• Title/Summary/Keyword: 임상 결과 예측

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A Study on Emotional Labor, Resilience and Psychological Well-Being of Clinical Nurses (임상간호사의 감정노동, 회복탄력성 및 심리적 안녕에 관한 연구)

  • Kwon, Young-Eun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.339-346
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    • 2018
  • The purpose of this study is to investigate the relationship between emotional labor, resilience, and psychological well-being in clinical nurses, and to investigate ways to improve their psychological well-being. Data collection was conducted for nurses working in two general hospitals housing 300 beds in Incheon and Chungcheongnam-do. A total of 187 nurses were interviewed from June 10 to August 20, 2016. Data were analyzed using frequency and percentage, mean, standard deviation, t-test, analysis of variance (ANOVA), Pearson's correlation, and multiple regression analysis. In this research, 94.7% of the subjects were female, their mean age was 29.80, 61.5% of them had received associate of nursing degrees, and 70.6% were single. Results of the research showed that emotional labor averaged $3.37{\pm}.50hours$, resilience was $3.29{\pm}.45hours$, and psychological well-being was $3.25{\pm}.47hours$. There was a negative correlation (r=-.165, p<.05) between time spent on emotional labor and psychological well-being, and a positive correlation between time spent on recovery resilience and psychological well-being (r=.686, p<.01). Resilience was a predictor of psychological well-being, explained by a rating of 46.8% (F=164.43, p<.001). Based on the results of this study, developing a program that can improve resilience to improve the psychological well-being of clinical nurses involved in high emotional labor is suggested.

Convergence Factors Affecting the Grit of Nursing Students Experiencing Clinical Practice (임상실습을 경험한 간호대학생의 그릿(Grit)에 미치는 융복합적 영향)

  • Park, Ju-Young;Woo, Chung-Hee;Kim, Ju-Eun
    • Journal of Digital Convergence
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    • v.16 no.1
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    • pp.165-175
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    • 2018
  • This study was tried to investigate the convergence factors affecting the grit of nursing students who experienced clinical practice, focusing on recent interest in grit. The study subjects were 126 juniors and seniors in a nursing college, and the data were collected from June 1, 2017 to June 8, 2017. They were analyzed using the SPSS 23.0 statistical program(Independent t-test와 One Way ANOVA, Person's Correlation, Stepwise regression, hierarchical). The analyzed data showed that grit of the subjects was positively correlated with self-esteem (r=.160, p=.037) and self-efficacy (r=.232, p=.004) And self-efficacy (r=.541, p<.001). According to the results of the multiple regression analysis, only the self-efficacy significantly predicted grit (${\beta}=.232$, p=.009). As a result, this study provides a more comprehensive understanding of the variables related to Grit, and it can be especially valuable for the direction of what education should be helpful to nursing students in clinical practice.

The SOFA Score to Evaluate Organ Failure and Prognosis in the Intensive Care Unit Patients (중환자실에 입원한 환자의 장기부전 및 예후 평가를 위한 SOFA 점수체계의 의의)

  • Kim, Su Ho;Lee, Myung Goo;Park, Sang Myeon;Park, Young Bum;Jang, Seung Hun;Kim, Cheol Hong;Jeon, Man Jo;Shin, Tae Rim;Eom, Kwang Seok;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Seung-Joon
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.329-335
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    • 2004
  • Background : The Sequential Organ Failure Assessment (SOFA) score can help to assess organ failure over time and is useful to evaluate morbidity. The aim of this study is to evaluate the performance of SOFA score as a descriptor of multiple organ failure in critically ill patients in a local unit hospital, and to compare with APACHE III scoring system. Methods : This study was carried out prospectively. A total of ninety one patients were included who admitted to the medical intensive care unit (ICU) in Chuncheon Sacred Heart Hospital from May 1 through June 30, 2000. We excluded patients with a length of stay in the ICU less than 2 days following scheduled procedure, admissions for ECG monitoring, other department and patients transferred to other hospital. The SOFA score and APACHE III score were calculated on admission and then consecutively every 24 hours until ICU discharge. Results : The ICU mortality rate was 20%. The non-survivors had a higher SOFA score within 24 hours after admission. The number of organ failure was associated with increased mortality. The evaluation of a subgroup of 74 patients who stayed in the ICU for at least 48 hours showed that survivors and non-survivors followed a different course. In this subgroup, the total SOFA score increased in 81% of the non-survivors but in only 21% of the survivors. Conversely, the total SOFA score decreased in 48% of the survivors compared with 6% of the non-survivors. The non-survivors also had a higher APACHE III score within 24 hours and there was a correlation between SOFA score and APACHE III score. Conclusion : The SOFA score is a simple, but effective method to assess organ failure and to predict mortality in critically ill patients. Regular and repeated scoring enables patient's condition and clinical course to be monitored and better understood. The SOFA score well correlates with APACHE III score.

