• 성인간호학회지
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• 제27권5호
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• pp.481-492
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• 2015

Purpose: The purpose of this study was to examine the effects of the evidence-based clinical practice guidelines on Postoperative Nausea and Vomiting (PONV). Methods: The research design was a non-equivalent control group with a non-synchronized design. The participants were the patients undergoing gynecologic laparoscopy. Data were collected from July, 2014 through January, 2015. The participants in the experimental group (n=35) received an assessment of risk factors of PONV, aroma therapy, and P6 acupressure method as recommended in the guidelines. Those in the control group (n=35) received usual nursing care. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test using SPSS/WIN 19.0 program. Results: The occurrence of nausea and vomiting, the level of nausea and vomiting, and the need for antiemetic medicine in the experimental group were significantly less than those in the control group after surgery. The levels of postoperative pain and the amounts of time for nursing activities in the experimental group were significantly reduced than those in the control group after surgery. The levels of satisfaction were significantly higher in the experiment group than that of the control group. Conclusion: The evidence-based guidelines is recommended for nursing practice as a guidance for managing PONV and helping the recovery of patients after laparoscopic surgery.

• Journal of Korean Biological Nursing Science
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• 제19권2호
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• pp.86-97
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• 2017

Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

• Journal of Yeungnam Medical Science
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• 제8권1호
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• pp.72-78
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• 1991

척추 마취로 제왕절개술을 받은 건강한 30명의 산모를 대상으로 ephedrine sulfate의 정맥적 주군(15명)과 정맥내 주사군(15명)의 산모혈압과 심박, 오심, 구토, Apgar scores, 산모와 태아의 혈압가스압 등을 비교 관찰하였든바 다음과 같은 결론을 얻었다. 1) 척추마취후 적주군의 수축기 산모혈압은 의의있는 변화가 없었으나(p>0.1), 정주군에는 5, 7분 후 술전치에 비해 통계학적으로 의의있게 하강하였으며(p<0.005), 적주군과의 비교에서도 의의있는 변화를 나타내었다(p<0.001). 2) 적주군에서 정주근보다 오심, 구토의 발생 빈도가 낮았다(p<0.001). 3) 산모의 심박, Apgar scores, 산모와 태아의 혈액 가스압에는 양군간 유의한 차이는 없었다. 이상과 같이 제왕절개술을 위한 척추 마취시 ephedrine의 예방적 정맥내 적주가 안전하고 효과적일 것으로 사료된다.

• 대한간호학회지
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• 제47권6호
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• pp.731-743
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• 2017

Purpose: Chemotherapy-induced nausea and vomiting (CINV) can cause severe malnutrition. However, relationships between CINV levels, non-pharmacological coping methods, and nutritional status of female cancer patients have rarely been investigated. Therefore, this study aimed to analyze their relationships in gynecologic cancer patients. Methods: Participants receiving a highly and moderately emetogenic chemotherapy were recruited. The level of CINV was assessed using a numeric rating scale. Coping methods were determined using multiple-choice self-report questionnaires and categorized into seven types for statistical analysis. Nutritional status was evaluated using biochemical and anthropometric parameters. Results: Among all the 485 patients, 200 eligible inpatients were included. Despite the administration of prophylactic antiemetics, 157 patients (78.5%) still experienced CINV, and several used nonmedically recommended coping methods, such as just enduring the symptom or rejecting food intake. A total of 181 patients (90.5%) had nutritional disorders. Although the level of CINV was indirectly related to the occurrence of nutritional disorders, patients who rejected food (${\beta}=1.57$, p=.023) and did not use physical measures (${\beta}=-1.23$, p=.041) as coping methods were under the high risk of nutritional disorders. Conclusion: Korean gynecologic cancer patients had high levels of CINV and were at high risk of nutritional disorders, which may be related to the use of nonscientific coping methods, possibly due to cultural backgrounds and lack of proper nutritional program. Therefore, developing a culturally appropriate educational program for the cancer patients with CINV is urgently needed.

