• Title/Summary/Keyword: Care of address

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Delirium Management: Diagnosis, Assessment, and Treatment in Palliative Care (섬망의 돌봄: 완화의료 영역에서의 진단, 평가 및 치료)

  • Seo, Min Seok;Lee, Yong Joo
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.201-210
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    • 2016
  • Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

Perceptions of Quality Nursing care of Patients and Families (질적 간호에 대한 환자와 가족의 지각)

  • Chi, Sung-Ai;Kwon, Sung-Bok;Park, Eun-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.247-275
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    • 1998
  • The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

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Comparison of Root Cause Analysis Software for Investigating Patient Safety Incidents (환자안전사건 조사용 근본원인분석 소프트웨어의 비교)

  • Choi, Eun-Young;Lee, Hyeon-Jeong;Ock, Min-Su;Jo, Min-Woo;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.23 no.1
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    • pp.11-23
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    • 2017
  • Root Cause Analysis (RCA) has been widely used as a structured approach to investigate patient safety incidents. RCA helps identify what, how, and why something happened, therefore preventing recurrence of incidents. Since many quality tools can be used during RCA, various formats of RCA exist. If RCAs are performed incorrectly or incompletely, they are likely to produce unusable results. To address this issue, RCA software has been developed. The use of RCA software in investigating patient safety incidents may offer several advantages, such as potential reduction in learning time, shortening of the analytic process, facilitation of collection, analysis, and presentation of data and production of meaningful RCA reports. We introduced six healthcare RCA software and compared characteristics. Results from this study will enable the RCA team to choose proper RCA software.

Dimensions and Assessment of Korean Parenting Style (한국 부모의 자녀 양육방식에서의 차원과 평가)

  • 조복희;이진숙;이흥숙;권희경
    • Journal of the Korean Home Economics Association
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    • v.37 no.10
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    • pp.123-133
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    • 1999
  • The purpose of the study was to develop the parenting style scale which is reflecting cultural background of Korean parent's parenting for their children. The instalment was designed based on the literature reviews and on the Baumrind's parenting style. A total of three hundred and sixty two mothers whose children from first and second grade in elementary school completed the Questionnaires. The questionnaires consisted with the items addressing different types of parenting style which include love and care, encouragement of independence, enjoyment in parenting, communication, control, control of aggressiveness, strategies of control , request of maturity. Factor of analysis was applied to examine validity of Korean parenting style scale. Based on the factor analysis, 33 items selected for final questionnaire and two factors discovered. The first factor which named 'warmth'included 20 items such as love and care toward their children, communication, enjoyment in parenting, encouragement toward independency. The second factor which named'control'included 13 items such as control of children's behavior and discipline of children. Warmth factor accounted for 46% of variance and control factor accounted for 18% of variance. Internal consistency was also checked. Although warmth and control factor represented a moderate internal consistency, control factor showed lower correlations then warmth factor. The reliability estimates (Cronbach alpha) were. 87 and 71 for warmth and control factor respectively. Korean parenting style scale can be used to address the appropriateness of Baumrind's theoretical assumptions in parenting style as well as to examine parenting style for Korean population. However, this instalment was developed with Korean mothers only. Further analysis need to be addressed with fathers.

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The Concept of Academic Medicine and Its Potential Establishment in Korea (학술의학(Academic Medicine)의 개념과 한국에서의 정착 가능성)

  • Han, Hee Chul
    • Korean Medical Education Review
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    • v.21 no.2
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    • pp.63-72
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    • 2019
  • The purpose of this study was to introduce the concept of academic medicine to the medical societies of Korea and to identify any potential obstacles in the establishment of academic medicine in Korea. The core concepts of academic medicine include medical education, research, and patient care. Academic medicine can be practiced in the unique area of healthcare involving medical schools and teaching hospitals by faculty physicians in the academic medicine field. Through academic medicine, the next generation of healthcare professionals is trained, new discoveries can be made, and patients can find new hope for a cure. The flourishing of academic medicine has resulted in substantial advancements in medicine over the past few centuries, but at the turn of the 21st century, there was concern that academic medicine was on the decline. To address this concern, the International Campaign to Revitalize Academic Medicine was established and announced five scenarios to 2025 to debate the future of academic medicine. Although the system resembles that of Western medical societies, Korean medical societies were not familiar with academic medicine, and poor conditions caused by the distorted healthcare system in Korea have actually interfered with the nurturing of academic medicine. One of the main problems may include less interest in medical education and research relative to clinical practice by medical societies and the government. Collaborative efforts from both medical societies and the government are needed to establish academic medicine successfully in Korea for a better future.

Rehabilitative goals for patients undergoing lung retransplantation

  • Massimiliano Polastri;Robert M. Reed
    • Journal of Yeungnam Medical Science
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    • v.41 no.2
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    • pp.134-138
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    • 2024
  • Lung retransplantation (LRT) involves a second or subsequent lung transplant (LT) in a patient whose first transplanted graft has failed. LRT is the only treatment option for irreversible lung allograft failure caused by acute graft failure, chronic lung allograft dysfunction, or postoperative complications of bronchial anastomosis. Prehabilitation (rehabilitation before LT), while patients are on the waiting list, is recognized as an essential component of the therapeutic regimen and should be offered throughout the waiting period from the moment of listing until transplantation. LRT is particularly fraught with challenges, and prehabilitation to reduce frailty is one of the few opportunities to address modifiable risk factors (such as functional and motor impairments) in a patient population in which there is clearly room to improve outcomes. Although rehabilitative outcomes and quality of life in patients receiving or awaiting LT have gained increased interest, there is a paucity of data on rehabilitation in patients undergoing LRT. Frailty is one of the few modifiable risk factors of retransplantation that is potentially preventable. As such, it is imperative that professionals involved in the field of retransplantation conduct research specifically exploring rehabilitative techniques and outcomes of value for patients receiving LRT, because this area remains unexplored.

