• Title/Summary/Keyword: Clinical Practice Stress

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Preventive Strategies of Ventilator Associated Pneumonia

  • Kim, Jin-A;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.42-55
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    • 2009
  • Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

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A Meta-analysis of the Variables related to the Major Satisfaction of Nursing students. (국내 간호대학생의 전공만족도 관련변인에 대한 체계적 고찰과 메타분석)

  • Kim, Shin Hyang;Baek, Min Ja
    • Journal of Korean Public Health Nursing
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    • v.33 no.3
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    • pp.409-419
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    • 2019
  • Purpose: Factors related to the major satisfaction of nursing students were systematically searched and quantitatively synthesized. Methods: Meta-analysis was conducted upon 47 articles in Korean master and doctorate degree dissertations and academic journals. Meta-analysis of major satisfaction-related variables was conducted using Comprehensive Meta-Analysis (CMA) 2.0 program. The effect size of the related variables was analyzed by converting the statistic r value to Fisher's Z. Results: The overall average effect size of major satisfaction was the largest effect size (ES=.49), followed by cognitive factors (ES=.58), affective factors (ES=.45), and psychomotor factors (ES=.31). The cognitive factors were in the order nursing professionalism(ES=.70), nurse's image (ES=.65), and critical thinking disposition (ES=.36). The affective factors were self-esteem (ES=.59), emotional intelligence (ES=.55), career identity (ES=.49), self-efficacy (ES=.48), college adjustment (ES=.45), practice satisfaction (ES=.45), resilience (ES=.42), (ES=.40), grit (ES=.34), and stress (ES=.26). The psychomotor factors were clinical performance ability (ES=.38) and career search behavior (ES=.31). Conclusion: The results of this study are valuable when giving consideration to the variables related to nursing students' major satisfaction, for developing a strategic model to enhance the satisfaction of nursing students.

Comparison of Skin Stimulation Method and Topical Anesthetic Cream on Pain and Heart Rate Variability during Arteriovenous Fistula Puncture in Hemodialysis Patients (혈액투석 환자의 동정맥루 천자 시 피부자극법과 국소마취크림 도포에 따른 통증과 심박변이도 비교)

  • Kang, Hyo Young;Chae, Young Ran
    • Journal of Korean Biological Nursing Science
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    • v.21 no.3
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    • pp.207-216
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    • 2019
  • Purpose: The purpose of this was to compare effects of application of the skin stimulation method and topical anesthetic cream on pain, heart rate variability and satisfaction according to nursing intervention methods during arteriovenous fistula puncture in chronic renal failure hemodialysis patients. Methods: This study was a crossover design. Participants were 36 patients with chronic renal failure receiving hemodialysis treatment. Two forms of intervention were applied to participants, and then pain and heart rate variability were measured during the puncture. Results: There were no statistically significant differences according to each treatment in vein pain and artery pain. Also, there were no statistically significant differences according to each treatment in stress index, sympathetic activity (LF), parasympathetic activity (HF) and sympathetic activity/parasympathetic activity (LF/HF ratio). Satisfaction with application of skin stimulation method was statistically higher than that of topical anesthetic cream application. Conclusion: This suggests that application of the skin stimulation method complements disadvantages of topical anesthetic cream application and demonstrates possibility of application as a nursing intervention method which can be conveniently used by nurses in clinical practice.

Concept Analysis of Clinical Nurse's Self-Efficacy (병원 간호사의 자기효능감에 대한 개념분석)

  • Kim-Su Jin;Yoon So Yeon;Lee Bo Ram;Hong Jin Ha;Hwang Do Hyeon;Yoo Seul Gee;Shin-Na Yeon
    • Journal of Digital Policy
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    • v.2 no.3
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    • pp.25-32
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    • 2023
  • This study was done clarify the concept of clinical nurse's self-efficacy. This study was conducted using Walker & Avant's concept analysis framework, There were five aspects of the concept of Clinical Nurse's Self-Efficacy: To have faith and expectation that nurses can overcome stress and adversity in the clinical environment, To have a clear direction by believing that nurses themselves have the ability to perform nursing tasks, Allowing nurses to continue their work by believing that they have appropriate judgment to control various situations in clinical practice, Having a challenging sense of goal and motivating for the future through active participation in nursing work, and influencing various aspects from individual nurses to patients and hospital organizations. This conceptual analysis of clinical nurses' self-efficacy can recognize the need to prepare an educational system to improve nurses' self-efficacy and conduct related research.

