• Title/Summary/Keyword: 치료목표

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Phase of Nurse-Patient Relationships (인간관계 - 간호에 있어서의)

  • Yoo Kyung Za
    • The Korean Nurse
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    • v.6 no.5 s.31
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    • pp.92-100
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    • 1967
  • Nursing Process의 일련의 합목적적인 성격을 평가할 때 간호계획은 환자의 질병을 자신의 중대한 학습경험으로 만듣는데 필요한 단계를 포함하도록 할 수 있다. 환자 자신의 경험의 의미를 이해한다는 것은 nursing이 교육적이고 치료적이며 또 성숙시키는 힘으로써 기능을 하다록 하기 위해 필요한 것이다. 환자의 곤란(질병등)에 대한 초기의 연상은 분화되고 문제에 포함된 모든 요인들을 정리하고 확대시킬 필요가 있다. 왜냐하면 이들은 환자와 그의 목표에 지대한 영향을 미치기 때문이다. 문제에 대한 태도를 분명히 한다는 것은 새로운 환경의 도전에 의해 재생된 과거와 또는 새로운 욕구와 감정의 표현을 가져온다. 늘 풍부하고도 무조건적인 보살핌을 주는 보조자를 상징하는 nurse와의 동일시는 필요하다고 느끼는 욕구와 자기를 위협하는 문제를 처리하는 한 방편이 된다. 초기의 욕구가 처리되면 이들 욕구는 더욱 성장하여 더 성숙한 욕구가 다시 생기게 된다. 환경이 제시하는 것을 철저히 이용한다는 것은 문제에 대한 새로운 분화를 가져오며 인간관계의 기술을 개선시킨다. 개인적 노력을 통해 새로운 목표는 실현될 수 있다. 병원 환경에서 사회 생활에로 참여하는 것은 N-P relationship의 해결을 필요로 하고 새로운 사회적 상호 의존 관계를 위해 인격의 강화가 필요하다. 환경적 결핍 위에 resolution이 일어났을 때는 환자의 육구는 강화되고 전체적 경험의 동정이 제한된다.

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유방염 관리를 위한 기록의 분석

  • 한홍율
    • Journal of the korean veterinary medical association
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    • v.30 no.10
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    • pp.592-615
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    • 1994
  • 1. 체세포점수(SCS)는 적절히 사용되었을 때 큰 이익을 가져다 주는 가치있는 조사항목이다. 2. 권장된 유방염 예방관리계획을 잘 적용할 수 있는 대부분의 우군에서는 SCS 목표를 3.0으로 잡는 것이 바람직하다. 3. 체세포점수(SCS)자료는 비유횟수, 착유일수와 신규감염, 만성감염, 중증감염된 그 해의 달 그리고 평균 SCS별로 정돈하면 아주 유용하다. 4. 체세포점수(SCS)양상과 SCS치가 높은 젖소들은 우군의 유방염 문제를 진단하는데 유용하며 목표를 세우고 유방염 예방대책을 수립하는데 도움을 준다. 5. 임상관찰과 치료기록, 원인균 검사성적자료와 연관시킨 SCS 자료는 가장 좋은 유방염 평가기록일 수 있다. 6. 목장에 근무하는 전직원이 유방염에 관한 자료의 이용에 있어 전문적 지식을 갖추고 있으면 초기에 유방염 문제에 개입할 수 있게 되어 비유기중에 항생제에 사용을 줄일 수 있다. 따라서 유질이 향상되고 농가의 수입증대를 도모할 수 있다.

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Target Controlled Conscious Sedation with Propofol and Remifentanil for the Extraction of Impacted Wisdom Teeth (매복지치 발치 시, Propofol과 Remifentanil을 이용한 목표조절농도주입(TCI) 의식하 진정)

