• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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• v.7 no.11
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• pp.525-536
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• 2017

Purpose: The aim of this study was to identify the factors influencing ICU (intensive care units) length of stay of adult patients with critical illness. Methods: This study was adopted descriptive design. 270 patients who were admitted to ICU in general hospital, Seoul were analyzed. Results: A total of 270 patients, 116 (43%) patients had stayed more than 5 days. The length of stay of intensive care unit was significant positive correlation with the FCI(Functional Comobidity Index) score(r=0.33, p<.001) and APACHE(Aacute Physiology and Chronic Health Evlauaion) II(r=0.19, p=.001). In multiple logistic regression, the predictors of ICU length of stay were admission route (p=0.013), FCI score (p<0.001), APACHE II(p=0.012). Conclusions: Heatlh care providers in ICU should be aware that patients who admit to emergency departments and have higher disease severity are more considered to reduce their ICU length of stays.

• The Journal of the Korea Contents Association
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• v.14 no.5
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• pp.211-223
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• 2014

The aim of this study was to identify the levels of family members' burden and to describe factors influencing on famiCX*//8ly caregiver's burden when they are planned to transfer to general ward from the intensive care units (ICU). A descriptive survey was used with a convenience sampling of 101 family members of ICU patients at S university hospital in C city, Korea from August to November, 2010. The data were analyzed with SPSS 18.0 program. The level of object burden in family members had statistically significant differences with level of consciousness, number of patients' monitoring devices, and tracheostomy tube. The level of subject burden had statistically significant differences according to patients' gender, patients' education level, and relationship with patients. Transfer anxiety was showed statistically positive correlation with objective and subjective burden. We found transfer anxiety was statistically significant predictor of family caregiver's objective burden with explanatory power 12.7%. Family members' subjective burden were statistically influenced by patients' gender and transfer anxiety. These factors explained 23.8% out of total variance of family members' objective burden. The structured individualized method of transfer is recommended with further research of ICU families to further examine the dimension of transfer anxiety and how it affects family members' burden and patient outcomes.

• Proceedings of the Korea Information Processing Society Conference
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• 2016.10a
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• pp.823-824
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• 2016

우리나라의 중환자실 면회 시스템은 대부분 대학병원 기준 하루 2번 20분~30분의 짧은 면회시간을 가지고 있다. 중환자실의 보호자들은 매번 시간을 맞추어 면회를 해야 하며 면회 인원수에도 제약을 받고 있어 제한적인 면회 시스템을 가지고 있다. 이처럼 중환자실의 면회 시스템이 많은 제한을 가지고 있는 것은 중환자실 환자들과 병문객간의 감염 위험 요인을 최소화하기 위함이 있다. 따라서 '중환자실 면회 시스템'을 제작하여 매번 면회를 오지 못하는 상황에서도 원거리 면회를 가능하게 하며 환자와 병문객 간의 감염 위험 요인을 최소화 하여 보호자들에게 심리적인 안정감을 제공하는 것이 목적이다.

• The Journal of the Korea Contents Association
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• v.14 no.2
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• pp.421-429
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• 2014

This study set out to investigate the burden and needs of family members of ICU(Intensive Care Unit) patients facing a crisis situation of a family member being hospitalized in ICU and check their connections. Data were collected from May to October 2013. The subjects include 93 main family caregivers of patients hospitalized in ICU at four general hospitals in the B area for three days or longer. Collected data were put to t-test, ANOVA, Scheff$\acute{e}$ test, and Pearson's correlation coefficient analysis with the SPSS WIN 20.0 program. As a result, the family members of ICU patients scored mean 3.56 points(out of five) on burden and mean 3.58 points(out of four) on needs, recording a moderate or higher level in both the areas. There was significant difference(F=3.463, p=.036) in burden according to the general characteristics with the number of days in the hospital. There was significant positive correlation(r=.332, p<.001) between their burden and needs. Those findings indicate that an active nursing intervention to reduce the burden of the families of ICU patients in a crisis situation and check their needs will be able to mitigate the family crisis and further have positive influences on the recovery of ICU patients.