Latent Profile Analysis of PTSD symptoms and PTG among Adults in South Korea: the Differences in Binge Eating, Non-Suicidal Self-Injury, and Problem Drinking Behaviors (잠재프로파일분석(LPA)을 활용한 PTSD 증상과 외상 후 성장 수준의 양상: 폭식, 비자살적 자해, 문제성 음주행동에서의 차이)

  • DeokHee Lee;DongHun Lee;HayoungJung
    • Korean Journal of Culture and Social Issue
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    • v.25 no.4
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    • pp.325-351
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    • 2019
  • The present study examined patterns of co-occurrence between DSM-5 posttraumatic stress disorder(PTSD) symptoms and posttraumatic growth(PTG) among Korean populations(n= 860). Latent profile analysis was used to identify subclasses and suggested that the 3-class model fit best: (1) Low PTSD/Mild PTG group (2) Low PTSD/High PTG group; (3) High PTSD/High PTG group. Class membership was predicted by demographic variables, social isolation, and frequency of traumatic experiences. Classes also differed with respect to self-destructive behaviors(binge eating, non-suicidal self-injury, and problem drinking). These findings contribute to future research about the coexisting patterns of PTSD and PTG, and to identify high-risk individuals who suffer from trauma-related problems in clinical practice.

Coenzyme Q10: a progress towards the treatment of neurodegenerative disease

  • Kumar, Peeyush;Kumar, Pramod;Ram, Alpana;Kuma, Mithilesh;Kumar, Rajeev
    • Advances in Traditional Medicine
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    • v.10 no.4
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    • pp.239-253
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    • 2010
  • Coenzyme $Q_{10}$ ($CoQ_{10}$, or ubiquinone) is an electron carrier of the mitochondrial respiratory chain (electron transport chain) with antioxidant properties. In view of the involvement of $CoQ_{10}$ in oxidative phosphorylation and cellular antioxidant protection a deficiency in this quinone would be expected to contribute to disease pathophysiology by causing a failure in energy metabolism and antioxidant status. Indeed, a deficit in $CoQ_{10}$ status has been determined in a number of neuromuscular and neurodegenerative disorders. Primary disorders of $CoQ_{10}$ biosynthesis are potentially treatable conditions and therefore a high degree of clinical awareness about this condition is essential. A secondary loss of $CoQ_{10}$ status following HMG-CoA reductase inhibitor (statins) treatment has been implicated in the pathophysiology of the myotoxicity associated with this pharmacotherapy. $CoQ_{10}$ and its analogue, idebenone, have been widely used in the treatment of neurodegenerative and neuromuscular disorders. These compounds could potentially play a role in the treatment of mitochondrial disorders, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, Friedreich's ataxia, and other conditions which have been linked to mitochondrial dysfunction. This article reviews the physiological roles of $CoQ_{10}$, as well as the rationale and the role in clinical practice of $CoQ_{10}$ supplementation in different neurological diseases, from primary $CoQ_{10}$ deficiency to neurodegenerative disorders. These will help in future for treatment of patients suffering from neurodegenerative disease.

Memory of Pain and Preemptive Analgesia (통증의 기억과 선행진통)

  • Song, Sun-Ok
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.12-20
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    • 2000
  • The memory of pain can be more damaging than its initial experience. Several factors arc related the directions of pain memory: current pain intensity, emotion, expectation of pain, and peak intensity of previous pain. The possible mechanisms behind the memory of pain are neuroplastic changes of nervous system via peripheral and central sensitization. Peripheral sensitization is induced by neurohumoral alterations at the site of injury and nearby. Biochemicals such as K+, prostaglandins, bradykinin, substance P, histamine and serotonin, increase transduction and produce continuous nociceptive input. Central sensitization takes place within the dorsal horn of spinal cord and amplifies the nociceptive input from the periphery. The mechanisms of central sensitization involve a variety of transmitters and postsynaptic mechanisms resulting from the activations of NMDA receptors by glutamate. and activation of NK-1 tachykinnin receptors by substance-P and neurokinnin. The clinical result of peripheral and central sensitization is hyperalgesia, allodynia, spontaneous pain, referred pain, or sympathetically maintained pain. These persistent sensory responses to noxious stimuli arc a form of memory. The hypothesis of preemptive analgesia is that analgesia administered before the painful stimulus will prevent or reduce subsequent pain and analgesic requirements in comparison to the identical analgesic intervention administered after the painful stimulus, by preventing or reducing the memory of pain in the nervous system. Conventionally, pain management was initiated following noxious stimuli such as surgery. More recently, however many have endorsed preemptive analgesia initiated before surgery. Treatments to control postsurgical pain are often best started before injury activates peripheral nociceptors and triggers central sensitization. Such preemption is not achieved solely by regional anesthesia and drug therapy but also requires behavioral interventions to decrease anxiety or stress. Although the benefit of preemptive analgesia may not be obvious in every circumstance, and in many cases may not sufficient to abolish central sensitization, it is an appropriate and human goal of clinical practice.

