• Title/Summary/Keyword: 임상 경과

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The Mediating Effect of Social Support and Stress on Optimism and Psychological Well-being in Clinical Nurses (임상간호사의 낙관성과 심리적 안녕감 간의 관계에서 사회적 지지와 스트레스의 매개효과)

  • Sohn, Sue Kyung;Kim, Mi Sook;Lee, Young Sin;Park, Hae Kyeong;Roh, Mi Young
    • Journal of East-West Nursing Research
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    • v.20 no.1
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    • pp.63-71
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    • 2014
  • Purpose: This study proposed to identify the mediating effect of social support and stress on optimism and psychological well-being in clinical nurses. Methods: Data were collected through structured questionnaires. The participants of this study were 207 clinical nurses who worked at hospitals in the metropolitan cities of B & U. Data were collected from September 3 to September 30, 2013. The data were analyzed using t-test, ANOVA, Scheffe's test, Pearson's correlation coefficients, and multiple regression with SPSS WIN v 20.0. Results: The mean scores of optimism, social support, stress, psychological well-being were $3.61{\pm}0.62$, $3.65{\pm}0.64$, $0.82{\pm}0.59$, $3.36{\pm}0.38$ respectively. Social support and stress showed mediating effects between optimism and psychological well-being. Conclusion: Based on this study, intervention programs to reduce stress and create support systems for clinical nurses should be developed to improve their psychological well-being.

Development of the Core Task and Competency Matrix for Unit Managers (병원 간호단위관리자의 핵심직무 ­- 핵심역량 매트릭스 개발)

  • Lee, Tae Wha;Kang, Kyeong Hwa;Lee, Seon Heui;Ko, Yu Kyung;Park, Jeong Sook;Lee, Sae Rom;Yu, Soyoung
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.2
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    • pp.189-201
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    • 2017
  • Purpose: The aim of this study was to develop the nursing management core task and competency matrix for hospital unit managers. The perceived level of importance and performance of identified core competencies by unit managers were also investigated. Methods: Literature review and expert survey identified nursing management core task and competencies. Subsequently, the core task and competency matrix was developed and validated by expert panel. A survey of 196 nurse managers from 3 cities identified perceived importance and performance of core competiences. Results: Thirty-eight nursing management core task and thirty-seven nursing management core competencies were identified comprising five categories; Clinical practice knowledge, Evidence-based practice, Employee development, Strategic planning and Initiative. Based on the core task and competencies, the task and competency matrix for unit managers was developed. In the analysis of importance and performance of core competencies, the mean score of importance ($3.50{\pm}0.30$) was higher than the mean score of performance ($3.03{\pm}0.34$). Conclusion: The development of core task and competencies for unit managers in hospitals provides a guide for the development and evaluation of programs designed to increase competence of unit managers.

Development of Reinforcement of Resilience and Relation Program for New Nurses (신규 간호사의 관계지향(Reinforcement of Resilience and Relation) 프로그램 개발)

  • Lee, Miyoung;Jeon, Mi-Kyeong;Lee, Mi-Kyoung;Im, Sookbin;Byun, Eun Kyung;Chung, Eunja
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.2
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    • pp.186-197
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    • 2020
  • Purpose: The purpose of this study was to develop a program for reinforcing the resilience of new nurses and relation-oriented organizational culture. Methods: An Intervention Research (IR) model was used to develop a program. Literature review, focus group interviews with nurses and need surveys were conducted from August to December 2018. Based on the results of the investigation, the researcher developed the content of a program. The program was revised by nurse managers for the content validation. Results: According to the results of the need surveys, 58.8% of the participants thought relation-oriented culture was the most ideal, and 61.8% of the participants wanted to participate in a program for organizational culture improvement. In the focus group interview, not only new nurses but also wards and nursing organizations should be a target subject of the program. Reinforcement of resilience and relation (3R) program was developed as a one-year course, which includes a 'mentor-mentee' program and a 'thanks' program. Conclusion: It would contribute to improving the resilience of new nurses and creating a relation-oriented organizational culture by 3R program. The 3R program could play a role as expanded program from an existing pragmatic short-term training program for improving the competencies or communication skills of new nurses.