• Tuberculosis and Respiratory Diseases
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• v.66 no.1
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• pp.27-32
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• 2009

Background: The management of patients with lung cancer has improved recently, and many of them will require admission to the medical intensive care unit (MICU). The aim of this study was to examine the clinical characteristics and to identify risk factors for mortality in patients with lung cancer admitted to the MICU. Methods: We conducted retrospective analysis on 88 patients with lung cancer admitted to the MICU between April 2004 and March 2008. Results: Of the 88 patients (mean age, 66 years), 71 patients (80.7%) had non-small cell lung cancer and 17 patients (19.3%) had small cell lung cancer. Distant metastasis were present in 79 patients (89.8%). The main reasons for MICU admission were acute respiratory failure (77.3%), sepsis (11.4%), and central nervous system dysfunction (4.5%). Mechanical ventilation was used in 54 patients (61.4%). Acute Physiology and Chronic Health Evaluation (APACHE) II score, length of MICU stay, need for mechanical ventilation, source of MICU admission were correlated with MICU mortality. The type of lung cancer and metastasis were not predictive factors of death in MICU. Conclusion: Most common reason for ICU admission was acute respiratory failure. Mortality rate of lung cancer patients admitted to the MICU was 65.9%. APACHE II score, length of ICU stay, need for mechanical ventilation, source of MICU admission were predicted factors of death in the MICU.

• The Journal of the Korea Contents Association
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• v.16 no.3
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• pp.1-10
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• 2016

The purpose of this study was to examine the effect of aroma inhalation on stress, anxiety and depression in coronary care unit patients. The study was a nonequivalent control group non-synchronized design. Participants were thirty patients for the experimental group, and thirty-three patients for the control group. The instruments were VAS, the equipment, developed by Spielberger(1972) and adapted by Kim & Shin(1978), Beck Depression Inventory-II(BDI-II). Data were collected from 25 February, 2015 to 8 May, 2015. The data were analyzed number and percentage, $x^2$-test, t-test, paired t-test. There were no statistically significant effects of aroma inhalation treatment for patients in coronary care unit on the stress, anxiety, and depression. Therefore, it is required follow-up studies that it is tried in a variety of ways for reducing the stress, anxiety, and depression in coronary care unit patients,

• Korean Journal of Clinical Pharmacy
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• v.20 no.2
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• pp.107-113
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• 2010

서 론: 중환자실에서 집중적 인슐린 요법에 의한 평균혈당강하는 사망률을 감소시키는 것으로 나타났으나 이로 인한 저혈당 및 혈당변동은 새로운 문제로 대두되고 있다. 본 연구에서는 혈당과 관련한 여러 요인들이 사망에 미치는 영향을 규명하고 적정 혈당치를 확인하고자 하였다. 연구방법: 2008년 2월부터 7월 사이인 6개월 동안 서울아산병원 외과계 중환자실에서 4일 이상 재실한 18세 이상의 성인 환자를 대상으로 전자 의무기록 조사를 통해 후향적으로 연구가 진행되었다. 연구를 위해 환자의 인구학적 특성, 수술의 종류, 중환자실에서의 재실기간, 사망여부, 스테로이드 사용 유무, 기계적 인공호흡기의 사용유무, 신대체요법의 사용유무, 혈당치, 재실기간 중 스테로이드 사용유무와 인슐린 양, 입원 후 첫 24시간 동안의 포도당 주입속도, 입원 후 2일 이내와 그 이후에 발생한 균혈증 감염, APACH II와 SOFA 점수를 조사하였다. 혈당수치는 각각의 환자에서 중환자실 입실 후 가장 처음 측정된 혈당, 재실기간 중 가장 높은 혈당과 가장 낮은 혈당수치를 조사하였고 중환자실 전체 재실기간 동안 혈당수치의 평균과 변동계수를 계산하였다. 이상의 혈당관련지표를 포함한 인자들이 일차 종속변수인 사망에 어떠한 영향을 주는지를 환자를 생존군과 사망군으로 나누어 분석하였고 ROC (receiver operator characteristic) 곡선을 사용하여 혈당지표와 APACH 및 SOFA 점수의 cut-off치를 구하여 이로부터 단변량 및 다변량 분석을 시행하였다. 결 과: 연구에 포함된 환자는 170명 이었고 그 중 23명이 연구 기간 중 중환자실에서 사망하였다. 생존자에 비해 사망자의 최대혈당은 유의적으로 높았고 최소혈당치는 유의적으로 낮아 높은 변동계수를 보였다. ROC곡선으로부터 산출된 혈당치들의 cut-off 수치는 최소혈당치 70 mg/dL, 변동계수 25%, 최대혈당치 250 mg/dL, 평균혈당치 150 mg/dL이었다. 다변량분석에서 최소혈당이 70 mg/dL 보다 큰 경우가 낮은 경우에 비해 오즈비가 0.922(95% 신뢰구간 0.881-0.965)로 유의성 있게 낮았으며 변동계수가 25% 보다 높은 집단의 경우 그보다 낮은 집단에 비해 오즈비가 1.121(95% 신뢰구간 1.017-1.236)로 유의성 있게 높았다. Kaplan-Meier 생존분석 결과 최소혈당치 70 mg/dL와 변동계수 25%에 따라 생존기간에 유의성 있는 차이가 나타났다.(각각 P < 0.001, P < 0.05) 결 론: 고혈당 발생의 감소뿐 아니라 최소혈당치를 70 mg/dL 이상으로 유지하면서 변동을 최소화하는 것이 외과계 중환자실에서의 사망률감소를 위한 중요한 요인임을 알 수 있었다.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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• v.6 no.12
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• pp.55-67
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• 2016