• Child Health Nursing Research
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• 제6권1호
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• pp.60-68
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• 2000

The purpose of this study is to assess the effect of progressive muscle relaxation therapy on nausea, vomiting and anxiety experienced by children who were histologically diagnosed as malignancy and have received cancer chemotherapy. Twenty subjects with 10 in experimental group and 10 in control group, between the age of 7 to 12 years participated in this study. All subjects were admitted for inpatients chemotherapy at the S hospital between April to August 1998. The methods used for interventional muscle relaxation were both the 16 items of the progressive muscle relaxation therapy developed by Jacobson and the 4 items of the muscle relaxation therapy by Wolpe. The method for assessing nausea, vomiting was the Index of Nausea and Vomiting by Rhodes et al and that for anxiety was State-Trait Anxiety Inventory for Children by Spielberger. The data was analysed by repeated measures ANOVA and Scheffe test using SAS program. The results were as follows : 1. On measurement of nausea, vomiting, in the experimental group, the mean values of the second and the third measurements showed tendency to slightly decrease compared with the first measurement, but there was no statistically significance. And in the control group, there were no significant differences among first measurement, second measurement and third measurement. Also there was no significant difference in the mean values assessing nausea, vomiting between experimental and control group (F=1.33, p=0.2645). 2. The results assessing state anxiety showed, in the experimental group, progressive decrease in mean values at each measurement, while the control group showed no significant differences between the mean values of each measurement. Also there was statistically significant difference in state anxiety measurements between experimental and control group(F=4.36, p=0.05). In conclusion, muscle relaxation therapy for school-aged children with chemotherapy could not be effective to decrease nausea, vomiting, but it could be effective to decrease anxiety.

• 동서간호학연구지
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• 제15권1호
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• pp.26-33
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• 2009

Purpose: The purpose of this study was to examine the effect of Nei-Guan acupressure on nausea, vomiting, and anorexia in gynecological cancer patients receiving chemotherapy. Methods: Subjects consisted of 40 patients with cancer who were hospitalized and had chemotherapy at a general hospital located in Gyeonggi province, Korea. Control subjects (n=20) received only chemotherapy and intervention subjects (n=20) received Nei-Guan acupressure during their chemotherapy. The data were collected from February to October in 2008. Nausea and vomiting were measured with the Rhode's Index of Nausea, Vomiting, and Retching, and anorexia was measured using a Visual Analog Scale. Data were analyzed by X$^2$-test, t-test, repeated measures ANOVA. Results: Severity of nausea and vomiting in the intervention group was significantly less than in the control group. Repeated measure ANOVA revealed significant group effect (F=28.09, p=.000), time effect (F=321.48, p=.000), and interaction effect (F=7.90, p=.000). Severity of anorexia in the intervention group was significantly less than in the control group. Repeated measure ANOVA revealed significant group effect (F=28.68, p=.000), time effect (F=52.32, p=.000), and interaction effect (F=6.35, p=.000). Conclusions: Acupressure can be applied as a supportive nursing intervention to relieve nausea, vomiting, and anorexia in patients receiving chemotherapy.

• 턱관절균형의학회지
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• 제13권sup호
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• pp.21-26
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• 2023

본 증례에서는 틱 장애 증상과 오심 구토를 동반한 환자에게 턱관절균형요법을 병행한 한방 치료를 적용하여 증상의 호전을 관찰하였다. 따라서, 이와 같은 경우에 턱관절균형요법을 적용하여 중추신경계와 자율신경계를 안정화시켜 틱장애 증상을 개선시킬 뿐만 아니라 전체적인 척추 정렬을 바로잡음으로써 소화기계와 관련된 흉추의 안정화를 통하여 관련된 증상의 호전에도 효과가 있을 것으로 사료된다.

• Journal of Hospice and Palliative Care
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• 제16권4호
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• pp.205-215
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• 2013

