• Title/Summary/Keyword: Advanced general hospital

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The Roles of Critical Care Advanced Practice Nurse

  • Sung, Young-Hee;Yi, Young-Hee;Kwon, In-Gak;Cho, Yang-Ae
    • Journal of Korean Academy of Nursing
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    • v.36 no.8
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    • pp.1340-1351
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    • 2006
  • Purpose. To determine and compare the perception among nurses and doctors of the roles and tasks of critical care advanced practice nurses (APNs) in order to establish standardized and formally agreed role criteria for such critical care APNs. Method. This study measured and analyzed the necessity of each of the roles and tasks of critical care APNs, as perceived by nurses and doctors, through a survey of 121 participants: 71 nurses in 7 intensive care units (ICUs) at a general hospital in Seoul, and 50 doctors who used ICUs. Data collection utilized a questionnaire of 128 questions in the following fields: direct practice (79), leadership and change agent (17), consultation and collaboration (15), education and counseling (11), and research (6). Results. Both the nurses' and the doctors' groups confirmed the necessity of critical care APNs, with doctors who frequently used ICUs indicating a particularly strong need. As for the priority of each role of critical care APNs, the nurses considered direct practice to be the most critical, followed by education and counseling, research, consultation and collaboration, and leadership and change agent. The doctors also considered direct practice to be the most critical, followed by education and counseling, consultation and collaboration, research, and leadership and change agent. There was a statistically significant difference between how the two groups regarded all the roles, except for the consultation and collaboration roles. As for the necessity of each role of critical care APNs, the nurses considered research to be the most necessary, followed by education and counseling, consultation and collaboration, leadership and change agent, and direct practice. The doctors, on the other hand, considered education and counseling to be the most necessary, followed by research, consultation and collaboration, leadership and change agent, and direct practice. The responses of the two groups to all the roles, except for education and counseling roles, were significantly different. Conclusion. Nurses and doctors have different perceptions of the roles and tasks of critical care APNs. Thus, it is necessary for the combined nursing and medical fields to reach an official agreement on a set of criteria to standardize for the roles and tasks of critical care APNs.

Cross Sectional Assessment of Health Related Quality of Life (HRQoL) among Patients with Cancer in Malaysia

  • Farooqui, Maryam;Hassali, Mohamed Azmi;Knight, Aishah;Shafie, Asrul Akmal;Farooqui, Muhammad Aslam;Saleem, Fahad;ul Haq, Noman;Othman, Che Noriah;Aljadhey, Hisham
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3017-3021
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    • 2013
  • Background: Health Related Quality of Life (HRQoL) is an important aspect in identifying cancer patients' perceptions of being diagnosed with cancer and the assessment of treatment outcomes. The present study aimedto assess the profile and predicators of HRQoL of Malaysian oncology patients. Materials and Methods: A cross sectional study adopting the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was conducted. All cancer patients attending Penang General Hospital between August-November 2011 were approached. Descriptive statistics were used to assess demographic and disease related characteristics of the patients. All analyses were performed using SPSS v 16.0. Results: Three hundred and ninety three cancer patients met the inclusion criteria and were enrolled in the study. The mean age was 53.9 ($SD{\pm}13$) years. The cohort was dominated by females (n=260, 66.2%). Nearly half (n=190, 48.3%) of the participants were of Malay ethnicity, practicing Islam as their religion (n=194, 494%). Two hundred and ninety six (n=296, 75.3%) had beene diagnosed with cancer within six months to 3 years previously. The most common primary cancer site was breast (n=143, 36.4%). The mean Global Health Status (GHS) score was 60.7 (SD=21.3). Females (mean GHS score of 62.3, p=0.035) with Malay ethnicity (mean GHS score of 63.8, p=0.047), practicing Islam as their religion (mean GHS score of 63.0, p=0.011) had better GHS scores. Patients having medical insurance had good scores (mean 65.6, p-0.021). Marital status was significantly associated with GHS scores (p=0.022). Bone cancer patientshad the lowest mean GHS score of 49.2 (p=0.044). Patients at very advanced stages of cancer featured a low GHS mean score of 52.2 (p<0.001). Conclusions: The present study identified many demographic and disease related factors which may contribute to the HRQoL of cancer patients, pointing to the necessity for improved management of disease symptoms and provision of psychological and financial support.

Retrograde Analysis of Complications of Jejunal Free Flap after Total Pharyngo-Laryngo-Cervical Esophagectomy in Advanced Hypopharyngeal Cancer Treatment (하인두암에서 후두인두 및 경부 식도 전 적출술 후 유리 공장 이식술의 합병증에 대한 후향적 분석)

  • Min, Hyun-Jin;Hyun, Dong-Woo;Kim, Young-Ho;Choi, Eun-Chang;Kim, Kwang-Moon;Kim, Se-Heon
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.43-46
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    • 2008
  • Hypophayngeal cancers are usually diagnosed in advanced stages and in many cases, they need total pharyngocervical esophagectomy and surgical reconstruction. Among many surgical reconstructive methods, jejunal free flap has anatomical and functional advantages such as tubed nature, peristaltic activity, excellent blood supply. In this study we analysed the surgical procedure and complications of jejunal free flap after total pharyngo-cervical esophagectomy. 20 cases performed jejunal free flap from 1995 to 2007 at Severance Hospital were reviewed. According to time of onset, early and late complications were reviewed. Surgical procedure was reviewed with operation record. Oral diet tolerance was reviewed on the basis of pharyngogram and subjective symptoms. The most common complication was stricture, and it occurred in 40% of cases and 63% of them were managed with conservative care. As early complication, fistula formation was all managed with conservative care. Oral feeding tolerance after jejunal free flap was 65% and 7 patients were tolerable to general diet. In our study, stricture was the most common complication and its management is important in post op oral diet tolerance.

