• Title/Summary/Keyword: 퇴원계획

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Factors Affecting the Readmission Experience of Liver Cirrhosis Patients (간경변증 환자의 재입원 경험에 영향을 미치는 요인)

  • Yoon, Mi-Lim;Eun, Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.5
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    • pp.111-120
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    • 2020
  • This study examined the factors affecting the readmission of patients with liver cirrhosis, and focused on self-care, social support, and drinking refusal self-efficacy. The subjects were 75 cirrhosis patients who were admitted to medium-sized hospitals at S-city for two months from May 2019 to June 2019. The data was analyzed with the SPSS (Version 25) program, and logistic regression analysis was performed on the factors affecting readmission. The results were self-care (27.49±0.53 out of 60), social support (52.80±16.44 out of 90), and drinking refusal self-efficacy (42.39±22.76 out of 80). The readmission method was classified into planned and unplanned admissions. Unplanned readmission was found to differ depending on the drinking experience (OR: 4.16) and the presence of complications (OR: 5.11) within a month of discharge rather than that of the planned readmissions, accounted for 19.7%. It will be very important to reduce the occurrence of complications by early management of patients with cirrhosis, and increase the drinking refusal self-efficacy, and so reduce unplanned readmission and prevent the progression and deterioration of cirrhosis. The drinking experience and the occurrence of complications can be reduced through interventions that increase self-care, social support, and drinking refusal self-efficacy. Nursing interventions are needed to prevent patients with cirrhosis from drinking and to manage the complications due to relapse into alcoholism.

Valve Leaflet Escape of Edwards Duromedics Mechanical Valve - A Case report - (Edwards Duromedics 기계판막엽 탈출 - 1례 보고 -)

  • 윤영남;유경종
    • Journal of Chest Surgery
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    • v.35 no.1
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    • pp.60-63
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    • 2002
  • Edwards Duromedics mechanical valve was introduced into clinical use in 1982 and is still being used today after several modifications. Valve-related complications after mechanical valve replacement are thiombo-embolism, endocarditis, valve malfunction, valve leaflet escape and fracture. Incidence of valve leaflet escape is very low. A 40 year-old male patient who had undergone mitral replacement with a 31mm Edwards Duromedics mechanical valve(model

Pulmonary Aspergilloma Treated by one Stage Cavernostomy and Myoplasty (공동절개술과 근육충진술을 이용한 폐국균증의 수술)

  • 안현성;김응중;신윤철;지현근;최광민
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.729-732
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    • 2001
  • A 49-year-old male patient was admitted with chief complaint of hemoptysis. Preoperative chest PA and CT scan revealed air-filled large cavitary lesion at the right upper lobe with typical meniscus sign. Serum anti-fungus antibody for Aspergillus was positive and he was diagnosed as aspergilloma. We planned RULobectomy but it was impossible due to severe pleural adhesion in apex and mediastinal pleura. Therefore, we performed a cavernostomy and serratus anterior muscle flap transposition in one stage. The patient recovered without complication and was followed up for 8 months without recurrence of hemoptysis.

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Factors Effected on Program Needs of the Elderly People with Mental Illness -Focused on the Nursing Home in Busan- (노인정신장애인의 프로그램 욕구에 미치는 영향 요인 -부산지역 정신요양원을 중심으로-)

  • Kim, Sun-Joo
    • The Journal of the Korea Contents Association
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    • v.8 no.10
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    • pp.198-207
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    • 2008
  • The purpose of this study supplies the basic data to plan the optimum mental health service that is reflected needs of the elderly people with mental illness by checking how their demographic-sociological distinctive feature and function level have an effect on their needs of mental health service by being absent situation of a study of the elderly people with mental illness. As results of analysis, the residental type, the disease period, and the decision person of admission-discharge control of demographic-sociological distinctive feature is much effect on needs of programs and also effect commonly on the needs of the health promotion program and the discharge support program. Generally, the function level of the elderly people with mental illness is favorable and the order of function level is the group activity program, the counseling program, and the resource network program.

A survey of leisure participation and leisure exploration of community dwelling stroke patients (지역사회 거주 뇌졸중 환자의 여가 참여 및 여가 탐색 조사)

  • Jeong, Eun-Hwa
    • Journal of Industrial Convergence
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    • v.18 no.4
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    • pp.41-49
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    • 2020
  • The purpose of this study was to provide basic information on leisure participation and leisure exploration of community-dwelling stroke patients through a multi-dimensional leisure participation evaluation tool. The subjects in this study were 35 people living with stroke in the community. As a result of study, the most involved leisure activities were in order of watching TV, communicating, and exercise alone. Most of the satisfaction level of leisure participation was 7-10 points, but exercise alone was 5.2 points due to the purpose of health management. Leisure exploration was the most frequent exercise alone and sports, and interest was 8-10 points. The most important obstacles for leisure participation were physical problems depending on the nature of the stroke disease. Through the results of this study, it is necessary to activate a stroke patient's discharge plan and activate a community stroke patient's leisure intervention program so that they can participate in leisure activities of their choice through voluntary leisure exploration.

