• Title/Summary/Keyword: 환자의 편의성

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Effect of Education and Counselling-based Cardiac Rehabilitation Program on Cardiovascular Risk, Health Behavior and Quality of Life in Elderly with Coronary Artery Disease (교육상담 기반 심장재활 프로그램이 노인 관상동맥질환자의 심혈관 위험도, 건강행위 및 삶의 질에 미치는 효과)

  • Won, Mi-Hwa
    • The Journal of the Korea Contents Association
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    • v.15 no.6
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    • pp.303-313
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    • 2015
  • Purpose: The purpose of this study was to investigate the effect of education and counselling-based cardiac rehabilitation program on cardiovascular risk, health behavior and quality of life in elderly with coronary artery disease. Methods: A quasi-experimental study used a non-equivalent control group pre-post test design. A five week education and counselling-based cardiac rehabilitation program for the elderly with coronary artery disease was developed and offered to the experimental group. Participants were drawn from hospital in Busan. Twenty two were selected for the experimental group while 22 were assigned to a control group. Cardiovascular risk, health behavior and quality of life were measured. Results: There was a statistically significant difference in the cardiovascular risk(U=118.5, p=.002), health behaviors(t=5.200, p=<.001) and quality of life(t=2.431, p=.001) between the experimental group and the control group. Conclusion: Education and counselling-based cardiac rehabilitation program can be not only an effective nursing intervention for old patients having coronary artery disease, but also the very basis of further research on aged people who have the same symptom.

The Lives Experience of Visiting Nurses of Home-based Long-term Care Service Center (재가장기요양기관 방문간호사의 간호 경험)

  • Byun, Jinyee
    • The Journal of the Korea Contents Association
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    • v.19 no.11
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    • pp.603-618
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    • 2019
  • This study aims to explore the meaning and nature of the nursing experience of visiting nurses of home-based long-term care service centers by using van Manen's hermeneutic phenomenological approach. A total of 10 home-visiting nurses working in Seoul and Gyeonggi-do Province were recruited through purposive, convenience, and snowball sampling and participated in the study. Data were collected from January 7, 2017 to October 12, 2018 through in-depth individual interviews with the participants. The analysis resulted in 6 essential themes regarding the lived experience of visiting nurses: 'establising a good rapport with the patient and his or her family caregiver', 'building the foundation of visiting nursing by performing autonomously nursing procedures for the patient', 'facing the reality not to be able to work as much as I want due to the limitations of the support system in performing work as a visiting nurse', 'upset when sincerity could not be delivered', 'following the calling of medical personnel by taking responsibility for 'my patient', and 'pledging oneself to career-long work, feeling reward as a visiting nurse.' The findings of the study help understand the role and importance of visiting nurses and contribute to the preparation of practical measures to improve the quality of home-visiting nursing.

Open Source-Based Surgical Navigation for Fracture Reduction of Lower Limb (오픈소스 기반 수술항법장치의 하지 골절수술 응용검토)

  • Joung, Sanghyun;Park, Jaeyeong;Park, Chul-Woo;Oh, Chang-Wug;Park, Il Hyung
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.38 no.5
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    • pp.497-503
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    • 2014
  • Minimally invasive intramedullary nail insertion or plate osteosynthesis has shown good results for the treatment of long bone fractures. However, directly seeing the fracture site is impossible; surgeons can only confirm bone fragments through a fluoroscopic imaging system. The narrow field of view of the equipment causes malalignment of the fracture reduction, and radiation exposure to medical staff is inevitable. This paper suggests two methods to solve these problems: surgical navigation using 3D models reconstructed from computed tomography (CT) images to show the real positions of bone fragments and estimating the rotational angle of proximal bone fragments from 2D fluoroscopic images. The suggested methods were implemented using open-source code or software and evaluated using a model bone. The registration error was about 2 mm with surgical navigation, and the rotation estimation software could discern differences of $2.5^{\circ}$ within a range of $15^{\circ}$ through a comparison with the image of a normal bone.

Recognition of Good Death, Attitude towards the Withdrawal of Life-Sustaining Treatment, and Attitude towards Euthanasia in Nurses (좋은 죽음에 대한 인식, 연명치료 중단 및 안락사에 대한 종합병원 간호사의 태도)

  • Kim, Sook-Nam;Kim, Hyun-Ju
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.136-144
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    • 2016
  • Purpose: To provide practical data for bioethics education, we identified correlations between recognition of good death, attitude towards withdrawal of meaningless life-sustaining treatment, and attitude towards euthanasia in nurses. Methods: Using convenience sampling, we recruited 218 nurses who had at least six-month work experience in one of the six general hospitals with 500 or more beds in Seoul, Busan, and Gyeongsang province. All participants understood the purpose of the study and agreed to take part in the study. The research tools used included the Concept of Good Death Measure (CoGD), the measurement tool for attitudes towards withdrawal of meaningless life-sustaining treatment (WoMLST), and the measurement tool for attitudes towards euthanasia. Data were analyzed using an Independent t-test, one-way ANOVA, and Pearson's correlation coefficient using SPSS 21 for Windows. Results: Nurses had normal levels on CoGD, WoMLST, and attitudes towards euthanasia. Nurses' CoGD, WoMLST, and euthanasia scores significantly differed depending on their education level, working period, and the importance of religion to them. A negative correlation was found between the CoGD and WoMLST scores, and WoMLST and euthanasia scores were positively correlated. Conclusion: Nurses should be trained to deal with ethical issues that may arise while caring for terminal patients. It is necessary for nurses to understand the concepts related to CoGD, WoMLST, and euthanasia, and to promote bioethics education with focus on decision-making and problem-solving ability in ethically conflicting situations.

