• Title/Summary/Keyword: 척수 손상

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Sexual Activity and Factors Influencing the Sexual Adjustment in Men with Spinal Cord Injury (남성 척수손상 장애인의 성실태 및 성적응에 미치는 요인)

  • Kim, Sun Hong;Lee, Bum Suk;Han, Suk Jung
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.290-302
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    • 2014
  • Purpose: The purpose of this study was to identify sexual activities of males with spinal cord injury (SCI) and influential factors of sexual adjustment. Methods: A correlational survey was conducted among a total of 135 males with SCI. Results: After SCI, patients maintained low levels of sexual adjustment, and a main obstacle of sexual rehabilitation was decreased erectile function (65.2%). Sexual desires recovered in 84.4%, with 62.4% patients reporting more than once intercourse experiences. The erectile function of participants with normal, decreased or no erectile function were 13.0%, 62.6% and 24.4%, respectively. 8.1% of the participants reported no problem with ejaculation. Patients with incomplete SCI had better preserved erectile function than those with complete SCI (t=-4.627, p<.001). Patients with upper motor neuron injury had better preserved erectile function than those with lower motor neuron injury (t=2.446, p =.016). Sexual adjustment was relevant to age, job, degree of injury, post-injury period, sexual desire, intercourse experience, erection therapy, erectile function, and sexual health. Sexual adjustment was a factor of sexual health with a power of 24.2%. Conclusion: The main obstacle of sexual rehabilitation for males with SCI decreased erectile function. Erection and ejaculation are dependent on the severity and level of SCI. The major influence on sexual adjustment is sexual health.

Factors Effect on Quality of Life of Spinal Cord Injury Patients (척수 손상 환자의 삶의 질 영향요인 분석)

  • 신성례;김애리
    • Journal of Korean Academy of Nursing
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    • v.31 no.1
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    • pp.126-138
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    • 2001
  • The purpose of this study is to act nursing intervention strategies to promote quality of life (QOL) in Spinal Cord Injury patients. Therefore, the study is designed to evaluate religion, marital status, educational background economic status, level of injury, voiding pattern, transportation by driving, rehabilitation education, self-concept, sexual status, perceived barrier, powerlessness, depression, hope, social support, self-efficacy, anxiety, ADL, perceived hopelessness, personality and pain for QOL at the same time. It was gathered empirical data was collected using a self report questionnaire from 61 patients during a six month period after SCI at 5 general hospitals, at 2 rehabilitation centers and at 2 rehabilitation schools province from Jun. 18, 1999 through Sep. 28, 1999. The reliability of the 19 instruments was tested with Cronbach's alpha which ranged from .6319 to .9769. For the data analysis a SAS program was used for Pearson correlation coefficients, and stepwise multiple regression. The results were as follows; 1. The mean of total item score in the QOL scale was 2.814, which showed a much lower score than the cancer points. 2. There was a significant correlation between self concept, transportation by driving, perceived barrier, powerlessness, depression, hope, social support, self-efficacy, anxiety, ADL and QOL.(${\gamma}$= .27~-.79, p< .05) 3. Stepwise multiple regression analysis showed that; a) Depression was the main predictor of QOL and account for 53.7% of the variance in QOL. b) Hope, ecomic status and body satisfaction accounted for 8%, 4%, 3.4% respectively and these variables combined accounted for 69.2% of the variance in QOL. In conclusion, to begin with, it is important to reduce depression and to help for SCI points to inspire hope, economic status and body satisfaction. That will be short cut for nursing strategies to enhance QOL.

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Development of Information System in Nursing Practice;spinal cord injury patients (간호실무를 위한 정보체계 개발;척수손상 환자를 중심으로)