Purpose: The aims of this were to analyse the quantitative research trends and describe the factors influencing health related to quality of life (HRQoL) and instruments used to HRQoL after Intensive care units (ICU) discharge. Methods: This study were included 84 published papers regarding HRQoL after ICU discharge from initial data to December 2015. Results: The majority of papers were performed abroad. Only 4 papers with regard to HRQoL of ICU survivors were performed by nurses. 36 studies (42.8%) were used to measure HRQoL ICU survivors using the SF-36. 29 studies (34.5%) were used to measure HRQoL at 3~6 months after ICU discharge. Older age, longer length of stay at ICU, severity of illness, anxiety and depression were main risk factors to lower HRQoL in ICU patients. Conclusions: This study provides a better understanding of quality of life follwing critical illness. Therefore, further stduy is needed to develop patient centered intervention considered patients'health status and recovery phase. Additionally, large prospective multicenter cohort studies should be required.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.82-82
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• 1993

Tracheostomy was done to form temporary opening in the trachea, to remove secretion, to maintain ventilation and to protect against aspiration. In recent times, with the development of care methods such as low pressure cuff, endotracheal intubation is being combined with tracheostomy in the treatment of patients who are treated long period in the intensive care units and the duration from endotracheal intabation to tracheostomy is like to prolong. To determine the proper time of tracheostomy in the patient in the intensive care units, authors reviewed retrospectively the 96 patients who received the tracheostomy procedure among the 8776 patients who were admitted in the intensive care units of Asan medical center form March 1990 to March 1993, and analyzed the complications of tracheostomy, decannulation and the cause of decannulation failure according to disease, age indication of endotracheal intubation and duration of endotracheal intubation.

• Journal of Hospice and Palliative Care
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• v.20 no.2
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• pp.122-130
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• 2017

Purpose: The purpose of this study is to describe and understand the meaning and the structure of subjective experiences of intensive care nurses with death of patients with do-not-resuscitate (DNR) orders. Methods: Data were collected from eight intensive care nurses at general hospitals using individual in-depth interviews and analyzed by phenomenological research method. Results: The nurses' experiences were grouped into four theme clusters: 1) ambiguity of death without correct answer, 2) a dilemma experienced at the border between death and work, 3) the weight of death that is difficult to carry and 4) death-triggered reflection of life. Conclusion: It is necessary to develop accurate judgment criteria for DNR, detailed regulations on the DNR decision process, guidelines and education on DNR patient care for nurses. It is also needed to develop an intervention program for DNR patients' families.