Prostate Cancer Screening in a Healthy Population Cohort in Eastern Nepal: an Explanatory Trial Study

  • Belbase, Narayan Prasad;Agrawal, Chandra Shekhar;Pokharel, Paras Kumar;Agrawal, Sudha;Lamsal, Madhab;Shakya, Vikal Chandra
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2835-2838
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    • 2013
  • Background: Prostate cancer features a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in males. Objective: To explore the situation of prostate cancer in a healthy population cohort in Eastern Nepal. Materials and Methods: This study was conducted in the Department of General Surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal from July 2010 to June 2011. Males above 50 years visiting the Surgical Outpatient Department in BPKIHS were enrolled in the study and screening camps were organized in four Teaching District Hospitals of BPKIHS, all in Eastern Nepal. Digital rectal examination (DRE) was conducted by trained professionals after collecting blood for assessment of serum prostatic specific antigen (PSA). Trucut biopsies were performed for all individuals with abnormal PSA/DRE findings. Results: A total of 1,521 males more than 50 years of age were assessed and screened after meeting the inclusion criteria. The vast majority of individuals, 1,452 (96.2%), had PSA ${\leq}4.0$ ng/ml. Abnormal PSA (>4 ng/ml) was found in 58 (3.8%). Abnormal DRE was found in 26 (1.72%). DRE and PSA were both abnormal in 26 (1.72%) individuals. On the basis of raised PSA or abnormal DRE 58 (3.84%) individuals were subjected to digitally guided trucut biopsy. Biopsy report revealed benign prostatic hyperplasia in 47 (3.11%) and adenocarcinoma prostate in 11 (0.73%). The specificity of DRE was 66.0%with a sensitivity of 90.9% and a positive predictive value of 38.5%. The sensitivity of PSA more than 4ng/ml in detecting carcinoma prostate was 100% and the positive predictive value for serum PSA was 19.0% Conclusions: The overall cancer detection rate in this study was 0.73% and those detected were locally advanced. Larger community-based studies are highly warranted specially among high-risk groups.

Fermented ginseng, GBCK25, ameliorates steatosis and inflammation in nonalcoholic steatohepatitis model

  • Choi, Naeun;Kim, Jong Won;Jeong, Hyeneui;Shin, Dong Gue;Seo, Jeong Hun;Kim, Jong Hoon;Lim, Chae Woong;Han, Kang Min;Kim, Bumseok
    • Journal of Ginseng Research
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    • v.43 no.2
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    • pp.196-208
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    • 2019
  • Background: Nonalcoholic steatohepatitis (NASH) is one of the chronic inflammatory liver diseases and a leading cause of advanced liver fibrosis, cirrhosis, and hepatocellular carcinoma. The main purpose of this study was to clarify the effects of GBCK25 fermented by Saccharomyces servazzii GB-07 and pectinase, on NASH severity in mice. Methods: Six-wk-old male mice were fed either a normal diet (ND) or a Western diet (WD) for 12 wks to induce NASH. Each group was orally administered with vehicle or GBCK25 once daily at a dose of 10 mg/kg, 20 mg/kg, 100 mg/kg, 200 mg/kg, or 400 mg/kg during that time. The effects of GBCK25 on cellular damage and inflammation were determined by in vitro experiments. Results: Histopathologic analysis and hepatic/serum biochemical levels revealed that WD-fed mice showed severe steatosis and liver injury compared to ND-fed mice. Such lesions were significantly decreased in the livers of WD-fed mice with GBCK25 administration. Consistently, mRNA expression levels of NASH-related inflammatory-, fibrogenic-, and lipid metabolism-related genes were decreased in the livers of WD-fed mice administered with GBCK25 compared to WD-fed mice. Western blot analysis revealed decreased protein levels of cytochrome P450 2E1 (CYP2E1) with concomitantly reduced activation of c-Jun N-terminal kinase (JNK) in the livers of WD-fed mice administered with GBCK25. Also, decreased cellular damage and inflammation were observed in alpha mouse liver 12 (AML12) cells and RAW264.7 cells, respectively. Conclusion: Administration of GBCK25 ameliorates NASH severity through the modulation of CYP2E1 and its associated JNK-mediated cellular damage. GBCK25 could be a potentially effective prophylactic strategy to prevent metabolic diseases including NASH.