  • Kang, In-Soon;Kim, Myung-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.2
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    • pp.43-57
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    • 1996
  • The purpose of this research conducted has been an the development of a computer program to be used for nursing of spinal cord injury patients. The research is also intended to contribute by supplying the basic data, to the development of other programs in relevant areas where similar nursing information system is required. This research used System Development Life Cycle method. Results from the study were as follows : The scope of Information System in nursing practice were based on a wide range of mateials as charts at four hospitals in Pusan that cover the nursing period of spinal cord injury patients from admission to discharge and other sources of reference, the research is done for nursing diagnosis, nursing history, admission and discharge education, and the performing of doctor's order, which were divided into a subsystem that consisted of help, Patient Management, Performing of Docter's Order, and Basic Data Management and then these was analysed systematically using Hierachy Plus Input Process Output, necessary information, data flow diagram, and conceptual designs were developed for chosem system. Furthemore, the system has been programed by a conceptual design that includes the objects of the program and the origins of the sources. The oder to make sure of the proper function, the computer program was actually applied to a nursing practice that had been developed for a hypothetical situation through the two nurses who were in charge of spinal cord injury patients after they were trained to understand the structure and the contents of computer program about the nursing practice from using the computer program developed. Also, the compensatory strategy has been worked out against any problems to arise. It is expected that this kind of nursing practice information system to be used for the spinal cord injury patients that has been developed through the processes shown above will increase the satisfaction for both patients and nurses by enabling them to give more professional advice and service to the development of more information systems for many hospitals.

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A Study on Rehabilitation Nursing Diagnoses used for the Clients with Stroke and Spinal Cord Injury in Korea (뇌졸중과 척수손상환자에게 적용되는 간호진단에 관한 연구)

  • Suh, Moon-Ja;Lim, Nan-Young;Kang, Hyun-Sook;Kim, Keum-Soon;Yang, Kwang-Hee;Cho, Bok-Hee;Lee, Myung-Hwa;Oh, Hae-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.1
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    • pp.22-28
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    • 1999
  • The development of standards and guidelines of rehabilitation nursing has been the major concerns for providing better nursing to the rehabilitation clients. As the patients with stroke and spinal cord injuries are the most prevalent physical disabilities in Korea, this study focussed on the nursing diagnoses of these two groups of patients. In order to identify the nursing diagnoses frequently used In their practice for the patients with stroke and spinal cord injuries, a survey was done with the questionnaire form developed by the research team. The surveyee were the staff nurses working at rehabilitation wards more than 2 years from 8 general hospitals in Korea, They identified and set the priorities of 13 nursing diagnoses from 79 stroke patients and 10 nursing diagnoses from 35 patients with spinal cord injuries during the periods from March 1 to June 2, 1999. The identified nursing diagnoses for the stroke patients are impaired physical immobility, sensory-perceptual alteration, activity intolerance, self-care deficit, altered defecation, altered urination, risk for injury, unilateral neglect, impaired skin integrity, altered thought processes, pain, altered health maintenance, dysreflexia. The identified nursing diagnoses for spinal cord injuries are altered urination, altered defecation, impaired skin integrity, pain, risk for injury, reflex incontinence, impaired physical immobility, self-care deficit, activity intolerance, knowledge deficit.

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A study on learning needs about altered elimination of spinal cord injury patients : A comparison patients에 and nurses에 perceptions (척수손상환자의 배설장애에 대한 학습요구 : 환자 대 간호사 지각 비교)

  • 김인자
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.129-142
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    • 1994
  • The purpose of this study determine and compare spinal cord injured(SCI) patients’ and nurses’ perceptions of SCI patients’ learning needs about altered elimination and then provide nursing data for more effective SCI patients’ learning process. Data collection was done from September 3 to October 2, 1993. For this study, 36 SCI Patients(12 paraplegia, 24 quadriplegia) and 20 nurses who were working neurosurgery or rehabilitation unit in 3 general hospitals in C and I city were selected. Data collection was accomplished by Questionnaire method and the instrument developed by the investigator, elicited information about learning needs about altered elimination of SCI patients from SCI patient, nurse, rehabilitation doctor, nursing professor, nursing graduate students. The questionnaire composed altered urinary elimination part with 10 categories and altered bowel elimination part with 10 categories. The results of this study were as follows : 1. There was no significant difference in learning needs about altered urinary elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered urinary elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=2.48, p=.017). 2. There was no significant difference in learning needs about altered bowel elimination of the paraplegic SCI patients’ perceptions and nurses’ perceptions of the paraplegic SCI patients. But there was significant difference in learning needs about altered bowel elimination of the quadriplegic SCI patients and nurses’ perceptions of the quadriplegic patients(t=-3.00. p=.005). 3. Degree of paraplegic SCI patients’ perceived learning needs about altered urinary elimination was 2.4083 and quadriplegic SCI patients’ perceptions were 2.0750. Degree of paraplegic SCI patients’ perceived learning needs about altered bowel elimination was 2.3972 and quadriplegic SCI patients' perceptions were 2.181.

