• Title/Summary/Keyword: 외래 환자경험

Search Result 99, Processing Time 0.027 seconds

Narrative Inquiry on Experience of Mentally Ill Patients in Psychiatric Day Hospital Care (정신과 환자의 낮병원 이용 경험에 대한 내러티브 탐구)

  • Eom, Kwang-Jin;Maeng, Hae-Young;Kim, Jung-Yoo
    • Journal of the Korea Convergence Society
    • /
    • v.11 no.4
    • /
    • pp.265-275
    • /
    • 2020
  • This narrative inquiry examines the experience of mentally ill patients who used the psychiatric day hospital care service. The researchers in this inquiry conducted in-depth interviews three times with four patients who used day hospital care and data was also collected from additional conversations when patients were on outpatient visit after being discharged from the day hospital. The inquiry uses the narrative research method to describe the experience of using day hospital services as follows; a springboard to reconnect to the world, a place to be empowered and set the mind at ease, and a guide to direction in life. This inquiry is meaningful in that it deals with the in-depth stories of the mentally ill patients who experienced the day hospital care. Based on the results of the inquiry, the following policy suggestions are made; institutional support for reducing social isolation of psychiatric patients, activation of various support systems and further program development.

The Effects of Self-Efficacy Promoting Pulmonary Rehabilitation Program in Out-Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 외래환자에서 자기효능감증진 호흡재활프로그램의 효과)

  • Jung, Jang Hee;Kim, Jung Youp
    • Tuberculosis and Respiratory Diseases
    • /
    • v.61 no.6
    • /
    • pp.533-546
    • /
    • 2006
  • Background: The aim of this study was to determine the effectiveness of self-efficacy promoting pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). Methods: thirty six patients, with clinically stable COPD were randomly assigned: 18 to a rehabilitation group and another 18 as a control group, The subjects participated in a the self-efficacy promoting pulmonary rehabilitation program for 8 weeks. This program consisted of education, breathing retraining, exercise training, relaxation and counseling. The control group received education only. The outcome variables were self-efficacy, dyspnea, exercise endurance, pulmonary function, and quality of life. Dyspnea was measured using the modified Borg scale. Exercise endurance was measured by the six minute walking distance. The quality of life was measured by the quality of life index for pulmonary disease patients. Results: In the rehabilitation group after performing the self-efficacy promoting pulmonary rehabilitation program, the self-efficacy score, exercise endurance, and quality of life score were higher than the control group (p=0.007, p=0.038, and p=0.039, respectively). and the exertional dyspnea score was significantly lower than controls(p=0.045). However, the dyspnea score and FEV1 were similar after performing the self-efficacy promoting pulmonary rehabilitation program. Conclusion: The self-efficacy promoting pulmonary rehabilitation program is effective to in improve self-efficacy, exertional dyspnea, exercise endurance and quality of life in patients with COPD.

Childhood Trauma and Pharmacotherapy Retention among Outpatients with Panic Disorder (공황장애 외래 환자의 아동기 외상과 약물치료 유지)

  • Kim, Dong Joo;Kim, Daeho;Lee, Jinbok;Kim, Yaeseul;Sohn, Sujin
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.28 no.1
    • /
    • pp.53-62
    • /
    • 2020
  • Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

Outpatient Chest Tube Management with Using a Panda Pneumothorax Set with a Heimlich Valve (Panda Pneumothorax Set with Heimlich Valve에 의한 외래에서의 흉관 관리)

  • Choi, Soon-Ho;Lee, Mi-Kyung;Ryu, Dae-Woong
    • Journal of Chest Surgery
    • /
    • v.42 no.4
    • /
    • pp.497-501
    • /
    • 2009
  • Background: Prolonged air leakage and pleural fluid drainage from a chest tube may delay removing the chest tube after a patient undergoes video-assisted thoracoscopic wedge resection and the patient is otherwise ready for discharge. We reviewed 37 outpatients patients who were being managed with a postoperative chest tube (a Panda Pneumothorax set with a Heimlich valve). Material and Method: From January 2005 to December 2007, 294 patients underwent video-assisted thoracoscopic wedge resections & pleurodesis. Of them, 37 patients met the criteria for outpatient chest drainage management with using a Panda Pneumothorax set with a Heimlich valve. The patients received written instructions, and they demonstrated competence with using the Panda system. The patients returned for chest tube removal after satisfactory resolution of their air leak and pleural fluid drainage. Result: The patients discharged with a Panda pneumothorax set had a longer duration of hospital stay (mean: 10.3$\pm$1.7 days, range: 11 to 17 days) as compared with the patients without a Panda pneumothorax set (mean: 6.2$\pm$1.5 days, range: 4 to 7 days). The chest tube was removed successfully from the patients with a Panda pneumothorax set at an average of 9.8$\pm$1.6 days (range: 9$\sim$18 days) after discharge. There were no major complications. Four patients experienced minor complications. Thirty six patients (97.3%) experienced uneventful and successful outpatient chest tube management. Conclusion: Successful postoperative outpatient chest tube management with using the Panda set was accomplished in 36 selected patients. This program resulted in a substantially reduced hospital cost and enhanced patient satisfaction by allowing earlier discharge.