Clinical Feature of Submersion Injury in Adults (성인 익수 손상의 임상적 특성)

  • Jung, Chi Young;Cha, Sung Ick;Jang, Sang Soo;Lee, Sin Yeob;Lee, Jae Hee;Son, Ji Woong;Park, Jae Yong;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.3
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    • pp.287-296
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    • 2003
  • Background : Drowning represents the third most common cause of all accidental deaths worldwide. Although few studies of submersion injury were done in Korea, the subjects were mainly pediatric patients. The purpose of this study is to describe the clinical feature of submersion injury in adults. Methods : The medical records of 31 patients with submersion injury who were >15 years of age and admitted to Kyungpook National University Hospital from July 1990 to March 2003 were retrospectively examined. Results : The most common age-group, cause, and site of submersion accidents in adults were 15-24 years of age, inability to swim, and river followed by more than 65 years of age, drinking, and public bath respectively. The initial chest radiographics showed bilaterally and centrally predominant distribution of pulmonary edema at lung base in about 90% of patients with pulmonary edema represented by submersion injury but at only upper lung zone in 10%. Eventually, 25 patients (80.6%) survived without any neurologic deficit and 2 patients (6.5%) with significant neurologic deficit, and 4 patients (12.9%) died. Age, arterial gas oxygenation, and mental status among baseline variables showed significant difference for prognosis. Conclusions : More than 65 year of age, drinking, and occurrence in public bath were relatively important in submersion injury of adults, and the successful survival of 80.6% of patients suggests that cardiopulmonary resuscitation should be intensively done in even adults.

The Use of Pharmacogenomic Method for the Prediction of Antidepressant Responsiveness (약리 유전학적 방법을 이용한 항우울제 치료반응성의 예측)

  • Kim, Doh Kwan;Lim, Shinn-Won
    • Korean Journal of Biological Psychiatry
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    • v.9 no.1
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    • pp.25-33
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    • 2002
  • Serotonin transporter(5-HTT) is one of the major action site of antidepressants in neuronal cells. According to the recent studies, it is known that the functional polymorphism in the promoter region of the 5-HTT gene(5-HTT linked polymorphism repetitive element in promoter region, 5-HTTLPR) is associated with antidepressant responsiveness, and the distributions of 5-HTTLPR is various among the different populations. Our preliminary study suggested that it is possible to measure the endophenotype of 5-HTTLPR genotype by examining the pharmacodynamic research of the 5-HTT in platelet membranes. However, there are limitations to predicting the antidepressant responsiveness only from the endophenotypic characteristics of 5-HTT gene promoter polymorphism, and therefore we propose to use the pharmacogenomic methods for overcoming these limitations. We found that the significant correlations existed among the genetic polymorphisms of biogenic amine transporters whose structure and characteristics are similar to the 5-HTT, and the predictable odds ratio of antidepressant responsiveness are increased significantly by combining the effect with other associated polymorphisms, compared to the effect of 5-HTT promoter polymorphism only. These results support the hypothesis that antidepressant treatment has to be individualized according to the genetic and ethnic background of depressed patients. It would be possible to develope the evaluation tools to predict the antidepressant responsiveness and its side effect profile, if scientists reveal the genes related to the action mechanism as well as the metabolism of antidepressants so as to discover the interaction of those genes and contribution of endogenotypes toward antidepressant responsiveness.

