• 임상간호연구
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• 제26권3호
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• pp.365-373
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• 2020

Purpose: The purpose of this study was to evaluate the effect of preoperative warming to prevent hypothermia in surgery for patients undergoing total hip replacement arthroplasty under spinal anesthesia. Methods: A randomized experimental study was conducted. Data were collected at an S University hospital in Gyeonggido from December 3, 2019 to March 31, 2020. A random allocation program was used to randomize participants into intervention and control groups. A total of 90 participants were assigned to the study: 30 people were randomized to a pre-warming group using Bair Hugger forced-air warming blankets(Model 505) 30 minutes before surgery, 30 to a pre-warming group 15 minutes before surgery, or 30 to a control group. The findings from 88 participants were analyzed. For data analysis, χ2 test and ANOVA were used utilizing the SPSS 21.0 program. Results: The pre-warming group 30 minutes before surgery had significantly higher body temperature than the control group, from 30 minutes after inducing anesthesia to the end of anesthesia. Body temperature over anesthesia time showed significant differences among the three groups, but there were no statistically significant differences in interactions between time and groups. Conclusion: Warming patients' body for 30 minutes before surgery was effective in maintaining normal body temperature while preventing intraoperative hypothermia.

• 근관절건강학회지
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• 제22권2호
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• pp.96-104
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• 2015

Purpose: The purpose of this study was to identify the relationship between intraoperative level of caring and anxiety among patients who underwent spinal surgery under local anesthesia. Methods: The study participants included 162 patients who had spinal surgery under local anesthesia at a general hospital in B metropolitan city between July 20 and September 20, 2014. To measure the caring behaviors of patients under local anesthesia, we used the Caring Behavior Measurement, and state anxiety was measured by the State Trait Anxiety Inventory. The collected data were analyzed using a SAS program. The differences in anxiety levels based on participants' characteristics were analyzed with t-test and an analysis of variance. The correlation between levels of caring and anxiety was tested with Pearson's correlation coefficient. Results: Education and caring levels showed significant relationship with the anxiety level of patients with spinal surgery under local anesthesia. Conclusion: To decrease the level of anxiety in patients undergoing spinal surgery under local anesthesia, it is necessary to educate and train operating nurses about the intra-operative caring behavior.

• 문화기술의 융합
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• 제4권2호
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• pp.171-178
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• 2018

본 연구는 근골격계 수술을 앞두고 있는 환자를 대상으로 라벤더를 이용한 향기흡입이 수술전 불안 감소에 미치는 효과를 규명하기 위해 시행되었다. 연구설계는 비동등성 대조군 전-후 설계의 유사실험연구(Quasi-experimental design)이다. 연구의 대상은 척추마취나 부분마취로 근골격계 수술을 받는 대상자 60명으로 실험군 30명 대조군 30명이었다. 연구도구는 활력징후 중 혈압과 맥박, 수술 전 불안 자가평가 도구 APAIS(Amsterdam preoperative anxiety information scale)이다. 자료분석은 PASW(SPSS)20.0을 이용하여 실험군과 대조군간의 동질성 검증을 t-test, $x^2$검증, Fisher's exact test, paird t-test를 이용하여 분석하였다. 연구결과에서 라벤더 향기흡입이 근골격계 수술환자의 수술전 불안을 감소시키고, 향기요법 시행 후에 수축기 혈압과 이완기 혈압의 유의미한 감소를 보이는 결과를 나타냈다. 이러한 결과는 수술을 앞둔 환자에게 비약물적 중재를 통해 불안의 감소 및 혈압과 맥박을 안정화시키기 위한 간호전략으로 향기요법을 사용할 수 있을 것이라 사료된다.

• 대한간호학회지
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• 제47권4호
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• pp.456-466
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• 2017

Purpose: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. Methods: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming. Results: Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG ($x^2=6.15$, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group. Conclusion: Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.