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Factors Influencing Social Participation in People with Musculoskeletal Conditions - Applying ICF relevant categories - (ICF 관련 범주에 따른 근골격계질환 장애인의 사회참여 관련요인)

  • Shin, Eun Kyoung;Lee, Han Na
    • Korean Journal of Social Welfare
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    • v.65 no.1
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    • pp.5-31
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    • 2013
  • The principle objective of this study is to determine factors affecting social participation for physically disabled people with musculoskeletal conditions (spinal cord injury, muscular dystrophy, osteogenesis imperfecta, rheumatoid arthritis) in South Korea using ICF relevant categories of the international classification index by WHO. The subjects of this study 352 people with physical disabilities, the data were collected using ICF component(body functions, body structures, activities and participation and environmental factors) and the relevant categories deprived from ICF core sets. The collected data were evaluated with descriptive analysis, ANOVA, correlation analysis, and multiple regression analysis. The results of this study can be summarized as follow. The mental function, Neuromusculoskeletal and movement-related functions, Genitourinary and reproductive functions, Skin and related structures, Learning and applying knowledge, General tasks and demands, and Mobility positively influenced social participation in people with musculoskeletal conditions. However individual factors and environmental factors didn't statistically significant affect on social participation. The implications of the study is to examine by ICF components of universal approach on disability study and utilized the relevant ICF categories as measurement tools.

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Development of Home Care Nursing Intervention Protocols for Spinal Cord Injury Patients Based on NIC (NIC에 근거한 척수손상환자의 가정간호 중재 프로토콜 개발)

  • Moon, Seong-Mi;Kim, Sun-Hee
    • Journal of Home Health Care Nursing
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    • v.8 no.1
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    • pp.25-37
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    • 2001
  • Spinal cord injury patients need rehabilitation after the acute stage. They should be cared for at home to decrease hospitalization. Home care nurses play an important role in making spinal cord injury patients who have physical. and psychosocial problems do their best. For effective care, home care nurses need standardized nursing intervention protocols for spinal cord injury patients, but they are rarely developed. Therefore, this study was conducted to develop home care nursing protocols, based on NIC, that are applicable to spinal cord injury patients at home. Forty home care nursing charts of spinal cord injury patients registered in a home care nursing agency from July 1st, 1994 to August 31st, 1999 in S city were analyzed. Fifteen home care nurses participated in this study as a user validity validation group, The results of this study are as follows. 1. Fifteen nursing diagnoses were classified through the frequency analysis of home care nursing charts and previous literature for 40 spinal cord injury patients: altered urinary elimination, constipation, high risk for impaired skin integrity, chronic pain, impaired skin integrity, impaired social interaction, knowledge deficit, bowel incontinence, high risk for injury, altered role performance, care giver role strain, impaired physical mobility, sexual dysfunction, dysreflexia, and ineffective breathing pattern. 2. Based on validation by experts and user validities, 93 nursing interventions which were above ICV(Index of Content Validity) .80 were chosen. 3. Nursing intervention protocols which showed above ICV .80 were developed.

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Voluntary Motor Control Change after Gait Training in Patients with Spinal Cord Injury (척수신경손상 환자의 보행훈련 전.후의 능동적 근육제어의 변화)

  • 임현균;이동철;이영신;셔우드아더
    • Journal of Biomedical Engineering Research
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    • v.24 no.2
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    • pp.133-140
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    • 2003
  • In this study, muscle activity was measured using surface EMG (sEMG) during a voluntary maneuver (ankle dorsiflexion) in the supine position was compared pre and post gait training. Nine patients with incomplete spinal cord injury participated in a supported treadmill ambulation training (STAT), twenty minutes a day, five days a week for three months. Two tests, a gait speed test and a voluntary maneuver test, were made the same day, or at least the same week, pre and post gait training. Ten healthy subjects' data recorded using the same voluntary maneuvers were used for the reference. sEMG measured from ten lower limb muscles was used to observe the two features of amplitude and motor control distribution pattern, named response vector. The result showed that the average gait speed of patients increased significantly (p〈0.1) from 0.47$\pm$0.35 m/s to 0.68$\pm$0.52 m/s. In sEMG analysis, six out of nine patients showed a tendency to increase the right tibialis anterior activity during right ankle dorsiflexion from 109.7$\pm$148.5 $mutextrm{V}$ to 145.9$\pm$180.7 $mutextrm{V}$ but it was not significant (p〈0.055). In addition, only two patients showed increase of correlation coefficient and total muscle activity in the left fide during left dorsiflexion. Patients' muscle activity changes after gait training varied individually and generally depended on their muscle control abilities of the pre-STAT status. Response vector being introduced for quantitative analysis showed good Possibility to anticipate. evaluate, and/or guide patients with SCI, before and after gait training.

