• Acute and Critical Care
• /
• 제33권4호
• /
• pp.197-205
• /
• 2018

Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.

• 지역사회간호학회지
• /
• 제15권2호
• /
• pp.308-322
• /
• 2004

Purpose: 'The purpose of the present study was to understand students' experiences from their standpoint, to identify relevant variables and to examine into their relations by analyzing and describing what phenomenon 'nursing students' visiting ambulatory bathing service' is, what are the reasons for the phenomenon, and what interactions are in the phenomenon. Method: The subjects were thirteen students. Data were collected through in-depth interviews and analyzed by Strauss and Corbin's analysis method. Result: With regard to ambulatory bathing service, participants responded 'lack of education', 'inexperienced personal relations' and 'disappointment with recipients families'. They recognized 'burden' and 'compassion'. The intensity of generated 'burden' and 'compassion' was determined by volunteering persons, the degree of health care service, recipients' response and interaction of climate. When 'burden' and 'compassion' were generated, participants selected their own coping strategies. Strategies in the situation of 'burden' and 'compassion' were significantly influenced by 'burden' and 'compassion' and structural situation - 'mutual relation structure,' 'volunteers' capability,' 'the degree of volunteering guidance,' 'community participation,' 'recipients' environment,' 'information sharing,' 'special vehicle equipment' and 'economical burden.' Strategies include' service training,' 'receiving volunteering training,' 'preliminary service preparation,' 'volunteering.' 'connection to local medical center,' 'intention,' 'information sharing,' 'passive response to recipients' appreciation' and 'the understanding of publicity'. The results of selected 'burden' and 'compassion' are described with 'worthiness' and 'cohesion' as follows. Conclusion: This study is significantly meaningful in that it examined bathing service welfare in its initial stage. There are not much outcome from previous studies. However. it is meaningful that this study intended to develop theories on the nature of experiences and the relations among concepts derived from the visiting ambulatory bathing service process of nursing students. Professors who taught social volunteering in universities understood the experience of nursing students who did the visiting ambulatory bathing service. Consequently, professors will provide an effective instruction to enable these students to carry out visiting ambulatory bathing services efficiently in order to meet demands when they conduct the services. For the volunteering service activity in major-related fields among college students' social volunteering activities, they recognized the necessity of systematic education and preparation.

• 한국콘텐츠학회논문지
• /
• 제22권7호
• /
• pp.384-394
• /
• 2022

본 연구에서는 코로나19 이후 복지대상자들의 인구사회학적 특성(성별, 자녀유무, 가구형태)에 따른 생활 및 건강 문제들을 세밀하게 분석하여, 보다 실질적이고 구체적인 복지정책 및 서비스의 방향을 제시하고자 하였다. 서울시 𐩒𐩒구에 거주하는 행복e-음 대상자 중 500명을 무작위로 선정하여, 대상자의 전반적인 생활영역, 신체적, 정신적 건강 등에 대한 설문조사를 실시하였고, 분석방법은 t-test와 ANOVA분석, 교차분석을 실시하였다. 분석 결과 고용과 자녀 돌봄, 여가 및 문화활동, 전반적인 사회활동의 제한과 관련된 어려움에서 성별과 자녀유무 또는 가구형태에 따른 차이가 있는 것으로 나타났다. 건강상태와 관련해서는 코로나19 이전 보다 이후에 정신건강 상태가 나빠진 것으로 나타났고, 전반적인 삶의 만족도도 낮아진 것으로 나타났다. 또한 코로나블루와 죽음에 대한 생각과 관련해서 집단 간 차이가 있는 것으로 나타났다. 이러한 연구 결과를 토대로 코로나19 이후 뉴노멀 사회에서 필요한 복지서비스의 방향에 대해 제언하였다.

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

• 보건행정학회지
• /
• 제32권3호
• /
• pp.258-271
• /
• 2022

The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.

• Tuberculosis and Respiratory Diseases
• /
• 제82권4호
• /
• pp.348-356
• /
• 2019

Background: Recently, the number of lung transplants in South Korea has increased. However, the long-term outcome data is limited. In this study, we aimed to investigate the long-term outcomes of adult lung transplantation recipients. Methods: Among the patients that underwent lung transplantation at a tertiary referral center in South Korea between 2008 and 2017, adults patient who underwent deceased-donor lung transplantation with available follow-up data were enrolled. Their medical records were retrospectively reviewed. Results: Through eligibility screening, we identified 60 adult patients that underwent lung (n=51) or heart-lung transplantation (n=9) during the observation period. Idiopathic pulmonary fibrosis (46.7%, 28/60) was the most frequent cause of lung transplantation. For all the 60 patients, the median follow-up duration for post-transplantation was 2.6 years (range, 0.01-7.6). During the post-transplantation follow-up period, 19 patients (31.7%) died at a median duration of 194 days. The survival rates were 75.5%, 67.6%, and 61.8% at 1 year, 3 years, and 5 years, respectively. Out of the 60 patients, 8 (13.3%) were diagnosed with chronic lung allograft dysfunction (CLAD), after a mean duration of $3.3{\pm}2.8years$ post-transplantation. The CLAD development rate was 0%, 17.7%, and 25.8% at 1 year, 3 years, and 5 years, respectively. The most common newly developed post-transplantation comorbidity was the chronic kidney disease (CKD; 54.0%), followed by diabetes mellitus (25.9%). Conclusion: Among the adult lung transplantation recipients at a South Korea tertiary referral center, the long-term survival rates were favorable. The proportion of patients who developed CLAD was not substantial. CKD was the most common post-transplantation comorbidity.