  • Bang, Bo-Young;Shin, Teo-Jeon;Seo, Kwang-Suk;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.10 no.2
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    • pp.159-165
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    • 2010
  • 배경: 매복지치의 수술적 발치 시 propofol과 remifentanil을 이용한 목표조절농도주입(Target controlled infusion) 의식하 정주진정법의 적절한 주입농도를 제시하고 그 안전성을 평가하고자 하였다. 방법: 매복지치의 수술적 발치가 예정된 미국마취학회 신체 등급 분류 1, 2에 속하는 15-65세, 142명(여 83명, 남 59명)의 환자를 대상으로 소급 연구하였다. 환자는 수술 전 목표조절농도주입법을 이용한 의식하 진정법 사용에 관한 동의서를 작성하였다. 정맥내 삽관을 시행하고 수액을 공급을 시작하고, 4-5 L/min의 산소를 비관을 통해서 공급하였다. Propofol과 remifentanil의 초기 목표 혈중농도는 각각 $0.5\;{\mu}g/ml$와 1.0 ng/ml로 정하였다. 수술 중, 환자의 불안 통증 정도에 따라 목표농도를 조절하였으며 최저 농도와 최대 농도, 평균 농도, 주입된 총 용량을 기록하였다. 또한 수축기혈압과 맥박 수, 산소포화도, 호기 말 이산화탄소량을 수술 시작 전, 수술 중 5분 간격으로 확인하고 기록하였다. 모든 측정치는 평균 $\pm$ 표준편차나 환자의 수, 초기 측정치에서의 백분율 편차로 표시하였다. 결과: 수술 동안의 목표 혈중농도의 평균은 propofol은 $0.54{\pm}0.11\;{\mu}g/ml$이고, remifentanil은 $1.11{\pm}0.30\;ng/ml$였다. 수술 중 조절된 최대농도는 propofol은 $0.6{\pm}0.23\;{\mu}g/ml$이고, remifentanil은 $1.3{\pm}0.63\;ng/ml$였다. 이는 의식하 진정에 해당되는 범의의 농도라고 할 수 있겠다. 진정동안 환자의 언어적 의사소통은 유지 되었으며 산소 포화도는 4-5 L/min 의 산소 보충 하에 98%이상으로 유지되었다. 수축기 혈압과 맥박은 대부분의 환자에서 정상변위범위(${\pm}20%$)내에서 유지되었다. 결론: 본 연구는 목표조절 농도주입 의식하 진정에서 사용된 농도(propofol $0.5\;{\mu}g/ml$, remifentanil 1.0 ng/ml)는 안전하게 의식하 진정을 가능한 것을 보여준다. 이는 치과 치료 시 목표조절농도 주입의식하 진정법에서 적절한 목표농도를 제시한다.

The Effect of Family-Centered Coaching Based on Sensory Integration on the Performance of Children with Autism Spectrum Disorder (감각통합 기반의 가족중심코칭이 자폐스펙트럼장애 아동의 작업수행에 미치는 효과)

  • Kim, Yoon-Sung;Kim, Kyeong-Mi;Chang, Moon-Young;Hong, So Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.19 no.2
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    • pp.12-25
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    • 2021
  • Objective : This study explored the effects of family-centered coaching using a sensory integration-based approach on the levels of performance and satisfaction for children with autism spectrum disorder (ASD). Methods : From April 16, 2020 to August 6, 2020, participants included 10 children with ASD, between the ages of three to six who met the inclusion criteria, and their guardians. I used the Canadian Occupational Performance Measure (COPM) to evaluate the children's levels of performance and satisfaction and the Goal Attainment Scaling (GAS) to evaluate their occupational performance. The experimental group (n=5) continued the sensory integration therapy while receiving their personalized family-centered coaching training for 60 minutes per week. This continued for four weeks via home visits and video calls. The control group (n=5) also continued to receive the sensory integration therapy while receiving sensory integration-based general counseling in relation to activity objectives. Results : Statistically significant differences were found in the scores of COPM performance and satisfaction and the GAS scores between the experimental group and the control group, before and after the intervention (p<.05). Statistically significant differences were found in score changes in COPM and GAS, between the two groups (p<.05). Cohen's d also showed a big effect size on the scores of COPM satisfaction (d=2.768) and the GAS scores (d=2.786). Conclusion : This study demonstrated that the sensory integration-based, family-centered coaching had more positive effects on the level of performance and satisfaction of children with ASD, than general counseling.