Prevalence and Risk Factors of Unmet Healthcare Needs among Korean Adults with Hypertension (한국인 고혈압 환자의 의료접근성 및 미 충족 의료실태와 위험요인 분석)

  • Oh, Heeyoung;Gil, Eunha
    • Korean Journal of Adult Nursing
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    • v.29 no.1
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    • pp.22-31
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    • 2017
  • Purpose: The purposes of this secondary analysis study was to examine prevalence, risk factors and unmet healthcare needs among adults with hypertension. Methods: A sample of 3,386 adults over the age of 40 with hypertension were drawn from the Korea Health Panel Study (2013). Using SPSS 22.0 version, descriptive statistics including frequency, percentage, chi-square and logistic regression were performed. Results: Results showed that 18.9% of the sample reported unmet healthcare needs with the most frequently cited one was financial burdens (43.2%). The reported experiences of unmet healthcare needs differed by gender, marital status, vision or hearing impairment, memory problem, impaired mobility, subjective health status, total family income, depressive episode and the difficulty in making decisions. The sample participants were more likely to report unmet healthcare if they had vision impairment, low income and perception that their health status as moderate to poor. Those without vision impairment were less likely to report unmet healthcare needs. Conclusion: The identified risk factors of unmet healthcare needs should be addressed which would enhance access both to health care and to resolution of unmet healthcare needs. Since visual ability seems to impact perception of unmet healthcare needs, it may be useful to find ways to address this factor.

Current concepts of Laser dentistry (임상가를 위한 특집2 - Current concepts of Laser dentistry)

  • Eun, Hee-Jong
    • The Journal of the Korean dental association
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    • v.49 no.11
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    • pp.670-678
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    • 2011
  • Various sorts of dental devices for the dental treatment have been introduced and adopted during past several years. Dental Laser, among all devices, seems to be possible for applying to over the whole treatments and widely employed. Furthermore, this article is to introduce that Dental Laser is intended to care patients secured with the effectual treatment against Conventional procedures based upon its studies. The advantages of Dental Laser treatment-along with LLLT (Low Level Laser Therapy) effect, biostimulation effect, and minimal invasive technique - make the patients reduce their fear of the operation, lighten the inconvenience of post operation, and shorten the treatment period. In particular, it is worth considering that the use of laser-assisted therapies is associated with a marked reduction in the use of analgesics and anti-inflammatory medications compared with conventional procedures. This article is to state advantages and differences of Dental Laser treatment compared with Conventional procedures, and to emphasize to become well-acquainted with the precautions for safety and effective Dental Laser treatment. In case of operating Dental Laser with lack of the instructions, it will cause the unpredicted fatal results; therefore this treatment requires special care in its operation. Henceforward, it is anticipated that infinite treatment protocols will be introduced by applying Dental Laser, and this is to address the utilization of Dental Laser.

Green and Healthy Living in a High-rise, High Density Urban Environment: The Hong Kong Housing Authority's Experience

  • Fung, Ada Y.S.
    • Land and Housing Review
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    • v.5 no.3
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    • pp.131-136
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    • 2014
  • The Hong Kong Housing Authority (HKHA) develops and implements a public housing programme to meet the housing needs of people who cannot afford private rental housing. The HKHA has an existing stock of about 740,000 public rental flats (PRH). According to the 2014 Policy Address, the Government aims to provide an average of about 20,000 PRH units and about 8,000 Home Ownership Scheme (HOS) units per year. We care for the environment. In developing new housing estates, we conduct thorough environmental studies such as microclimate studies and air ventilation assessment, and use passive design to harness the natural characteristics of our sites. We employ environment-friendly design and construction methods, using modular flat design, pre-cast and pre-fabricated construction techniques as well as recycled, green construction materials. We conduct Carbon Emission Estimation for all our projects, conserve the use of natural resources and reduce wastes throughout the life cycle of buildings. We care for people. We adopt the principles of Universal Design and Barrier Free Access for the convenience and welfare of people of all ages and abilities. We carry out Community Engagement to collect stakeholders' views and aspirations, and incorporate them in the design of our projects. We also carry out surveys of residents' views after the occupation of new estates to gauge our success and identify areas for improvement.

The COVID-19 Correspondence Work Experience of Community Health Practitioners (보건진료 전담공무원의 코로나19 대응경험)

  • Ha, Jae-Hyun;Lee, Hyun-Ju
    • Research in Community and Public Health Nursing
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    • v.33 no.2
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    • pp.139-152
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    • 2022
  • Purpose: This study aims to describe and understand the meaning and nature of community health practitioners' coping with COVID-19. Methods: In-depth interviews were conducted with 12 community health practitioners from August to October 2021, to describe and understand the nature of their coping with COVID-19. The collected data were examined and described based on Colaizzi's phenomenological method. Results: 16 theme clusters and five categories were derived from the community health practitioners' experience of coping with COVID-19. The categories derived were: a war that began without notice, a variety of correspondence tasks assigned, struggling to fulfill given roles, correspondence tasks becoming more systematic, and a fight that has not yet ended. Conclusion: Community health practitioners handled various response tasks related to COVID-19, and faithfully fulfilled their professional roles while performing the primary task of medical care. Hence, attention is required on issues related to the establishment of the national emergency healthcare system and improvement of professional competence of community health practitioners even after the COVID-19 pandemic is over. Furthermore, it is necessary to make ceaseless efforts to address those issues and, in order to do so, social interest and institutional support are needed.