• Journal of Chest Surgery
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• 제42권1호
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• pp.92-95
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• 2009

유육종증은 면역 반응에 의한 전신 육아종성 염증 질환으로 20~60%에서 심장을 침범하는 것으로 알려져 있으나 심장에만 국한된 유육종증(Isolated cardiac sarcoidosis)은 매우 드물며, 전신 증상의 발현이 없는 제한된 경우에 심장 이식을 고려해 볼 수 있다. 저자들은 완전 방실 차단으로 영구형 심장 박동 조율기(Permanent pacemaker)를 삽입한 심장 유육종증 환자에서 스테로이드에 반응하지 않는 심부전의 악화로 심장 이식을 시행하였기에 보고하는 바이다.

• 성인간호학회지
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• 제19권4호
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• pp.547-555
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• 2007

Purpose: The purpose of this study was to test a hypothetical model of health-related quality of life in patients with heart failure. The hypothetical model was derived from the Wilson and Cleary's model, the Rector's model, and published research findings. Methods: Data from 103 patients with heart failure were analyzed to determine the best multivariate health-related quality of life model given variables derived from the prior studies. The statistics programs SPSS 12.0 and LISREL 8.7 program were used for descriptive statistics and covariance structure analysis respectively. Results: The overall fitness of the path final model was good(GFI=.97, AGFI=.95, NNFI=1.06, NFI=.96, p=.96). Symptoms were directly affected by gender. HYHA Class was directly affected by only gender. Physical functioning limitation was directly affected by exercise. Health perception was directly affected by economics, symptom, and physical functioning limitation. Depression was directly affected by exercise and health perception. Heath-related quality of life was directly affected by physical functioning limitation and depression, indirectly affected by gender, economics, exercise, symptoms, NYHA Class, and health perception. This path analysis model explained 51% of health-related quality of life in patients with heart failure. Conclusion: To improve of health-related quality of life with heart failure patients, it is necessary to make nursing interventions for physical functioning and depression.

• 성인간호학회지
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• 제16권2호
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• pp.316-326
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• 2004

Purpose: The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. Method: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesII to IV. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. Result: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. Conclusion: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.

• 성인간호학회지
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• 제23권3호
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• pp.244-254
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• 2011

Purpose: The objective of this study was to evaluate adherence to self-care and identify associated factors in outpatients with Heart Failure (HF). Methods: Using a cross-sectional design, a convenience sample of 249 outpatient clinic patients were recruited at S university hospital. Between October 2009 and December 2009, data were collected through questionnaires and medical record review. Results: The total mean score of adherence to self-care was $18.07{\pm}3.56$ out of a possible 45 points. Among self-care dimensions, adherence to medication and low salt diet was high, while lower adherence was reported in contact with health professionals if symptoms such as weight gain, edema and fatigue were presented. Multivariate analysis adjusted for other socio-demographic and clinical factors showed that disease knowledge related to heart failure (p<.001) and left ventricular ejection fraction (p=.027) were independent predictors of adherence to self-care. These factors explained 23% of total variance in the adherence to self-care. Conclusion: Heart failure patients with higher disease knowledge and those who have good systolic function may be more likely to engage in adherence to self-care than those with lack of disease knowledge and low contractility. Further research is needed to confirm these results and identify other predictors of adherence to self-care.

• 성인간호학회지
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• 제19권1호
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• pp.132-143
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• 2007

Purpose: The purpose of this study was to identify effects of a self-management program on symptom and functional status, health perception, and quality of life(QOL) of patients with CHF. Methods: Patients with CHF as defined through clinical judgment using the Framingham criteria and EF<50% were enrolled in the study (experimental: 21, control: 20). The symptom focused self-management program consisted of coping behaviors for symptoms including dyspnea, chest discomfort/pain, dizziness, ankle edema, and basic self-management including medications, diets, activity, lifestyle changes. Experimental group received an educational booklet after survey, and periodic telephone follow-up by a trained nurse. Data were collected the 3rd day after admission and at 1 month, 3 months, and 6 months after discharge using questionnaires. Results: Significant differences were found in the presence of symptoms, health perception, and QOL between groups during follow-up. Although no significant difference was found in functional status, the experimental group reported better functional status than the control group. Conclusion: By facilitating self-management of CHF using tailored interventions including education programs and telephone monitoring, it is expected that patients will be able to monitor their symptoms routinely, adhere to therapeutic regimen, and have a better QOL.

• 성인간호학회지
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• 제17권1호
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• pp.56-67
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• 2005

Purpose: The main purpose of this study was to examine the effectiveness of a standardized telephone monitoring intervention in addressing the symptom experience and improving self-management ability in patients with heart failure. Methods: A non-equivalent control group pre-post test design was used. There were 17 patients in the experimental group, and 16 in the control group. According to the protocol, patients in the experimental group received 15 to 30 minute-telephone monitoring four times, once a week for 4 weeks. Data were analyzed by ${\chi}^2$-test, Mann-Whitney U test. Results: 1) The experimental group showed a significant increase in compliance with self-management compared to the control group. 2) There was a significant decrease in degree for 3 symptoms(DOE, PND, & continuing fatigue) in the experimental group, after telephone monitoring. However, the experimental group did not show significant decrease in the degree of the total symptom experiences. Conclusions: The results of this study provide evidence that standardized telephone monitoring is effective in relieving symptom experience and improving self-management in patients with heart failure over the course of telephone monitoring.