Reconstruction of a Large Cricotracheal Defect Using a Sternocleidomastoid Myoperiosteal Flap : A Case of Locally Aggressive Papillary Thyroid Carcinoma with Tracheal Invasion (갑상선 수술 후 흉쇄유돌근 근골막피판을 이용한 큰 기도 결손부 재건 1예)

  • Kim, Sang Min;Kim, Mi Ra;Kim, Yong-Wan;Baek, Moo Jin;Park, Jun-Ook
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.1
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    • pp.18-21
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    • 2015
  • 기관을 침범한 갑상선 악성종양을 제거한 후에 성문하부에 비교적 큰 기관 결손이 발생할 수 있다. 단단문합술은 넓은 부위의 결손부를 재건하는 방법으로 널리 받아들여지고 있지만, 문합부 파열, 반회후두신경마비, 재협착 등의 합병증이 발생할 수 있다. 본 증례는 기도를 침범한 갑상선 유두암종을 제거한 후 윤상연골과 기관연골의 비교적 큰 결손부를 흉쇄유돌근 근골막피판을 사용하여 안전하게 재건한 사례이다. 55세 남자 환자가 기도를 침범한 갑상선 유두상암으로 내원하였으며 기도침범은 윤상연골(둘레의 약 30%)과 4개의 기관연골(둘레의 약 50%)을 해당하는 넓은 부위였다. 수술 전 기관절개술을 시행하여 주위 기관연골의 상태가 좋지 않아 단단문합술 시행 후 문합부 파열 가능성이 있다고 판단하여 흉쇄유돌근 근골막피판을 이용하여 재건하기로 계획하였다. 갑상선 절제술, 경부림프절 절제술, 흉쇄유돌근 근골막피판을 이용한 재건술을 시행하였으며 수술 후 12일째 별다른 문제없이 퇴원하였다. 환자는 수술 후 현재 22개월 간 기도 협착 등의 별다른 합병증 없이 지내고 있다. 흉쇄유돌근 근골막피판은 성문하부나 기관지 전외측벽의 비교적 큰 결손부를 재건하는 데 유용하게 사용될 수 있다.

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Experimental Computer-Based Management System of Patients in Radiation Oncology (방사선치료 환자관리를 위한 컴퓨터 프로그램의 실험적 제작)

  • Choi, Ihl-Bohng;Kim, Choon-Yul;Bahk, Yong-Whee
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.169-172
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    • 1987
  • Currently, many computer systems are used in many areas of medicine including radiation oncology. For the most part, the computer system has proved to be useful in radiotherapeutic planning and dose calculation. There has been attempts to develop computer system including information management of patients, patient tracing, and office automation in radiation oncology department. But some of these available commercial systems have shortcomings. We developed a management system of patients in our radiation oncology department that integrated most of items for the evaluation of patents. In particular, the data were stored in a natural language (noncoded) and made themselves easily understandable by all clinical groups. In addition , the data could be isolated in files from which the computer could generate graphs and static data by the use of some simple commands. The system provided us with not only the functions of case review but functions of preparation of conferences, lectures and resident teaching.

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Both Carotid Endarterectomy in Obstrution of Carotid Arteries and Bypass Graft with Kidney Preservation in Obstrution of Abdominal AoRta -A Report of Case (양측 경동맥협착의 혈관내막절제수술 및 신장보호액 주입을 이용한 복부대동백 폐색 수술 치험 -1례 보고-)

  • 김병철;편승환
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.625-630
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    • 1997
  • A 56 years old male patient adklitted to our neurology department because of repeated tingling sensation in right 3, 4, 5th. (infers and weakness on grasping, which were progressively developed re ently. At this time, he had also suffered from claudication in both lower extremities. Carotid angiogram showed that right internal carotid artery was obstructed completely, and both common, both external and left internal carotid arteries had significant stenosis, Concommitantly, aortogram suggested complete obstruction just below the renal arteries. We plamled staged operation for two separated arterial lesions. Both carotid endarterectomy was performed. and we used carotid shunt for left side during operation. Abdominal aortic lesion was operated 2 weeks later We obligately clamped aorta just below the celiac artery and infuse4 kidney perservation solution to pertect kidney during ischemia. Reversed Y bypass graft and kidney perservation was successful despite of 40 minute ischemia. Postoperative courts was uneventful and patient was discharged without any specific problem.

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Simultaneous Off-pump Coronary Artery Bypass Surgery and Total Gastrectomy (동시에 시행한 체외순환 없이 시행하는 관상동맥우회수술과 위전절제술)

  • Park, Jeong-Ok;Ryu, Jae-Wook;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.56-59
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    • 2007
  • A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.

Is a Fast-track Critical Pathway Possible in Gastric Cancer Surgery? (위암 수술 후 조기회복을 위한 임상진료 지침서의 활용이 가능한가?)

  • Yi, Jeong-Min;Hur, Hoon;Kim, Sung-Keun;Song, Kyo-Young;Chin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.18-25
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    • 2009
  • Purpose: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. Materials and Methods: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. Results: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. Conclusion: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.

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