• 대한한방내과학회지
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• 제42권2호
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• pp.122-130
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• 2021

The purpose of this study is to report the effect of Korean medicine treatment on a pressure sore in a stroke patient. An 86-year-old female patient diagnosed with spontaneous intracerebral hemorrhage in the right basal ganglia had symptoms of left hemiparesis, dysphagia, and a 4.5-cm-by-2.5-cm left trochanteric pressure sore. Clinical outcomes were measured using the National Pressure Ulcer Advisory Panel (NPUAP) pressure injury stages, the Agency for Health Care Policy and Research (AHCPR) pressure ulcer stages, and the Braden scales. Treatment with Korean medicine, including acupuncture, herbal medicine, and dressing therapy, significantly improved the trochanteric pressure sore, as reflected by a NPUAP stage change from III to I, an AHCPR stage change from III to I, and a Braden scale change from 13 to 18. These findings suggest that Korean medicine treatment may be effective to treat pressure sores in stroke patients.

• 한국농촌간호학회지
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• 제15권2호
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• pp.66-73
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• 2020

Purpose: This study was done to report nursing case for ADL improvement of elders who have CVA(Cerebrovascular Accident) sequelae. Methods: The client had registered in the C visiting nursing center after being decided a long-term care Grade 2. Data were collected through consultation logs for recipients, Activities of Daily Living (ADL) records, fall risk assessment (Huhn) sheets, decubitus ulcer risk assessment (Braden Scale) sheets, cognition assessment (K-MMSE) sheets, long-term care benefit provision records, and interviews with visiting nurse. Data were collected and analyzed according to the Omaha System problem classification. The intervention scheme and the problem rating scale for performance were applied to present the case for home-visit nursing. Results: The client registered in August, 2018, was provided home-visit nursing care once a week as of September 2020. ADL, cognitive levels and decubitus ulcer risks were found to have improved. Conclusion: This case report presents the value of classifying nursing problems and checking nursing intervention provided to patients with problems of ADL. The presentation of home-visit nursing cases applying a standardized nursing problem classification scheme for clients with various problems showed that a high quality level of care is guaranteed and evidence-based nursing can be provided by visiting nurses.

• 대한간호학회지
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• 제23권4호
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• pp.617-630
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• 1993

Factors related to health promotion activities and quality of life in Korean women with arthritis have not been clearly identified. Predictors of health promotion might be identified that will enhance the well - being of this group. Accordingly, the findings of the study will contribute additional information about the relationship between health promotion and quality of life and will add to the research on quality of life of individuals with a leading cause of disability--arthritis. The purpose of the study was to examine the relationship of selected background factors (years of illness, perceived severity of illness, uncertainty in illness), perceived self- efficacy, and health promoting behaviors to the quality of life of Korean women with arthritis. A cross - sectional descriptive design was used in this study to investigate relationships among the variables of interest. The sample was composed of 96 women who had arhtrits and visited large university hospital in Seoul for regular check up or pre-scription of medication. The purpose of a descriptive correlational design was to determine the absence or presence of relationships among variables that were measurable (Polit & Hungler, 1981, p.147). The design of this study was appropriate because it yielded answers to the research questions and hypotheses regarding the relationships among the model variables. the Questionnaire contained demographic information, translated Mishel Uncertainty in illness Scale-Community form (MUIS-C) (Mishel, 1987), translated and modified Disease Course Graphic Scale(DCGS) which was developed by Braden (1990), translated Sherer. et al.’s General Self-Efficacy Scale (1982), The Health -Promoting Lifestyle Profile (HPLP), developed by Walker, Sechrist, and Fender (1987) and traslated to Korean by Ha, and quality of life was measured by Face Scale (Andrew, 1976). Several steps of verification for the translation process were carefully conducted. Data analysis included descriptive correlational statistics and multiple regression techniques. Health promotion was the only contributor to pre-dict quality of life. Results showed that enabling cognitive perceptual factor (self-efficacy) mediates the disruptive force (uncertainty in ill-ness) on achieving a health promoting self- help behavior. The findings of this study also indicated that illness - related variable of severity of illness was mediated by health promotion, which buffered it's impact on quality of life.

• 기본간호학회지
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• 제5권2호
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• pp.280-292
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• 1998

Pressure sores are a serious concerns in that respect to increasing risk of medical complications and medical costs. Prevention and care of pressure sores is an essential area of nursing practice. The nurse at ICU should be more careful of maintaining the skin integrity of patients especially than at any other place. This study was conducted to determine if the risk facotrs of pressure sores and nutritional status of the patients at risk for pressure sores is related the occurance of pressure sore. The risk group refers the patients having the below 14 scores of the braden scale. The 100 subjects were recruited from the ICU ward at an university hospital in Choongnam. The parameters for nutritional status are the blood chemistry including plasma protein, albumin, hemoglobin and the anthropometric measurements consisting of weight, BMI, LBM, the proportion of body fat, body fluid and triceps skin fold using bioimpedence analizer and caliper. The results are as follows : 1. The subjects were 55 years and stayed 8 days on average. Of the 100 subjects, males were 61%, neurologic/neurosurgical diseases were 68% and the incidence of pressure sores was 17% mainly occuring within 3days after the admission. 2. The present paralysis(or paraplegia) and edema(arm, leg, trunk) were showed more significantly the subjects with pressure sores than those without pressure sores. 3. Regarding with the nutritional status, the subjects with pressure sores had significantly lower the weight, BMI, LBM, body fluid, albumin than the ones without pressure sores. This results were supported the reports of previous studies that the decreased weight and albumin could be the important predictors of pressure sores. Thereafter we should encourage these factors to be utilized in predicting pressure sores for a comprehensive assessment. Nurse should identify patients at risk of the development of pressure sores, assess their nutritional status and dietary intake at regular intervals.

• 임상간호연구
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• 제18권1호
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• pp.29-38
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• 2012

Purpose: The purpose of this study was to examine the accuracy of general nurses' assessments of pressure ulcers in hospitalized patients. Methods: A total of 129 nursing records of assessments on pressure ulcers were analyzed. Assessment records of pressure ulcers by general nurses were compared to those by Wound, Ostomy, Continence Nurses (WOCN) on the same pressure ulcers. A WOCN of a nursing unit was a nurse certified by the hospital after completion of a formal WOCN course and passing a cyber education course, both offered by the hospital. The formal WOCN course was taught by an internationally certified WOCN. The inter-rater reliability among WOCNs was 98.2%. General nurses in this study did not receive a structured pressure ulcer education. Results: The accuracy for nursing assessment of pressure ulcers by general nurses compared to WOCNs' were evaluated in various ways and resulted in as follows; the existence of pressure ulcer 91.4%, site of pressure ulcer 85.3%, stage of pressure ulcer 85.3%, Braden scale 36.3%, size of pressure ulcer 51.9~64.3%, details of pressure ulcer 0~100%. Conclusion: The structured education about pressure ulcer assessment is important to enhance the accuracy of pressure ulcer assessment of hospitalized patients by general nurses.

• 대한간호학회지
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• 제47권6호
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• pp.794-805
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• 2017

Purpose: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. Methods: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. Results: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (${\pm}14.90$), 41.15 (${\pm}16.04$), 53.44(${\pm}24.67$), and 54.33 (${\pm}22.80$) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ${\geq}70$ years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ${\geq}36.5^{\circ}C$ (OR 3.12, 95% CI: 1.17~8.17); age ${\geq}70$ years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ${\geq}36.5^{\circ}C$ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. Conclusion: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.

• 한국의료질향상학회지
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• 제4권1호
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• pp.50-63
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• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.