• Journal of Korean Biological Nursing Science
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• 제19권4호
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• pp.227-240
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• 2017

Purpose: The purpose of this review was to identify the current status of nursing studies on heart failure (HF) patients in South Korea and to suggest future study direction. Methods: A literature review of databases such as KoreaMed, KERIS and nursing and allied health journal were searched with key terms 'heart failure' and 'nursing' for the period from January 2000 to February 2017. A total of 35 studies including 28 articles and 7 theses met the inclusion criteria. Results: Twenty-seven out of 35 studies were observational studies on outpatients and most of the studies did not mention the ejection fraction and New York Heart Association functional classification class (NYHA class) in the inclusion criteria. Self-care and health-related quality of life as psychological factors, and physical activity as a biological factor, were used as main variables. However, we found it difficult to understand how much score indicates better quality of life because of an inconsistent and wide score. In quality assessment, 8 intervention studies had no serious flaws. Conclusion: Further studies should consider more biological and social factors influencing HF. The quality assessment with respect to nursing intervention studies in HF showed that randomized and double-blind trials are needed.

• 기본간호학회지
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• 제26권1호
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• pp.52-61
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• 2019

Purpose: The aim of this study was to examine the mediating effect of self-efficacy in the relationship of physical and psychological symptoms to exercise adherence in patients with heart failure. Methods: The participants in this study were 186 patients with heart failure in two hospitals located in Busan. The measures included questions about general and disease characteristics, physical symptoms, psychological symptoms, self-efficacy for exercise, and exercise adherence. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, simple and multiple regression using Baron and Kenny steps for mediation. Results: There were significant differences in age, gender and comorbidity on exercise adherence. There were also significant correlations among physical and psychological symptoms, self-efficacy for exercise, and exercise adherence. Self-efficacy for exercise showed partial mediating effects in the relationship between physical symptoms and exercise adherence. Conclusion: Based on the findings of this study, the enhancement of self-efficacy for exercise may positively affect the exercise compliance of the patients with health failure, even while they are experiencing physical symptoms. Therefore, it is necessary to develop effective strategies to enhance self-efficacy for exercise.

• 중환자간호학회지
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• 제12권1호
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• pp.94-108
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• 2019

Purpose : Heart failure (HF) is considered an important medical burden with rehospitalization and mortality. Anemia is a major risk factor associated with the severity of HF. To improve the understanding of the impact of anemia in the population with HF, we explored the prevalence of anemia, its guidelines, relationship between anemia and mortality or rehospitalization, and limitation of reviewed papers of various populations with HF. Method: We used Whittemore and Knafl's integrative review methodology (2005), and thirty research papers were analyzed. PubMed, CINAHL, Cochrane, PsychInfo, Embase, Web of Science were searched for papers published between January 1960-June 2018. Results: Anemia in individuals with HF was primarily defined using the World Health Organization guideline. The prevalence of anemia in patients with HF varied from 9% to 56.7%. Moreover, such a condition significantly increases the prevalence of mortality or rehospitalization in patients with HF. The analyzed majority were non-prospective cohort study including secondary data analysis. Conclusion: Anemia in individuals with HF is a significant risk factor of mortality and rehospitalization. Prospective cohort studies should be designed to identify the optimal value for screening anemia and the impact of anemia on rehospitalization and mortality among HF patients.

• Journal of Nutrition and Health
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• 제43권3호
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• pp.224-232
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• 2010

본 연구에서는 우리나라 심부전 환자 78명을 대상으로 식이 섭취 빈도법을 통한 영양소 섭취량 조사를 시행하여 한국인 영양섭취기준과 비교하였으며 그 결과는 다음과 같았다. 1) 에너지와 단백질, 철분의 평균 섭취량은 한국인 영양섭취 기준에 비해 충분히 섭취하고 있었으나 나트륨 섭취가 과다하고, 칼륨 섭취가 부족한 불균형의 영양문제가 파악되었다. 2) 칼슘의 섭취가 부족한 환자들이 상당수 존재하여 심부전 환자의 골연화증 및 골다공증 위험이 높을 가능성이 있음을 확인하였다. 3) 비타민 $B_{12}$, 엽산의 섭취가 부족하며, 이외 리보플라빈, 나이아신 등의 비타민 섭취 부족의 가능성이 있음을 확인하였다. 4) 70세 이상의 고령 환자에서도 칼륨, 칼슘, 비타민 $B_{12}$, 엽산의 섭취가 부족한 것으로 나타났고 이러한 부족 현상은 고령 환자에서 더욱 심각한 것으로 파악되었다. 위의 결과로 보아 국내 심부전 환자의 경우 무기질, 비타민 등의 미량 영양소의 섭취 부족이라는 영양문제가 존재하고 있었다. 따라서 이러한 영양 결핍 문제가 지속된다면 심부전 환자의 장기적인 예후에 영향을 미칠 수 있을 것이므로 영양섭취 부족을 해결하기 위한 다각적 측면에서의 영양 섭취 평가 및 영양관리 대책과 지침이 마련되어야 할 것이다.