• 성인간호학회지
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• 제14권3호
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• pp.428-437
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• 2002

Purpose: The purpose of this study is to examine the changes of surgical patients' body temperature in applying warming to patients. The study of an effective nursing intervention, which aims to prevent hypothermia during surgical operations, use of anesthesia, and to remove dermal discomforts. The nonequivalent control group pre-test/post-test design was used for this quasi-experimental study. Method: The study subjects were adult patients who would take a surgical operation under general anesthesia in C Hospital; the surgical operations done were, total abdominal hysterectomy or Myomectomy; 20 patients were included in experimental group I, 20 patients were included in experimental group II, and 20 patients were in the comparative group. The total number of study subjects was 60. The data was collected from September the 1st, 2001 to October the 20th, 2001. The data was analyzed by SPSS program, F-test and Repeated measures of ANOVA. Multi-comparison method of DUNCAN was used for the sections that show the significant differences at the level of p<.05, which was a posterior examination. Result: 1) "The body temperatures of the three groups of patients will be respectively different at the end of the operations; experimental group I to which warming was applied before the operations, experimental group II to which warming was applied during the operations, and the comparative group with no warming being given," showed (F=12.609, p=.000). 2) "Degrees of shivering symptoms for the three groups will be respectively different at the end of the operations; experimental group I which applied warming before operations, experimental group II which applied warming during operations and the comparative group with no warming." Showed assumed (F=6.626, p=.000). Conclusion: Summing up the above study, the warming assumed during operations was a more effective nursing intervention for preventing patients' hypothermia than the warming assumed before operations.

• 여성건강간호학회지
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• 제21권4호
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• pp.321-331
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• 2015

Purpose: Purpose of this study was to identify the effect of structured information on immediate preoperative anxiety and uncertainty for women undergoing total laparoscopic hysterectomy. Methods: Sixty women who were admitted for total laparoscopic hysterectomy were recruited at a university hospital in Gyeonggi-do from June to October 2014. Thirty women were assigned to either the experimental or the control group. Women in the experimental group were provided structured information, which consisted of visual and auditory materials about surgical preparation and process, practical experience on devices such as IV-PCA pump and Inspiro-meter and actual experience on route to go to the operating room. State-anxiety, uncertainty, and blood pressure and pulse rate as biological indicators were measured before and after the intervention to examine the effect. Results: Significant group differences were found on state anxiety, uncertainty, including ambiguity, inconsistency, and unpredictability at the holding area. There was a significant difference on pulse rate in the operating room between the two groups. Conclusion: Findings demonstrated that the structured information provided for women undergoing laparoscopic hysterectomy preoperatively was effective on immediate preoperative anxiety and uncertainty. Nurses may contribute to decreasing patients' anxiety and uncertainty by utilizing this structured information preoperatively.

• 한국직업건강간호학회지
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• 제3권호
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• pp.41-53
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• 1993

본 연구는 산업 간호사의 통상증상에 대한 투약 및 처치, 타의료기관에 의뢰내용, 응급조치 내용을 업종별로 비교 분석코저 한다. 연구방법은 산업간호사회에 등록된 산업장 중 서울, 인천, 마산, 창원, 부산, 울산지역에 있는 130개 산업장에 근무하는 산업간호사를 대상으로 설문조사하였다. 연구결과는 다음과 같다. 1) 신체기관별 통상증상에 대한 처치 및 투약은 서비스업과 제조업, 기타제조업 모두에서 소화기계, 호흡기계증상에 대한 처치 및 투약 업무가 가장 많았으며 업종별로 보면 서비스업의 경우 소화불량, 감기, 근육통, 설사, 기침, 두통, 복통, 구토, 변비 등이 80% 이상을 차지하였다. 제조업의 경우 소화불량, 감기, 설사, 두통, 근육통 등이 많았으며 기타제조업의 경우 감기, 두통, 소화불량, 근육통, 설사, 기침, 눈다락지 순으로 나타났다. 2) 근로자를 타의료기관에 의뢰 하는 내용은 즉각적인 수술을 요할때나 골절, 내부장기의 손상, 두뇌손상, 출혈 등으로 나타났다. 3) 업종별 응급조치내용은 서비스업에서는 화상과 쇼크, 출혈이 가장 많았으며 유해물질의 급성중독의 경우가 가장 적었다. 제조업에서는 화상, 골절, 쇼크, 출혈, 유해물질의 급성중독이, 기타제조업에서는 화상, 골절, 쇼크, 출혈의 순으로 많았다. 4) 업종별 구비관리하고 있는 의약품은 서비스업종이 제조업, 기타제조업보다 많은 의약품을 구비하고 있었으나 경미한 통상증상에 대한 의약품으로 나타났다. 이러한 연구결과들을 통해 볼때 제조업, 기타제조업, 서비스업종의 보건관리자가 일차보건의료수준에서의 투약 및 처치를 시행하고 있는 바, 이에 대한 구체적이고 명확한 투약의 범위를 설정하여 보건관리자의 직무를 표준화할 필요가 있으며 서비스업종에 종사하는 근로자의 건강문제와 관련요인을 구체적으로 연구할 것을 제안한다.