Evaluation of the Efficiency of the Foxtail Millet Vacuum Cushion in Skin Cancer Radiation Treatment (자체 제작한 Foxtail Millet Vacuum Cushion의 광자선 피부암 치료 시 유용성 검증)

  • Choi, Shin-Cheol;Lee, Kyung-Jae;Jung, Sung-Min;Oh, Tae-Seong;Park, Jong-Il;Shin, Hyun-Kyo
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.189-196
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    • 2012
  • Purpose: The sufficiency of skin dose and the reemergence of patient set-up position to the success of skin cancer radiation treatment is a very important element. But the conventional methods to increase the skin dose were used to vacuum cushion, bolus and water tank have several weak points. For this reason, we producted Foxtail Millet Vacuum Cushion and evaluated the efficiency of the Foxtail Millet Vacuum Cushion in skin cancer Radiation treatment. Materials and Methods: We measured absolute dose for 3 materials (Foxtail Millet Vacuum Cushion, bolus and solid water phantom) and compared each dose distribution. We irradiated 6 MV 100 MU photon radiation to every material of 1 cm, 2 cm, 3 cm thickness at three times. We measured absolute dose and compared dose distribution. Finally we inspected the CT simulation and radiation therapy planing using the Foxtail Millet Vacuum Cushion. Results: Absolute dose of Foxtail Millet Vacuum Cushion was similar to absolute dose of bolus and solid water phantom's result in each thickness. it Showed only the difference of 0.1~0.2% between each material. Also the same result in dose distribution comparison. About 97% of the dose distribution was within the margin of error in the prescribed ranges ($100{\pm}3%$), and achieved the enough skin dose (Gross Tumor Volume dose : $100{\pm}5%$) in radiation therapy planing. Conclusion: We evaluated important fact that Foxtail Millet Vacuum Cushion is no shortage of time to replace the soft tissue equivalent material and normal vacuum cushion at the low energy radiation transmittance. Foxtail Millet Vacuum Cushion can simultaneously achieve the enough skin dose in radiation therapy planing with maintaining normal vacuum cushion' function. Therefore as above We think that Foxtail Millet Vacuum Cushion is very useful in skin cancer radiation treatment.

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MnBillnry protraction treatment of skeletal Class III children using miniplnte anchorage (Miniplate anchorage를 이용한 골격성 III급 부정교합 아동의 상악 전방견인 치료)

  • Cha, Bong-Kuen;Lee, Nam-Ki;Choi, Dong-Soon
    • The korean journal of orthodontics
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    • v.37 no.1 s.120
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    • pp.73-84
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    • 2007
  • The maxillary protraction headgear has been widely used in the treatment of skeletal Class III children with maxillary deficiency. A variety of treatment objectives which allow dentoalveolar movements may be established, but when only maxillary protraction without dentoalveolar movement is needed, one of the limitations in maxillary protraction with conventional tooth-borne anchorage is the loss of dental anchorage. This is because a bone remodeling occurs not only at circummaxillary sutures but also within the periodontal tissues. During protraction treatment in the mixed dentition phase, in older children or for the patient with multiple congenitally missing teeth, it is not uncommon to observe undesirable mesial movement of maxillary teeth. Such a side effect can be eliminated or minimized using absolute anchorage such as skeletal anchorage. The purpose of this case report is to introduce a new technique of the maxillary protraction headgear treatment using surgical miniplates.

Conservative Endodontic Treatment of Type III Dens Invaginatus : Case Report (Type III 치내치의 보존적 근관치료 : 증례보고)

  • Jo, Wansun;Lee, Nanyoung;Lee, Sangho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.2
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    • pp.174-179
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    • 2014
  • Dens invaginatus is a developmental anomaly resulting from an infolding of the enamel organ into the dental papilla prior to calcification of the dental tissue. Clinical and radiographic presentation of dens invaginatus shows a lot of variation. The classification proposed by Oehlers(1957) is most commonly used among classifications of dens invaginatus. Several treatments have been suggested to treat Type III dens invaginatus where the pulp remains healthy but the invagination is associated with a periodontitis. The top priority objective is to preserve pulp as sound as possible. Thus, if there is no definite evidence of pulpal disease, the conservative access which treat invagination as distinct from the pulp is necessary. But, Endodontic treatment of Type III dens invaginatus has the particular problems associated with achieving adequate chemomechanical debridement of the root canal system and invagination, predictable length control and consistent filling. In this case report, the endodontic treatment limited within invagination was performed for treatment of Type III dens invaginatus, and filling with Mineral Trioxide Aggregate(MTA) resulted in good prognosis.