The Results of Ender Nailing for the Proximal Humerus Fractures - Radiological Evaluation - (상완골 근위부 골절의 Erlder 정을 이용한 치료 결과-방사선학적 분석 -)

  • Park Jin Soo;Chung Moon Sang;Yoon Kang Sub;Baek Goo Hyun;Lee Ji Ho;Kang Seung Baek;Kim Dong Wook
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.187-198
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    • 1999
  • Purpose: The authors compared the results of Ender nailing for the proximal humerus fractures with those of the conservative methods radiographically. Materials and Method: Nine patients(mean age: 69 years.) received Ender nailing, and the other nine patients, conservative treatments(mean age: 73 years). All fractures were 2 part fractures. The Ender nails were inserted either through posterior elbow approach or transepicondylar approach. A simple Velpeau bandage was applied to the conservative treatment group. The average follow-up was 15 months. Results: The initial status of the anatomical reduction, i.e., the values of the medial shift, overlapping and the varus agulation, were little changed at follow-up radiographs in both the Ender nailing group and the conservative treatment group. There was no significant difference for the status of anatomical reduction between the Ender nailing group and the conservative treatment group. The stability of fixation by Ender nails, i.e., the degree of fanning out of the nails was poor in most cases. Not a few problems/complications happened in cases of Ender nailing group; back­ing out of the nail in three cases, penetration of the nails into the humeral heads in 3, fractures or cracking of the humerus around the nail insertion area in 4 and reduction loss in one. Conclusion: We could not get better results with the use of Ender nail. We use no longer Ender nails for the proximal humerus fractures. Further studies are needed for the better option for the proximal humerus fractures.

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Effects of Simulation-based Clinical Reasoning Education and Evaluation of Perceived Education Practices and Simulation Design Characteristics by Students Nurses (간호학생을 위한 시뮬레이션기반 임상추론 교육의 효과 및 설계특성과 교육상황 인식 평가)

  • Hur, Hea Kung;Song, Hee-Young
    • The Journal of the Korea Contents Association
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    • v.15 no.3
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    • pp.206-218
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    • 2015
  • This single-blinded, nonequivalent control group pretest-posttest study was undertaken to evaluate the effectiveness of simulation education on clinical judgement, collaboration, communication skills, and perceived education practices and simulation design characteristics among student nurses in Korea. Participants were 47 students (19 in the experimental group and 28 in the control group) recruited by convenience sampling. The simulation based clinical reasoning education consisted of seven weekly, 120-minute high fidelity simulations. All participants completed the pretest and 7-week post measurements of a clinical judgment, collaboration, and communication skills with 4-week post measurement of collaboration, and participants in the experimental group provided a measurements of perceived education practices and simulation design characteristics. Data were analyzed using repeated measured ANOVA, and mixed linear model with SAS 9.2. Significant improvements were found in the experimental group for clinical judgment, collaboration, communication skill, and perceived education practices and simulation design characteristics. The study results show the impact of the perceived education practices and simulation design characteristics on facilitating the effectiveness of simulation education. The findings suggest a feasible and sound teaching method for student nurses and the need for further studies with a larger sample.

Technological Governance Regarding Life-Sustaining Technologies: The Limitations of RRI and Bioethics ("한국의 연명의료정책과 기술 거버넌스: 사회에 책임지는 기술혁신(RRI)의 적용 한계와 생명윤리")

  • Lee, June-Seok
    • 한국과학기술학회:학술대회논문집
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    • 2015.12a
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    • pp.247-278
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    • 2015
  • Recently, as DNR prevails more and more in Korea, discussions regarding meaningless medical life-sustaining-treatment (LST) intensified. Some of the Supreme Court decisions are even discussed in mass media, causing public debates. These cases tell us that, as life-sustaining medical technologies are highly developed, more sociological and policy-related analyses are needed on them. Firstly, this study will review 40 previous studies that analyze recent discussions in Korea about LST. Secondly, this study also shows that in bioethical and policy-related perspectives, governance about LST calls for a new implications regarding thanatoethics and thanatopolitics. In this new theoretical framework, death with dignity (DwD) can be understood as a process of giving back the thanatopower to the subject who chooses his way of ending based on his sound and free will. Thirdly, some of the new LST or resuscitation technologies such as automated external defibrillators (AED) are developed in RRI framework. However, if subjects themselves choose not to apply those technologies on them, as in the case of DNR (do not resuscitate) vows, meaning of developing such technologies are to be questioned. But currently such questions regarding the limitations of RRI are seldom asked. I argue that in order to properly apply RRI framework on existing technology, we also need to consider these points.