A CASE REPORT OF TREATMENT OF RECURRENT GRANULAR-TYPE AMELOBLASTOMA (하악골에 발생한 재발성 법랑아 세포종의 치험례)

  • Yoon, Kyu-Ho;Rho, Young-Seo;Park, Seong-Won;Shin, Myoung-Sang;Jeon, In-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.179-185
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    • 1994
  • The Ameloblastoma is a true neoplasm of enamel organ-type tissue histopathologically. Ameloblastoma is recognized as a benign tumor, but its clinical behavior is locally invasive. Therefore treatment of choice is surgical resection rather than conservative enucleation. This is a case report about En-bloc excision of granular ameloblastoma arising from dentigerous cyst in the right mandibular angle area of 50-year male patient. He visited local clinic with chief complaint of facial swelling on the right mandibular angle area. Surgical removal was performed by cyst enucleation and En-bloc excision with preservation of inferior border of mandible. After 1 year, iliac bone graft was done and hyperbaric oxygen therapy was applied. We obtained a good result of bony regeneration without any sign of recurrence.

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Clinical Nutrition Management Status in Convalescent Hospitals Before and After Healthcare Accreditation Process (요양병원인증제 전·후의 요양병원 임상영양관리 현황 비교)

  • Lee, Changhee;Lee, Soo-Kyung
    • Journal of the Korean Dietetic Association
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    • v.20 no.3
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    • pp.199-211
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    • 2014
  • The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.

Neuroprotective Effects of Multi-vitamin Therapy in Transgenic Mouse Model of Amyotrophic Lateral Sclerosis (근위축성측삭경화증의 유전자 이식 마우스 모델에서 비타민 복합요법의 신경보호효과)

  • Min, Ju-Hong;Park, Jong-Ha;Cho, Ae-shin;Kim, Mi-Yeon;Hong, Yoon-Ho;Sung, Jung-Joon;Park, Kyung-Seok;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.7 no.2
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    • pp.101-106
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    • 2005
  • Background: There is no currently effective treatment for amyotrophic lateral sclerosis (ALS), although this disorder is a progressive neurodegenerative disease resulting in death within several years. Because recent evidence suggests that homocysteine (HC) is highly related to neurodegenerative disorders with aging, we tried to elucidate the effects of multi-vitamin therapy on G93A SOD1 transgenic mice. Methods: We treated this murine model of ALS with multi-vitamin (folic acid 1.97 mg/day, pyridoxine 0.98 mg/day, cyanocobalamin 0.1 mg/day) from 45 days of age, per oral. We performed the rotarod test from postnatal $10^{th}$ week, weekly. Results: We found that multi-vitamin reinforcement significantly prolonged average lifespan and delayed disease onset with improvement of motor performance. However, it did not significantly slow disease progression and statistical differences of weight loss were not observed between in transgenic mice and controls. Conclusions: These results suggest that multi-vitamin can be a potent therapeutic strategy for familial forms of ALS.

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The Effect of Repetitive Transcranial Magnetic Stimulation-Induced Proprioceptive Deafferentation to Ipsilateral and Contralateral Motor Evoked Potentials (반복적 경두개자기자극을 통한 고유감각 구심로 차단이 동측 및 반대측 운동유발전위에 미치는 영향)

  • Kim, Min-Jeong;Lee, Kyoung-Min;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.158-162
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    • 2006
  • Background: It has been proposed that proprioceptive input can modulate neural excitability in both primary motor cortices (M1) simultaneously, although direct evidence for this is still lacking. Previous studies showed that proprioceptive accuracy of one hand is reduced after the application of one-Hz repetitive transcranial magnetic stimulation (rTMS) for 15 minutes over the contralateral somatosensory cortex. The aim of this study was to investigate the effect of rTMS-induced central proprioceptive deafferentation to excitability of both M1 as reflected in ipsilateral and contralateral motor evoked potentials (MEP). Methods: MEPs of both abductor pollicis bravis (APB) muscles were recorded using single-pulse TMS over right M1 in seven healthy subjects. Immediately after one-Hz rTMS was applied for 15 minutes over the right somatosensory cortex, the MEP measurement was repeated. The proprioceptive function of the left thumb was assessed, before and after rTMS, using a position-matching task. Results: There was an increase in ipsilateral MEP after the rTMS: whereas no MEPs were recorded on the ipsilateral hand before the rTMS, MEPs were recorded in both ipsilateral and contralateral hand in three of seven subjects. At the same time, the mean log amplitude was reduced and the mean latency was prolonged in the contralateral MEP. Conclusions: rTMS-induced central proprioceptive deafferentation reduces the MEP generation in the contralateral hand, and fascilitates that in the ipsilateral hand. A further study with a larger sample seems warranted to confirm this finding and to elucidate the neurophysiology underlying it.

