• Korean Parent-Child Health Journal
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• v.6 no.1
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• pp.18-30
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• 2003

Congenital heart disease is the most frequently shown congenital disease among children, most of them can be corrected with operation. However, Patients and their parents need nursing intervention when they face this risky incident of operation. Therefore, parents' experiences are absolutely needed to plan nursing intervention to give practical help to the patients and their parents. The purpose of this study is to provide basic resources to develop a feasible intervention program for the parents by understanding the experiences related to the informed consent of cardiac surgery of their child. From January to June 2003, 10 parents of children patients with congenital heart disease were interviewed who filled out Operation Agreement before the primary operation after they are diagnosed as congenital heart disease in pediatric chest surgery of A hospital in Seoul. They were asked to give opinion regarding pre-operation needs and the interviewed information was analyzed. The results of this study are as follows : Firstly, they were asked what they felt before they were told about the operation of their children from the doctor before filling out the informed consent of operation. They felt 1) vague, 2) confusion of choose, 3) risky, 4) resented, 5) uneasy, 6) guilty, and 7) the burden of operation. Secondly, they were asked what they felt after they filled out the informed consent of operation and the doctor gave them detailed information on the operation of their children. They felt 1) confused, 2) responsible, 3) rejected, 4) angry, 5) plain, 6) to have hope, 7) trying to trust medical people, 8) that consolation is needed, and 9) conditional reduction of the burden of operation. Thirdly, followings are the categories of congenital parents' demand before operation based on the analysis of experiences related to the preparation of the informed consent of operation. 1) Information Demand (1) Anticipatory information (2) Concrete and precise information (3) Individual information 2) Support (1) Empathy (2) Parental supporting (3) Support of parents in the same situation 3) Education and consulting (1) Children-oriented Education (2) Consultation Considering the results of this study, parents of the child with congenital heart disease seem to have various emotional experiences related to filling out the informed consent and they need concrete and practical helps before cardiac surgery. This study proposes that systematic nursing intervention is needed according to the needs of the parents who have the child with congenital heart disease before operation in the field of child health nursing.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.2
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• pp.159-165
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• 2010

배경: 매복지치의 수술적 발치 시 propofol과 remifentanil을 이용한 목표조절농도주입(Target controlled infusion) 의식하 정주진정법의 적절한 주입농도를 제시하고 그 안전성을 평가하고자 하였다. 방법: 매복지치의 수술적 발치가 예정된 미국마취학회 신체 등급 분류 1, 2에 속하는 15-65세, 142명(여 83명, 남 59명)의 환자를 대상으로 소급 연구하였다. 환자는 수술 전 목표조절농도주입법을 이용한 의식하 진정법 사용에 관한 동의서를 작성하였다. 정맥내 삽관을 시행하고 수액을 공급을 시작하고, 4-5 L/min의 산소를 비관을 통해서 공급하였다. Propofol과 remifentanil의 초기 목표 혈중농도는 각각 $0.5\;{\mu}g/ml$와 1.0 ng/ml로 정하였다. 수술 중, 환자의 불안 통증 정도에 따라 목표농도를 조절하였으며 최저 농도와 최대 농도, 평균 농도, 주입된 총 용량을 기록하였다. 또한 수축기혈압과 맥박 수, 산소포화도, 호기 말 이산화탄소량을 수술 시작 전, 수술 중 5분 간격으로 확인하고 기록하였다. 모든 측정치는 평균 $\pm$ 표준편차나 환자의 수, 초기 측정치에서의 백분율 편차로 표시하였다. 결과: 수술 동안의 목표 혈중농도의 평균은 propofol은 $0.54{\pm}0.11\;{\mu}g/ml$이고, remifentanil은 $1.11{\pm}0.30\;ng/ml$였다. 수술 중 조절된 최대농도는 propofol은 $0.6{\pm}0.23\;{\mu}g/ml$이고, remifentanil은 $1.3{\pm}0.63\;ng/ml$였다. 이는 의식하 진정에 해당되는 범의의 농도라고 할 수 있겠다. 진정동안 환자의 언어적 의사소통은 유지 되었으며 산소 포화도는 4-5 L/min 의 산소 보충 하에 98%이상으로 유지되었다. 수축기 혈압과 맥박은 대부분의 환자에서 정상변위범위(${\pm}20%$)내에서 유지되었다. 결론: 본 연구는 목표조절 농도주입 의식하 진정에서 사용된 농도(propofol $0.5\;{\mu}g/ml$, remifentanil 1.0 ng/ml)는 안전하게 의식하 진정을 가능한 것을 보여준다. 이는 치과 치료 시 목표조절농도 주입의식하 진정법에서 적절한 목표농도를 제시한다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.9
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• pp.113-119
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• 2020

This study examined the effects of stepwise education for operation patient care according to nursing satisfaction on the critical thinking disposition and clinical performance. The participants were 192 junior students who signed a consent form with an explanation of the study. Data were obtained from the students on the first day of junior's first semester and the last day of junior's first and second semester. Data analysis was performed using the number, percentage, mean, standard deviation, Chi-square test, t-test, and repeated measure ANOVA through the SPSS/WIN 23.0 program. Results showed that nursing students with high nursing satisfaction had higher critical thinking disposition than those with lower nursing satisfaction (F=4.57, p=.012). There were no significant differences according to time (F=0.20, p=.821). The clinical performance was not significantly different according to nursing satisfaction (F=1.08, p=.343) and time (F=1.58, p=.210). This means that increasing nursing satisfaction would be a strategy for increasing the critical thinking disposition that was the core competency of nursing students.