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Comparison Analysis of Foot Pressure Characteristics during Walking in Stroke and Normal Elderly (뇌졸중 고령자와 정상인의 보행 시 족압 변화 및 비교 분석)

  • Jung, NamKyo;Park, Se Jin;Kwon, Soon-Hyun;Jun, Jongarm;Yu, Jaehak
    • Journal of Platform Technology
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    • v.9 no.3
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    • pp.36-43
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    • 2021
  • Stroke disease is one of the leading causes of death worldwide, and in particular, it is the most important causative disease that causes disability in the elderly. Since stroke disease often causes death or serious disability, active primary prevention and early detection of prognostic symptoms are very important. In particular, it is necessary to detect and accurately predict stroke prognostic symptoms in daily life and prompt diagnosis and treatment by medical staff. In recent studies, image analysis such as computed tomography (CT) or magnetic resonance imaging (MRI) is mostly used as a methodology for predicting prognostic symptoms in stroke patients. However, this approach has limitations in terms of long test time and high cost. In this paper, we experimented with clinical data on how stroke disease affects foot pressure in elderly in walking. Experiments have shown that there is a significant difference in * p < .05 in 12 cells between the stroke elderly and the normal elderly during walking. As a result, it is significant that we found a significant difference in the gait patterns in daily life of the stroke elderly and the normal elderly.

Comparison of Inhalation Scan and Perfusion Scan for the Prediction of Postoperative Pulmonary Function (수술후 폐기능 변화의 예측에 대한 연무 흡입스캔과 관류스캔의 비교)

  • Cheon, Young-Kug;Kwak, Young-Im;Yun, Jong-Gil;Zo, Jae-Ill;Shim, Young-Mog;Lim, Sang-Moo;Hong, Sung-Woon;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.111-119
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    • 1994
  • Background: Because of the common etiologic factor, such as smoking, lung cancer and chronic obstructive pulmonary disease are often present in the same patient. The preoperative prediction of remaining pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. $^{99m}Tc$-MAA perfusion scan has been used for the prediction of postoperative pulmonary function, but it may be inaccurate in case of large V/Q mismatching. We compared $^{99m}Tc$-DTPA radioaerosol inhalation scan with $^{99m}Tc$-MAA perfusion scan in predicting postoperative lung function. Method: Preoperative inhalation scan and/or perfusion scan were performed and pulmonary function test were performed preoperatively and 2 month after operation. We predicted the postoperative pulmonary functions using the following equations. Postpneurnonectomy $FEV_1$=Preop $FEV_1x%$ of total function of lung to remain Postlobectomy $FEV_1$=Preop $FEV_1{\times}$(% of total 1-function of affected lung${\times}$$\frac{Number\;of\;segments\;to\;be\;resected}{Number\;of\;segments\;of\;affected\;lung})$ Results: 1) The inhalation scan showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.94, 0.91, 0.87 respectively). 2) The perfusion scan also showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.86, 0.72, 0.87 respectively). 3) Among three parameters, $FEV_1$ showed the best correlations in the prediction by lung scans. 4) Comparison between inhalation scan and perfusion scan in predicting pulmonary function did not show any significant differneces except FVC. Conclusion: The inhalation scan and perfusion scan are very useful in the prediction of postoperative lung function and don't make a difference in the prediction of pulmonary function a1though the former showed a better correlation in FVC.

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Assessment of Cerebral Hemodynamic Changes in Pediatric Patients with Moyamoya Disease Using Probabilistic Maps on Analysis of Basal/Acetazolamide Stress Brain Perfusion SPECT (소아 모야모야병에서 뇌확률지도를 이용한 수술전후 혈역학적 변화 분석)