A Study on the Perception of Communication Between Doctors and Nurses in Advanced General Hospital (상급 종합병원 내 의사, 간호사 간 의사소통 인식에 대한 조사연구)

  • Yoo, Mi-Ja
    • Journal of Industrial Convergence
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    • v.20 no.1
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    • pp.77-86
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    • 2022
  • This study is a descriptive research study to understand the level of communication awareness between doctors and nurses, who are professional medical professionals, and the detailed areas and satisfaction of communication. Data were collected from 372 doctors and nurses at general hospitals located in C city from March to May 2021. The collected data were analyzed with descriptive statistics, mean and standard deviation, t-test, ANOVA, Scheffe test, and correlation analysis, using the SPSS/WIN 20.0 program. As a result, there was a difference in the awareness level of communication between doctor and nurse groups. Specifically, out of the detailed areas of communication recognized by doctors and nurses, there were statistically significant differences in openness(t=9.91), mutual understanding between occupations(t=5.25), and satisfaction(t=8.13) between the two groups. In addition, a positive correlation was found between the detailed areas and the communication satisfaction in both groups, showing that nurses have higher communication satisfaction with the higher openness(r=.72, p<.001), mutual understanding between occupations(r=.71, p<.001) and similarly, doctors also have higher communication satisfaction with the higher mutual understanding between occupations(r=.79, p<.001), timeliness(r=.73, p<.001). Therefore, these result suggest that it is necessary to develop a communication program that can effectively improve the weak areas such as mutual understanding between occupations and openness in nurses and doctors in order to ensure patient safety and provide quality medical care.

An Ethical Consideration on the Standard Operating Procedure Operation Status and the Ethical Review of the Vulnerable Research Subjects of Institutional Review Board, a Medical Institution in Korea (우리나라 의료기관 Institutional Review Board의 취약한 연구 대상자 관련 표준운영지침서 운영 현황과 윤리적 고찰)

  • Eun Hwa Byun;Byung In Choe
    • The Journal of KAIRB
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    • v.5 no.1
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    • pp.21-32
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    • 2023
  • Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

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Differences in the cardiovascular change in normal and obese according to treadmill exercise (트레드밀 운동에 따른 정상인과 비만인의 심혈관계 변화 차이)

  • Kyung-jin Lee;Young-jun Kim;Sung-hwan Ji;Jeongwoo Jeon;Jiheon Hong;Jaeho Yu;Jinseop Kim;Seong-Gil Kim;Dongyeop Lee
    • Journal of Advanced Technology Convergence
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    • v.2 no.2
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    • pp.39-47
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    • 2023
  • The purpose of this study is to examine the difference in cardiovascular changes between obese people and the general public using a treadmill. This study was conducted by recruiting 32 adult males who had no experience in hospital visits or treatment due to cardiovascular disease. The subjects were divided into an obese group and a general group based on BMI 25 and performed treadmill exercise for 12 minutes. SBP, DBP, HR, MAP, and PP before and after the treadmill were measured to see the difference in cardiovascular system changes. Data analysis was evaluated using an independent t-test. In the case of SBP, MAP, and PP, there were significant differences between groups (P<0.05). For DBP and HR, no significant difference was found between the two groups (P>0.05). The subjects of this study consisted only of healthy adult males in their 20s, and there is a limitation in that it was performed in a short time.

Case Report of Partial Endocardial Cushion Defect with Mild Pulmonary Hypertension in Old Age (경증의 폐동맥 고혈압을 동반한 고령에서의 심내막상 결손 환자 치험 1예)

  • Kim Woo-Shik;An Jae-Bum;Song Chang-Min;Kim Mi-Jung;Jung Sung-Chol;Shin Yong-Chul;Kim Byung-Yul;Kim In-Sub
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.633-636
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    • 2006
  • The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

The Exploratory Analysis on the Registry Data of Patients with Low Back Pain Applying Correlation Analysis Method (Correlation 분석 기법을 적용한 요통 환자에 관한 레지스트리 데이터의 탐색적 분석)

  • Park, Chang-Hyun;Park, Mu-Sun;Kim, Hyung-Suk;Cha, Yun-Yeop;Kim, Soon-Joong;Ko, Youn-Suk;Oh, Min-Seok;Hwang, Eui-Hyoung;Shin, Byung-Cheul;Kim, Chang-Eop;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.4
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    • pp.97-109
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    • 2017
  • Objectives The aim of this study is to analyze the patients who have low back pain through registry. Methods We registered patients with low back pain who visited department of korean rehabilitation medicine in university hospitals on study. We collected data from 116 subjects consisted of 51 inpatients and 65 outpatients and ruled out 8 who didn't have pattern identification data at the point of inpatient or outpatient visit so we analyzed 108 in total. We used Pearson's product moment correlation to find correlationship among variables, and analyzed statistical data using Phyton scipy library stats package. Results We set general features, region of the pain, physical examination, ROM, questionnaire results, pattern identification as variables and draw a conclusion by analyzing these variables. Conclusions Registry aimed at low back pain patients was established in department of korean rehabilitation medicine of university hospitals and exploratory analysis based on data were made. Through the registry, we expect that more advanced studies will be performed; for example, executing research which verifies effectiveness and stability of korean medical treatment or developing tools to fill the gap between pattern identification and disease identification.