• 임상간호연구
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• 제17권2호
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• pp.192-203
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• 2011

Purpose: The purpose of this study was to compare the body temperature (BT), blood pressure (BP) and shivering in patients undergoing operation under general anesthesia between the heated humidification circuit tube (HHCT) group and the non-HHCT group. Methods: Data were extracted from the participants' medical records from September 1st to December 30th, 2009. The HHCT group consisted of 50 cases who were applied with heated and humidified gas via a specially designed circuit under general anesthesia. The HHCT which was adjusted at $41^{\circ}C$ was applied from induction of general anesthesia to extubation. In comparison, the non-HHCT group consisted of 50 cases who were applied with gas through standard breathing circuit without heat and humidification. Collected data were analyzed by $x^2$ test, t-test and repeated measures ANOVA. Results: The BT and shivering were significantly different between two groups (p<.001). But the BP was was not signigicantly different between the HHCT group and the non-HHCT group. Conclusion: The application of heated and humidified gases to patients under general anesthesia was effective in preserving the body temperature and reducing the shivering.

• 임상간호연구
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• 제14권1호
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• pp.187-198
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• 2008

Purpose: Music intervention has long been used in research of patients undergoing surgical operation in reducing anxiety level and improve surgical outcome. However, there are few studies that have considered a patient's music preference. We investigated the effect of the tailored music intervention which chose music according to the patient's preference on anxiety level and vital signs. Method: The subjects were 50 patients who received regional anesthesia for surgical operation at D hospital in Pohang city from April, 2006 to November, 2006. All of the subjects were randomly assigned either music group (30 subjects) or non-music group (20 subjects). As the patients arrived in the operating room, vital signs were monitored until the subjects were transferred to the recovery room, while Spielberger's STAI-KYZ questionnaires were applied twice to measure preoperative and intra-operative anxiety. The data were analyzed by 2-test, t-test, one-way ANCOVA and repeated measures ANOVA using SPSS 12.0/PC+. Results: There were no significant differences between the two groups on vital signs. All of the vital signs increased when the subjects arrived in the operating room, but decreased quickly once the operation began, regardless of the groups. However, the music group reported significantly less intra-operative anxiety, compared to the non-music group (F=15.208, p<.000), when preoperative anxiety was treated as a covariance. Conclusion: The findings support that the use of music which was chosen by patients during the surgery significantly reduced patient's intra-operative anxiety during regional anesthesia.