• 가정∙방문간호학회지
• /
• 제13권1호
• /
• pp.5-15
• /
• 2006

Purpose : This study was done to examine the home care service provided by home care nurses and the level of client satisfaction in community. Method : Data were collected from 120 clients who received the home care service at the community home care service center in Pusan from 2th May. 2003 to 31th May 2003. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale by Kim. Data were analyzed by using SPSS/WIN 10.5 program. Result: 1) 67.5% among 120 clients was over sixty years old and 30.6% of clients received home visits 20 times by home care nurse. 2) The total number of home care services was 15,783. And most of the clients received therapeutic nursing care. 3) The mean score of satisfaction on provided home care services was 3.31, among 16 items, "The home care nurses kept up the secret of patients and family" was the highest($3.67{\pm}0.48$). the total level of satisfaction of home care services was very high, with mean score $3.31{\pm}0.32$. Conclusion : The satisfaction level of home care services was very high. so we can expect that the prospect of home care services is very challengeable. Therefore we should try to expand the service recipients with promotional education to assure close ties with the public health centers for the continuous home care service linking and make more efforts to improve the quality of the service.

• 가정∙방문간호학회지
• /
• 제10권1호
• /
• pp.73-84
• /
• 2003

This study was done to examine the home care service provided by home care nurses and the level of client satisfaction. Data were collected from 110 clients who received the home care service at the P-hospital in Pusan from 23th April, 2001 to 30th November, 2002. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale. Data was analyzed by using SPSS/WIN 10.5 program, the results of this study are summarized as follows; 1) 77.3% among 110 clients were over sixty years old. By the disease pattern. subjects were distributed into cancer(52.7%), cerebro-vascular disease(22.7%) and the others. 36.4% of clients were received home visits from 10 to 20 times by home care nurse. 2) The total number of home care services was 20,828. And most of the clients received the health education and training. 3) The mean score of satisfaction on provided home care services was $3.36\pm0.45$, out of 4. among 16 items. 'The home care nurses were kind enough' was highest ($3.59\pm0.49$), the total level of satisfaction of home care services was very high. with total mean score $53.84\pm7.16$. As mentioned above. the satisfaction level of home care services was very high. so we can except that the prospect of home care services is very challengeable. Therefore. we should try to expand the service recipients with promotional education to the home care clients under the cooperation with medical staff and make more efforts to develop the management system about clients' information. to improve the quality of the service, to assure close ties with the public health centers for the continuous home care service linking.

• 보건행정학회지
• /
• 제19권2호
• /
• pp.51-70
• /
• 2009

Background : Previous studies have reported that enhanced continuity of care prevented a sudden worsening in progress among chronic disease patients, and as a result was favorable for efficient spending of health care funds. This study aims to estimate the continuity of care of Korean with diabetes and to identify factors affecting the continuity of care. Methods : This study used the Korean National Health Insurance Claims Database which includes E11 (ICD-10) as a primary or secondary disease as of 2006. Study population is 1,160,725 type 2 diabetics (20-84 years). Continuity of Care Index (COC), Modified, Modified Continuity Index (MMCI), and Most Frequent Provider Continuity (MFPC) were used as indexes of continuity of care. Results : The continuity of care in the study population was $0.94{\pm}0.10$ as calculated by MMCI, $0.91{\pm}0.16$ as calculated by MFPC and $0.86{\pm}0.23$ as calculated by COC. The lower continuity of care was shown in the patients who were female, 65 and over years old, Medical Aid recipients, 13 times or more visitors, hospital users as main attending medical institution, patients experienced hospitalizations or comorbidities. Conclusion : The continuity of care for adult patients with type 2 diabetes was high in Korea, and showed variation according to patients' characteristics. This result provides empirical evidence for policymakers to develop or strengthen programs for managing patients showing low continuity of care.

• 한국콘텐츠학회논문지
• /
• 제12권12호
• /
• pp.282-290
• /
• 2012

현재 우리나라의 재가간호서비스는 보건소의 맞춤형 방문건강관리사업과 의료기관 가정간호사업, 그리고 노인장기요양보험의 방문간호서비스의 독립성과 전문성을 인정하면서, 각 영역간의 연계를 통해 사업의 중복성을 최소화하는 연계방안이 필요한 상황이다. 이에 본 연구는 재가간호서비스의 연계방안을 도출하기 위해 전문가들의 의견을 바탕으로 합의를 이끌어내는 델파이 기법을 활용하였다. 그 결과 제도적 차원의 연계와 의료적 차원의 연계라는 두 영역 안의 총 24개 항목이 연계방안으로 도출되었다. 재가간호서비스의 연계방안으로 도출된 24개의 항목은 재가간호사업 체계의 개선과 제공되는 서비스 질의 향상, 대상자의 만족도 증대 효과를 가져 올 수 있을 것으로 기대되며, 서비스의 중복을 최소화할 수 있는 방안을 모색함으로서 국가적 차원에서 복지 및 국민 건강관리의 효율성을 증대할 것으로 보인다. 이를 통해 궁극적으로 국민의료비의 절감과 더불어 재가간호서비스 증진에 기여할 것으로 여겨진다.