  • Lee, Ho-Young;Lee, Jae-Sung;Kim, Seung-Ki;Wang, Kyu-Chang;Cho, Byung-Kyu;Chung, June-Key;Lee, Myung-Chul;Lee, Dong-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.3
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    • pp.192-200
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    • 2008
  • To evaluate the hemodynamic changes and the predictive factors of the clinical outcome in pediatric patients with moyamoya disease, we analyzed pre/post basal/acetazolamide stress brain perfusion SPECT with automated volume of interest (VOIs) method. Methods: Total fifty six (M:F = 33:24, age $6.7{\pm}3.2$ years) pediatric patients with moyamoya disease, who underwent basal/acetazolamide stress brain perfusion SPECT within 6 before and after revascularization surgery (encephalo-duro-arterio-synangiosis (EDAS) with frontal encephalo-galeo-synangiosis (EGS) and EDAS only followed on contralateral hemisphere), and followed-up more than 6 months after post-operative SPECT, were included. A mean follow-up period after post-operative SPECT was $33{\pm}21$ months. Each patient's SPECT image was spatially normalized to Korean template with the SPM2. For the regional count normalization, the count of pons was used as a reference region. The basal/acetazolamide-stressed cerebral blood flow (CBF), the cerebral vascular reserve index (CVRI), and the extent of area with significantly decreased basal/acetazolamide- stressed rCBF than age-matched normal control were evaluated on both medial frontal, frontal, parietal, occipital lobes, and whole brain in each patient's images. The post-operative clinical outcome was assigned as good, poor according to the presence of transient ischemic attacks and/or fixed neurological deficits by pediatric neurosurgeon. Results: In a paired t-test, basal/acetazolamide-stressed rCBF and the CVRI were significantly improved after revascularization (p<0.05). The significant difference in the pre-operative basal/acetazolamide-stressed rCBF and the CVRI between the hemispheres where EDAS with frontal EGS was performed and their contralateral counterparts where EDAS only was done disappeared after operation (p<0.05). In an independent student t-test, the pre-operative basal rCBF in the medial frontal gyrus, the post-operative CVRI in the frontal lobe and the parietal lobe of the hemispheres with EDAS and frontal EGS, the post-operative CVRI, and ${\Delta}CVRI$ showed a significant difference between patients with a good and poor clinical outcome (p<0.05). In a multivariate logistic regression analysis, the ${\Delta}CVRI$ and the post-operative CVRI of medial frontal gyrus on the hemispheres where EDAS with frontal EGS was performed were the significant predictive factors for the clinical outcome (p =0.002, p =0.015), Conclusion: With probabilistic map, we could objectively evaluate pre/post-operative hemodynamic changes of pediatric patients with moyamoya disease. Specifically the post-operative CVRI and the post-operative CVRI of medial frontal gyrus where EDAS with frontal EGS was done were the significant predictive factors for further clinical outcomes.

Clinical Presentation of the Patients with Non-traumatic Chest Pain in Emergency Department (응급의료센터에 내원한 비외상성 흉통환자의 임상 양상)

  • Chung, Jun-Young;Lee, Sam-Beom;Do, Byung-Soo;Park, Jong-Seon;Shin, Dong-Gu;Kim, Young-Jo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.283-295
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    • 1999
  • Background: Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were $1.1{\pm}0.9$ in non-cardiac diseases, $1.4{\pm}1.1$ in cardiac diseases and $1.7{\pm}1.1$ in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. Conclusion: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

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Accuracy of soft tissue Profile change prediction in mandibular set-back surgery patients: a comparison of Quick Ceph Image $Pro^{TM}$ (ver 3.0) and $V-Ceph^{TM}$(ver 3.5) (하악골 후퇴 수술 환자의 연조직 측모 예측의 정확성: Quick Ceph Image $Pro^{TM}$(ver 3.0)와 $V-Ceph^{TM}$(Ver 3.5)의 비교)

  • Kim, Myoung-Kyun;Choi, Yong-Sung;Chung, Song-Woo;Jeon, Young-Mi;Kim, Jong-Ghee
    • The korean journal of orthodontics
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    • v.35 no.3 s.110
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    • pp.216-226
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    • 2005
  • The purpose of this study was to test and compare the accuracy and reliability of soft tissue profile predictions generated from two computer software programs (Quick Ceph Image $Pro^{TM}$ (ver 3.0) and $V-Ceph^{TM}$(ver 3.5)) for mandibular set-back surgery. The presurgical and postsurgical lateral cephalograms of 40 patients (20 males and 20 females) were traced on the same acetate paper with the reference taken as the cranial base outline. The presurgical skeletal outlines were digitized onto each computer program and the mandible was moved to mimic the expected surgical procedure with reverence to the mandibular anterior border and lower incisor position of the actual postsurgical skeletal outline. The soft tissue profile was generated and the amount and direction of skeletal movement was calculated with each software. The predicted soft tissue profile was compared to the actual postsurgical soft tissue profile. There were differences between the actual and the predicted surgical soft tissue profile charges in the magnitude and direction, especially the upper lip. lower lip and the soft tissue chin (P<0.05). Quick Ceph had more horizontal measurement errors and thickness errors for the upper lip and lower lip, but V-Ceph had more vertical measurement errors of the lower lip (P<0.05). There was a positive correlation between the prediction errors and the amount of mandibular movements in the vertical position of Sn, the horizontal position of Ls and the upper lip thickness for V-Ceph, and there was a negative correlation in the horizontal position and the thickness of the lower lip for Quick Ceph (P<0.05). However all of the Prediction errors of both imaging softwares were ranged within 3mm, and this was considered to be allowable clinically.