• 한국의학물리학회지:의학물리
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• 제3권2호
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• pp.1-12
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• 1992

전자선을 이용한 수술중 방사선치료를 위해서는 수술중에 드러내 놓은 종양에 고선량의 방사선을 조사하되 주변 정상 조직을 보존하기 위하여 cone 장치를 개발할 필요가 있으며, 임상에 필요한 자료를 얻는 것 뿐만아니라 콜리메이터에 의한 적정 X-선 창 크기도 정할 필요가 있다. holder와 cone으로 이루어진 알루미늄제 결합형 cone장치를 개발하였다. 광자선의 SSD 100cm에서 조사면 크기가 직경 4～9cm이면서 lcm씩 차이가 있는 28cm 길이의 원통형 cone을 만들였으며, holder는 cone의 직경이 7cm이상인 것과 미만인을 것을 접속시키기 위해 따로 두 개를 만들었다. holder의 측면에는 조사부위를 관찰하기 위한 거울과 조명등을 삽입할 수 있는 개구부를 두었다. cone에 의한 조사면 크기와 콜리메이터에 의한 X선 창의 크기의 여러 가지 결합에 대하여 수중의 전자선의 깊이선량분포독선 및 측방선량분포곡선, 선량분포를 1차원 물팬톰 장치로 조종하는 p-형 실리콘 검출기로 측정하였다. 출력계수도 p-형 실리콘 검출기로 수중에서 측정하였다. 전자선의 에너지와 cone의 크기의 결합이 일정할지라도 콜리메이터에 의한 X-선 창의 크기는 표면선량 및 최대신량점의 깊이, 80% 선량점의 깊이, 측방선량분포, 출력계수에 영향을 미쳤다. 그중, 출력계수의 변화가 가장 현저하였다. 예로서 9 MeV 전자선의 출력계수는 0.637과 1.549의 범위에 있었다. 콜리메이터에 의한 X-선 창의 크기는 수술중 전자선치료용 cone 장치의 벽으로 향하는 산란 전자의 양에 영향을 미치고, cone장치에서 다시 산란된 전자는 출력계수 뿐만 아니라 선량분포도 바꿀 것으로 생각된다. 따라서 수술중 전자선치료용 cone장치에 대한 선량분포 측정은 임상에서 선량의 불확정도를 최소화하기 위해 필수적이다.능적으로 평가되어야 하므로 앞으로 이에 대한 연구가 요구된다.수 있었다. 즉, $a^{*}$ / $b^{*}$ 의 비값이 1이상 흑은 1에 가까울 때는 미숙기, 0.8 부근 일때는 적숙기, 0.8보다 작아 질수록 적숙기에서 과숙기로 점차 옮아감을 알 수 있었다.지해줄 수 있는 문헌들이 충분히 고찰되지 못하였고, 이론적배경 또한 횡문화 이론과의 관련성이 적었다. 또한 횡 문화 연구에 기초가 되는 연구대상자의 사회 인구학적 특성과 역사적 배경은 잘 나타났으나, 이론적 연구와 경험적 연구 간에 괴리가 있었다. 3. 표본추출방법은 문화에 기반을 둔 대상자를 선정한다는 점에서 한계성 이 있었다. 4. 방법론적 이유로는 대상자와의 면담시간이 구체적으로 기술되지 않았으며, 고유한 언어를 통역하는 과정에서 의미론적 문제에 대한 고려가 부족하였다. 면접과 기록과정에서 보면 자료의 기록과정과 분류 및 분석과정이 명시되어 있지 않았다. 참여관찰과 면접방법을 사용시 이에 대한 자세한 기술이 되어 있지 않았다. 5. 연구결과의 적용 및 이에 대한 논의는 상당히 제한되어 있었는데, 수편의 연구만이 방법론 문제점과 앞으로의 연구분야에 대한 전망을 제시하였으며, 특이한 것은 어 떤 연구자도 이른 개발을 위한 적용 및 임상실무적 차원에서 간호에 대한 제언을 하지 않았다.유모델변수들은 유입-유출 자료들로부터 평가할 수 있으며, 이를 위해서 본 논문에서는 Gauss-Newton 방법을 이용한 Bard 알고리즘을 사용하였다. 서울 구로구 시흥동 산사태 발생 지역의 산사면에 대하여 개발된 모델을 적용하여 예제 해석을 수행함으로써, 지하수 흐름 모델이 산사태 발생 예측을 위하여 이용할 수 있음을 입증하였다. 또한, 매개변수분석 연구를 통하여, 변수 a값은 작은 변화에 대하여 목적함수값에 큰 변화를