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Relationship between psychological stress and hippocampus volume through meta-analysis (메타분석을 통한 심리적 스트레스와 해마용적 간의 관계)

  • Jo, Min-kyung;Hong, Changhee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.12
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    • pp.227-236
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    • 2018
  • This study was conducted to define hippocampal volume differences between a stress-laid group and normal individual group via meta-analysis. This investigation included studies that contained hippocampal volume measurements in association with stress from 1990 to 2016. Magnetic resonance imaging (MRI) measurements of hippocampal volumes were used to determine the mean size, standard deviation and sample size. The pooled effect size was measured by the standardized mean difference (SMD) with a 95% confidence interval. This meta-analysis included 13 studies comprising 374 stress subjects and 439 normal subjects. Eight studies targeted war-related veterans and holocaust survivors, while five targeted personal trauma associated with childhood abuse, rape, accident or financial hardship. The overall mean effect size (Hedges' g) was -0.70 (-1.04; -0.37). Overall, the SMD value was -0.70, with a moderate effect size, but high heterogeneity. Depending on the characteristics of the stressor, studies were divided by subgroups of war-related veterans and subjects with personal trauma and then analyzed again. In the war-related subgroup, the Hedges' g was -0.47 (-0.78; -0.16), while in the personal stressor-related subgroup it was -0.91 (-1.57; -0.26). These results indicate that there was a significant negative correlation between psychological stress and hippocampal volume.

Treatment of Osteochonritis Dissecans of Femoral Condyle (대퇴골과 박리성 골연골염의 치료)

  • Lee Dong-Chul;Kwon Soon;Son Wook-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.49-54
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    • 2002
  • Purpose : To analyze the clinical results of treatment for the osteochondritis dissecans of femoral condyle by age, the type of lesion and method of treatment. Methods : From March 1991 to February 2000, 17 patients (20 cases) with osteochondritis dissecans of the femoral condyle were followed up over 1 year. Three patients had bilateral lesion. There were 12 cases with trauma history (9 cases with sports injury and 3 cases with direct trauma). The initial symptoms were pain, clicking, locking, giving way in the order of frequency, pain was revealed in all cases. Clinical evaluation of IKDC and Hughston method were used for subjective and objective function. Results : The number of male patient was 12, and the mean age was 19.8 year old (11$\~$50). The location of the lesion was 14 cases in medial femoral condyle and 6 cases in lateral femoral condyle. The arthroscopic findings of the lesion in 15 cases were as follows, early separation in 6 cases, partially detachment in 4 cases, and crators and complete detachment in 5 cases. 5 cases were treated with mutiple drilling and 5 cases with Herbert screw fixation, 3 cases with Herbert screw fixation and bone graft. In early stage, 7 cases were treated with conservative method. In the grading of Hughston score, 6 cases were graded as excellent, 9 cases as good, 15 cases were graded as good to excellent. Based on the IKDC scale, 1 case was graded as normal, 6 as nearly normal, and 10 as abnormal. Conclusions : The trauma seemed to be important factor in occurrence of osteochondritis dissecans of the femoral condyle. The clinical results of juvenile period showed better than adolescence and adult period, it is necessary to detect the lesion as soon as possible. The result of subjective evaluation was worse than the Hughston evaluation. It was caused by limiting involvement of sports activity and limited activity in the adolescence.

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An Analysis of Factors That Affect Image Quality Deterioration in The Potable X-ray Examination on using Digital Wireless Detector (디지털 무선 검출기를 이용한 이동형 X선검사에서 영상품질 저하의 요인분석)

  • Yu, Young-Eun;Lim, Cheong-Hwan;Ko, Joo-Young
    • Journal of radiological science and technology
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    • v.37 no.2
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    • pp.93-100
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    • 2014
  • Recently the development of portable digital wireless imaging system, which acquires digital radiation images by using wireless LAN telecommunications function in an easy and fast way, provides lots of convenience for people. Considering the characteristics of portable imaging tests on emergency and critical patients, this study aims to suggest guidelines for Digital wireless detector by evaluating the effect of de-centering of focus-grid and displacement of subject in detector on the quality of image. The equipments used for this study were Elmo-T6 Digital Mobile X-ray system (SIMAZU Corp.), el' Tor ($14{\times}17$ "Wireless detector), Grid (10:1) and Chest & head phantom. After acquiring post-processing image according to dose increase and de-centering image of grid-focus and head phantom displacement image, this study compared, analyzed and evaluated these images by using a digital image analysis program by Image J. In the change of images based on dose increase, images were rough in the dose of 0.5 mAs, while there was no difference among images in the proper dose of 1~2 mAs and, especially from 2.5 mAs, average value of pixels radically decreased, affecting contrast. Over 3 mAs, contrast dropped due to saturation phenomenon of lungs. As the result of analysis using Image J program, with the increase of displacement between focus-grid and head phantom, the frequency of low pixel value also increase, causing the outline of surface image to disappear, which in turn affects contrast. For better quality imaging, a radiographer must be aware before the time of test that the image quality can be changed based on the critical patient's posture, movement, respiration, displacement of X-ray tube and distance of imaging.