말기암환자들은 암의 진행으로 인한 여러 가지 육체적, 정신적 증상들로 고통 받고 있으며, 통증뿐만 아니라 피로감, 쇠약감, 식욕부진, 오심 구토, 호흡곤란 등은 말기암환자의 삶의 질 감소에 큰 영향을 미친다. 피로감은 여러 기전 및 원인에 의하여 발생하는데, 치료 가능한 원인으로는 약물부작용, 빈혈, 심한 통증, 수면장애, 우울증 또는 불안감, 영양부족, 내과적 동반질환 등이다. 피로감의 주 기전으로는 사이토카인의 조절이상 및 시상하부-뇌하수체-부신축의 기능부전, serotonin의 조절이상 생체리듬의 파괴, ATP에서의 변화 등이다. 치료는 치료 가능한 원인을 제거하고 환자의 에너지를 보존할 수 있게 하는 방향으로 활동을 계획하고, 교육해야 하며, 약물 치료로는 corticosteroid와 psychostimulants를 사용할 수 있다. 식욕부진과 악액질도 여러 가지 치료 가능한 원인이 있을 수 있는데, 구내염, 구강 캔디다증, 구강 herpes, 구강건조, 변비, 통증과 호흡곤란같이 조절이 안 되는 증상, 섬망, 오심 구토, 우울증, 위장관 운동기능 장애, 역류성 식도염, 내분비 장애가 포함 된다. 식욕부전의 기전은 음식섭취를 조절하는 뇌의 생리적 기전의 이상과 관련, serotonin 분비 증가, IL-$1{\alpha}$, IL-1, IL-6, IL-8 TNF-${\alpha}$와 관련이 있다. 악액질의 기전은 에너지와 기질(substrate metabolism)에서의 변화, 종양에서 생산된 지질분해요소와 단백질 분해요소, 호르몬 이상, 암세포로부터 세포성장에 필요한 영양분을 빼앗기는 것, 에너지 섭취의 감소 등이다. 치료는 정신과 상담 및 환자와 가족의 교육인데, 교육할 때는 환자와 그 가족에게 식욕부진과 악액질이 암으로 인한 임종과정 중 일어나는 자연적인 현상이라는 것을 알리며, 다른 행동으로 환자를 돌보는 방법 등을 교육한다. 약물치료로는 megestrol acetate와 dronabinol, steroid를 사용할 수 있다. 오심 구토의 원인 중 치료가 가능할 수도 있는 것으로는 약물, 요독증, 감염, 불안증, 변비, 상부위장관 폐쇄, 고칼슘혈증, 저나트륨증이 있고, 치료는 metoclopramide, haloperidol, olanzapine 또는 ondansetron 등을 사용해 볼 수 있다. 말기 암에서 호흡곤란의 증상은 폐의 특별한 병변이 없이도 환자가 호소할 수 있는데, 이 경우 opioids가 효과적이다. 말기 암환자에서 환자의 증상을 경감시켜주기 위한 완화치료는 매우 중요하며, 환자의 증상을 잘 평가하고 적절한 치료 및 관리를 해 줌으로써 환자의 삶의 질을 향상시킬 수 있다. 따라서 이들 환자의 증상 호소에 더욱 관심을 갖고 적극적으로 치료하고 관리하여야 할 것이다.

• 동의생리병리학회지
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• 제25권6호
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• pp.1085-1088
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• 2011

This study aims to investigate the effect of acupuncture on PC6 for preventing opioid-induced nausea and vomiting under circumstance whether the participants are conscious or non-conscious. 143 patients receiving intravenous patient controlled analgesia(PCA) with fentanyl were assigned to three groups. Two groups were given acupuncture on PC6 before anesthesia(PreAN) or after anesthesia(PoAN) respectively. One group was control group without acupuncture treatment(NC). Assessment of nausea and vomiting was obtained from all patients for 48hours after surgery. The incidence of nausea and vomiting was significantly lower in the PreAN group and PoAN group than in the NC group. The severity of nausea was the lowest in PreAN group, second to in PoAN group, and the highest in NC group. This results show that acupuncture on PC6 even without patients' consciousness has effect on preventing PONV.

• 대한한방내과학회지
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• 제24권2_4호
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• pp.1023-1029
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• 2003

Objective: The purpose of this study is to inspect recovery state of patients suffering from nausea and vomiting, who received auricular acupuncture. On the other hand, we are going to examine effects of auricular acupuncture through the study of treatises on nausea and vomiting. Nausea and vomiting are ordinary symptoms of dispositional or functional disease. The symptoms often appear without obvious disorders that can be detected on various inspection. Methods: Auricular acupuncture needling was given to the patients who had reported the symptoms of nausea and vomiting. They were hospitalized at the korean oriental internal medicine of National Medical Center from Dec. 2002 to Aug. 2003. Result: Relatively quick response of treatment was acquired after auricular acupuncture on nausea and vomiting. Conclusion: This study shows that auricular acupuncture is effective in reducing nausea and vomiting without regard to causal disease.