum Folic Acid Levels on Metabolic Syndrome (혈중 엽산농도가 대사증후군에 미치는 영향 )

  • Yoonjin Park
    • Journal of the Korean Applied Science and Technology
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    • v.40 no.4
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    • pp.890-896
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    • 2023
  • This study aims to examine the relationship between serum folic acid levels and metabolic syndrome. The analysis data were downloaded and used for the 7th 3rd (2018) data of the National Health and Nutrition Survey and in this study, 495 men, 706 women, and a total of 1,201 people were finally analyzed. The data analysis used Chi-square and t-test for the difference in serum folic acid according to general characteristics, Pearson correlation for the relationship between sub-factors of metabolic syndrome, and logistic regression analysis for serum folic acid levels and metabolic syndrome indicators. According to the results of this study, there was a significant negative correlation between serum folic acid levels and waist circumference (r=-0.113, p<0.01), triglyceride (r=-0.086, p<0.05), and HDL-cholesterol (r=0.086, p<0.05) showed a significant positive correlation. As a result of regression analysis, in the case of HDL-cholesterol, the group with normal serum folic acid levels was significantly higher than the group with low (p<0.05). Therefore, through this study, it is proposed to develop appropriate eating habits and health education programs to prevent metabolic syndrome.

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
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    • v.25 no.3
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    • pp.597-607
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    • 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.

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