The Effect of Sensory Integrative Intervention Focused on Proprioceptive-Vestibular Stimuli on Adaptive Response of Children With Sensory Defensiveness: Case Study (고유-전정감각 중심의 감각통합 중재가 감각방어 아동의 적응반응에 미치는 효과: 사례보고)

  • Park, Ji-Hoon;Kim, In-Sun
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.2
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    • pp.29-39
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    • 2011
  • Objective : The purpose of this study is to verify the effect of sensory integrative intervention focused on proprioceptive-vestibular stimuli on adaptive response of children with sensory defensiveness. Methods : Subject of this study was a 6 years and 5 month old boy. The subject underwent a sensory integration (SI) treatment which was part of the SI treatment course administered by the Korean Sensory Integration Society, in 2011. The treatment goal and treatment plan had established based on the evaluation results. Treatment was done with 4 sessions and the adaptive responses of the subject were measured as outcome of the SI treatment. Results : During the SI treatment, the subject could participate in activities involving tactile stimulation without over-arousal. He also showed improved social interaction skills and his play was qualitatively extended. Conclusion : According to the results of this study, it was verified that sensory integrative intervention focused on proprioceptive-vestibular stimuli has positive effective on adaptive response for children with sensory defensiveness. For the future study, it is suggested to use standardized assessments in evaluation and provide information in changes of daily occupation as outcome data.

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The Effects of the Sensory Integration Intervention Focused on Combined Both Individual Therapy and Group Therapy for Sensory Integration Ability and Occupational Performance Abilities in Children With Somatodyspraxia: Case Study (체성실행장애 아동을 위한 개별치료와 그룹치료를 병행한 감각통합치료가 감각통합능력 및 작업수행능력에 미치는 효과: 개별 실험 연구)

  • Cho, Hye-Jin;Bong, Young-Soon;Lee, Ji-Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.11 no.2
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    • pp.13-26
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    • 2013
  • Objective : The purpose of the study was to investigate The effects of the sensory integration intervention focused on combined both individual therapy and group therapy for sensory integration ability and occupational performance abilities in children with somatodyspraxia. Methods : Once in a total of 12 weeks, baseline period of four sessions and twenty-four session intervention period, research process had combined individual therapy and group therapy for sensory integration therapy. The Design is ABA design of single-subject research design. For a comparison of each-side of the operation performance change in therapy for children, through the assessment Baseline at four sessions and reassessment at two sessions after intervention, the Occupational performance ability change was measured. During intervention period, Process changed the Sensory Integration ability was measured through the Goal Attainment Scale (GAS). Results : The Sensory Integration Ability combined Individual therapy and Group therapy have effect about improvement of the Sensory Integration ability and the Occupational performance ability for children with Somatodyspraxia. Conclusion : Henceforth, subject will undergo systematized experimental design, and when dependent variable such as Sensory Integration ability and the Occupational performance was measured, effect-measuring study needs through using reliable tools.

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The Preliminary Study for Development of Occupational Therapy Model Focused on Improving Living Functions within the Community Care System (커뮤니티 케어 제도 내 생활기능 향상 중심의 작업치료 모델 개발을 위한 기초 연구)

  • Lee, Chun-Yeop;Park, Young-Ju;Park, Kand-Hyun;Ji, Seok-Yeon;Kim, Hee-Jung
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.3
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    • pp.1-12
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    • 2018
  • Objective : This study conducted a preliminary study to develop a occupational therapy model focused on improving living functions within the community care system. Methods : From June to July, 2018, the literature on community care was researched, focusing on cases of Japan's Management Tool for Daily Life Performance (MTDLP), Sweden, United Kingdom, Germany and domestic S Elderly Care Centers and I Health Centers. Based on this information, a group of experts developed a occupational therapy model within the community care system. Results : Assessment tools such as occupation-based health promotional table, interest checklist, occupational goals for improving living functions, sheet for evaluation of living functions, survey of daily life time (weekday and weekend), and sheet for transition of living functions were developed to conduct evaluation for occupational therapy. The improving living functions program, analysis of activities based on ICF model, lifestyle redesign program, cognitive exercise therapy, the Lee Silverman Voice Treatment (LSVT), hospice, and home modification were also organized interventions already in place by occupational therapists. Conclusion : This study showed specific measures and models for the implementation of occupational therapy within community care systems. Occupational therapy is positioned as a specialized area that is essential to the client, and we look forward to the use of this model.