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Application of Proximal Stimulation for Somatosensory Evoked Potentials in Patients with Diabetic Polyneuropathy (당뇨병성 다발신경병증 환자에서 체감각유발전위검사 시 근위부 자극법의 적용)

  • Kwon, Hyung-Min;Nam, HyunWoo;Sung, Jung-Joon;Lee, Chang-Hee;Park, Young Joo;Moon, Min Kyong
    • Annals of Clinical Neurophysiology
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    • v.5 no.2
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    • pp.181-186
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    • 2003
  • Background: Somatosensory evoked potential (SSEP) is valuable for the evaluation of the central pathway. However, peripheral neuropathy sometimes renders the test useless by preventing the conduction from reaching the CNS. We postulated that the peripheral conduction problems could be overcome by proximal stimulation in SSEP and wanted to verify this in the study. Methods: Twenty patients with diabetic sensorimotor polyneuropathy were included. SSEP was elicited by stimulating the median and posterior tibial nerves. We compared the effect of distal and proximal stimulations in each SSEP in the aspect of presence/absence and various latencies of resultant waves. Results: Among the 40 cases, proximal stimulation caused reappearance of subsided waves in 10 cases (25%). In the median nerve SSEP, proximal stimulation made EN1 and CN2 visible which were not evident when distally stimulated. In the posterior tibial nerve SSEP, there was also improvement of forming waves when proximally stimulated. Conclusions: In the diabetic polyneuropathy, proximal stimulation of SSEP is more effective than the conventional distal stimulation in evaluating central pathway.

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Establishment and Perspective of the Korean ALS Registry (한국 근위축성측삭경화증 등록체계의 구축과 향후 전망)

  • Sohn, Eun-Hee;Kim, Byung-Jo;Kim, Jong-Kuk;Bae, Jong-Seok;Baek, Won-Ki;Suh, Bum-Chun;Sung, Jung-Joon;Ahn, Suk-Won;Cho, Joong-Yang;Hong, Yoon-Ho;The Korean ALS/MND Research Group, The Korean ALS/MND Research Group
    • Annals of Clinical Neurophysiology
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    • v.13 no.2
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    • pp.71-79
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    • 2011
  • Geographical differences in the incidence of amyotrophic lateral sclerosis (ALS) have been reported, and there are still many unresolved problems. The incidence as well as epidemiologic data of ALS is not known in Korea. Web-based multicenter registry of ALS, the Korean ALS registry, was established at January, 2011. The aim of "the Korean ALS registry" is the following: (1) to establish a database for the prospective collection of epidemiological information; (2) to assess the incidence and prevalence; (3) to find the temporal and geographic trends in the disease; (4) to define the full clinical spectrum of the disease; (5) to develop treatment guideline based on the database.

A Case of Endobronchial Mass-Like Rasmussen Aneurysm (기관지내 종양 형태로 나타난 Rasmussen 동맥류 1예)

  • Lee, Jeong Rok;Lee, Su Hwa;Jung, Sung Hoon;Song, So Hyang;Kim, Chi Hong;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.1
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    • pp.85-90
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    • 2004
  • A 69 year-old female was admitted to the hospital due to intermittent hemoptysis for 1 month. Emergent bronchoscopy revealed mass-like lesion almost completely obstructing right intermediate bronchus with multiple hemorrhagic spots. Bronchial arterial angiography was performed but failed to find out actively bleeding vessel. Spiral computerized tomography of the chest showed contrast enhanced bulging of the posterior portion of right main bronchus into the lumen of right intermediate bronchus suggesting Rasmussen aneurysm. The AFB smear of bronchial washing fluid was positive. Pulmonary arterial angiography and embolization were not performed due to improvement of clinical course with medical conservative care. Here we report a case of endobronchial mass-like Rasmussen aneurysm grossly suspected by bronchoscopy and diagnosed by spiral CT, which successfully managed by medical conservative care with antituberculous agents.