Health Behavior Associated with Outpatient Utilization (외래서비스 이용과 건강행태)

  • Shin, Min-Sun;Lee, Won Jae
    • The Journal of the Korea Contents Association
    • /
    • v.13 no.5
    • /
    • pp.342-353
    • /
    • 2013
  • Objectives: It attempted to analyze influencing factors on the utilization of outpatient services which were adopted to predisposing, enabling, and need factors in Anderson model. Methods: The current study analyzed "2007 Korean National Health Nutrition Survey" data, which selected 3,335 people nationwide by proportional systematic sampling. This study analyzed data of persons who used outpatient services in two weeks. It adopted Anderson Model to control contextual factors including socioeconomic factors. The study compared means and fitted logistic regression models and multilevel model. Results: The logistic regression model showed that persons purchased private medical insurance were less likely to use outpatient services than the persons did not purchase private medical insurance. Persons with hypertension and diabetes mellitus, overweight, and problem drinkers were more likely to use outpatient services. Persons with high school graduates or higher in education level and experience of accidents or intoxications were more likely to use outpatient services according to the multilevel analysis of mixed model which treated region as random effect. Conclusion: Higher level of perceived stress increased the probability to use outpatient service than lower level of perceived stress. As number of days a person had exercised increased, the probability to use outpatient service decreased. Overweight and problem alcohol drinking increased the probability of outpatient service use. Further research should be conducted to find more factors influencing outpatient service use.

Symptom Experiences, Sleep Quality and Quality of Life for Patients with Asthma (천식환자의 증상경험, 수면의 질 및 삶의 질에 관한 연구)

  • Chung, Mi-Ha;Park, Hyojung
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.17 no.11
    • /
    • pp.616-628
    • /
    • 2016
  • The purpose of this study was to examine symptom experiences, sleep quality, and quality of life in asthma patients and investigate any correlation among these factors. The study was conducted on 146 asthma patients that visited the Internal Medicine Department of Allergies at a hospital in Korea from March to June, 2015. Tools that were originally developed by Oh (1999) were used to measure the symptom experience of asthma patients. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) while quality of life was measured by the Short Form 36-Items Heath Survey (SF-36). The dates were analyzed by t-test, ANOVA, Scheffe test, and Pearson's correlation coefficient using the SPSS 20.0 program. Symptom experiences of asthma patients showed a positive relation with sleep quality (r=.468, p<.001) and negative relationship with quality of life; PCS (r=-495, p<.001) and MCS (r=-.411, p<.001). The symptom experiences of an asthma patient along with sleep quality and quality of life turned out to be correlated. Therefore, this study is expected to be utilized as a basis for the development of assessment tools and arbitration programs to elucidate symptom experiences of asthma patients from various aspects and enhance their sleep quality and quality of life.

Characteristics of Premenstrual Changes in Patients with Affective Disorder (정서장애 환자의 월경전기변화 특성)

  • Ko, Young-Hoon;Joe, Sook-Haeng;Suh, Kwang-Yun
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.7 no.1
    • /
    • pp.103-115
    • /
    • 1999
  • Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

  • PDF

Assisted Outpatient Treatment and Crisis Intervention in USA and their Implications for Korea (미국의 외래치료명령제도 및 위기대응과 국내적 시사점)

  • Park, Inhwan;Han, Meekyung
    • The Korean Society of Law and Medicine
    • /
    • v.19 no.1
    • /
    • pp.23-80
    • /
    • 2018
  • Since the 1960s, the United States' (U.S.) deinstitutionalization policy has reinstated people with mental illness into communities. Unfortunately, when untreated, some people with psychiatric disorders become homeless, and some commit serious crimes during a psychological crisis. Assisted Outpatient Treatment (AOT), also known as Kendra's Law in New York and Laura's Law in California, provides treatment, services and support to people with mental illness in the community. AOT has repeatedly been found effective and is recognized as an evidence-based practice. The response to the mental health crisis (crisis intervention) in the U.S. has also been successful in preventing worsening mental illness and related criminality and other issues. This paper provides an opportunity to create a platform from which to learn how to successfully apply the AOT and crisis intervention of the U.S. to South Korea within the cultural and societal context when establishing social services for people with mental illness in South Korea's communities.

Tracheal Rupture Following Double-lumen Endotracheal Tube Intubation -One Case Report- (이중관 기관 삽관후 발생된 기관파열 - 1례 보고 -)

  • 박승일;원준호;이종국
    • Journal of Chest Surgery
    • /
    • v.32 no.8
    • /
    • pp.765-767
    • /
    • 1999
  • Tracheobronchial rupture following tracheal intubation is a rare complication. We experienced a case of tracheal rupture following double-lumen endotracheal tube intubation. A 76 year old female was admitted due to coughing and chest discomfort. The operation was performed with the diagnosis of congenital broncho esophageal fistula. During the operation, accidently the main trachea was ruptured longitudinally. There was no history of surgical trauma. The ruptured trachea was repaired with prolene and monofilament absorbable sutures. The cause of tracheal rupture was suspected overinflation of the cuff. The patient was discharged from the hospital without any significant complications.

  • PDF

A Case of Vancomycin-Resistant Enterococci Peritonitis in a Pediatric Patient on CAPD Successfully Treated with Linezolid (지속성 외래 복막투석 소아에서 리네졸리드로 치료한 반코마이신 내성 장구균 복막염 1례)

  • Baek, Seung-Ah;Park, Sung-Sin;Kim, Sung-Do;Cho, Byoung-Soo
    • Childhood Kidney Diseases
    • /
    • v.12 no.2
    • /
    • pp.245-249
    • /
    • 2008
  • Peritonitis is one of the major complications of CAPD(continuous ambulatory peritoneal dialysis). Recently, multidrug-resistant organisms, such as vancomycin-resistant enterococcus(VRE) have been rarely reported by the pathogen as of CAPD-associated peritonitis. But, there is limited information on choices of effective therapy for VRE peritonitis in patients undergoing CAPD. We present a pediatric case of successful treatment of CAPD-associated peritonitis due to VRE with linezolid, and review of the literature.