Involvement of Serine Phosphorylation of Spinal Cord NR-2B Subunit of the N-methyl-D-aspartate Receptor Following Electroacupuncture Stimulation (전침자극이 척수 N-methy1-D-aspartate receptor외 NR-2B Subunit 인산화에 미치는 영향)

  • Kang, Byeol-Rim;Choi, Byung-Tae;Yoon, Hyun-Min;Min, Young-Kwang;Ahn, Chang-Beohn
    • Journal of Acupuncture Research
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    • v.24 no.2
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    • pp.63-71
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    • 2007
  • 목적 : 저주파에 해당하는 2Hz 전침 자극이 척수 N-methyl-D-aspartate receptor (NMDAR)의 NR-2B subunit의 발현 및 인산화에 미치는 영향을 조사하였다. 방법 : Sprague-Dawley계 흰쥐를 Storkson등의 방법에 의해 척수막의 지주막하강에 catheter를 삽입하는 수술을 행한 후 마비등의 척수 손상을 나타내지 않는 개체를 대상으로 하였다. N-methyl-D-aspartate (NMDA) antagonist인 D-2-amino-5- phosphonopentanoic acid (AP-5)를 투여한 후 족삼리와 삼음교에 해당하는 부위에 30분간 전침 자극하였다. 무통각 여부는 hot plate test를 시행하였으며 NMDAR NR-2 subunit 발현과 인산화 여부는 Western blot과 면역조직화학적으로 살펴보았다. 결과 : 전침 무통각은 전침 자극 후 180분 후까지 지속되었으며 NMDA antagonist인 AP-5를 투여하였을 때 전침 무통각이 저하되었으나 유의성은 나타내지 않았다. Western blot 분석으로 보아 NMDAR NR-2B 및 인산화 NR-2B의 발현은 전침자극에 의해 미약한 증가를 보이나 AP-5투여에 의해 현저한 저해를 보였다. 면역조직화학에 의한 척수배각 구역별 발현을 보면 NMDAR NR-2B 및 인산화 NR-2B는 전 배각에 걸쳐 관찰되나 경부(층판 V-VI)에서 약한 반응을 보였다. 전침 자극에 의한 각 군별 NR-2B 발현은 유의한 차이를 보여 주지 않았으나 인산화 NR-2B는 천층(층판I-II) 및 고유핵 층판(III-IV)에서 유의성 있는 증가를 보였다. 전침 자극시 AP-5 투여는 유의성은 보이지 않았으나 인산화 NR-2B 발현을 저해하였다. 결론: 저주파 2Hz 전침에 의한 무통각은 NMDA antagonist인 AP-5 투여에 의해 저해될 뿐 아니라 NMDAR NR-2B subunit의 인산화를 저해하는 것으로 보아 전침 무통각의 과정에 NMDAR 및 NMDAR NR-2B의 인산화가 관여함을 알 수 있다.

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Application of Intraoperative Neurophysiological Monitoring in Aortic Surgery (대동맥수술에서의 수술 중 신경계감시의 적용)

  • Jang, Min Hwan;Chae, Ji Won;Lim, Sung Hyuk
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.1
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    • pp.61-67
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    • 2022
  • Intraoperative neurophysiological monitoring (INM) ensures the stability and safety of specific surgeries in high-risk groups. As part of INM, intensive tests are conducted during the surgical process. When INM tests are applied during surgery, a delay in notifying the operating surgeon in cases of neurological defects can cause serious irreversible sequelae to the patient. Aortic replacement, which is necessitated due to aortic aneurysms and aortic dissection, is a complicated procedure that blocks the blood flow to the heart. When arteries that branch out from the aorta and supply blood to the spinal cord are replaced, blood flow to the spinal cord decreases, resulting in spinal ischemia. In aortic surgery, INM plays an important role in preventing spinal ischemia and serious complications by quickly detecting the early signs of spinal ischemia during cross-clamping and reporting it to the surgeon. Therefore, this paper was prepared to help examiners who conduct INM by detailing the process, method, time, and warning criteria for INM. This paper identifies the need for INM in aortic surgery and the process flow for a smooth test, accurate and rapid examination, and subsequent reporting.