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A literature study on the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) for patients with cancer (암환자의 성정(性情)과 심욕(心慾) 조절 방법에 대한 문헌적 고찰)

  • Jeon, Hyeonjin;Oh, Hyun-Joo;Lee, Sookyung
    • Journal of Sasang Constitutional Medicine
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    • v.30 no.4
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    • pp.11-21
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    • 2018
  • Objective The management of psychological distress in patients with cancer is a major concern in clinical practice. In this paper, we discussed how to apply the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) of Sasang constitutional medicine to patients with cancer. Methods We investigated the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) through the literature of " Gyukchigo (格致藁)", "Donguisusebowon-Sasangchobongyun (東醫壽世保元 四象草本卷)", "Donguisusebowon (東醫壽世保元) and "Dongmuyougo (東武遺稿)", and presented the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) for patients with cancer based on the clinical experience. Results We identified the equilibrium and harmony (中節) of sorrow-anger-joy-pleasure (喜怒哀樂) is the basis of treatment and suggested 'understanding of the others (知人)', 'understanding of the diseases (知病)' and 'knowing and acting (知行)' as methods to control of Seong-Jeong (性情) and covetous desire (心慾). The 'understanding of the others (知人)' and 'understanding of the diseases (知病)' could reduce the psychological distress. The 'knowing and acting (知行)' encourages the patients to overcome the covetous desire (心慾) and have a positive attitude to life and disease. Conclusion The controlling method of Seong-Jeong (性情) and covetous desire (心慾) of Sasang constitutional medicine could help cancer treatment controlling the psychological distress of patients with cancer, and could impact positively on the view of life and disease.

Safety and antifatigue effect of Korean Red Ginseng capsule: A randomized, double-blind and placebo-controlled clinical trial

  • Yang, Yi;Wang, Hong;Zhang, Ming;Shi, Mengxue;Yang, Cailing;Ni, Qiang;Wang, Qi;Li, Jing;Wang, Xuemei;Zhang, Chen;Li, Zhi
    • Journal of Ginseng Research
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    • v.46 no.4
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    • pp.543-549
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    • 2022
  • Background: In physical activity or labor, the human body is in a state of high intensity stress, and all parts or physiological functions of the body respond positively to maintain or balance the need for movement. The human body has many physiological changes in the process of movement, and fatigue is the external manifestation of various complex changes inside the human body. Fatigue is also a physiological mechanism of self-protection after the body reaches a certain level of activity, which can prevent the occurrence of life-threatening excessive functional failure. The generation of fatigue is a very complex process, and its mechanism has not been concluded yet. Therefore, it is an important work to search and screen the effective components of natural plants that have anti-fatigue effect and to explore their mechanism. Methods: This was a 8-week, randomized, double-blind, placebo-controlled clinical trial. A total of 110 subjects who passed physical examination were included according to the scheme design, and randomly divided into a test group which was given KRG and a placebo control group. The calculation is carried out according to the standard of sub-high-intensity exercise test. Results: There was no adverse effect on safety index of subjects after taking red ginseng capsule. After KRG treatment, subjective strength grade is significant lower than placebo treatment. Blood lactic acid content is significantly get lower after trial in KRG group, and significant lower than placebo group. Creatine phosphokinase(CK) content is significantly get lower after trial in KRG group, and significant lower than placebo group. Conclusion: According to the criterion in the test scheme, the result shows that KRG is helpful on relieving physical fatigue.

Factors influencing the transition shock of newly-graduated nurses (신규졸업간호사의 전환충격 영향요인)

  • Moon, Kil Je;Cho, Moo Yong
    • The Journal of Korean Academic Society of Nursing Education
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    • v.28 no.2
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    • pp.156-166
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    • 2022
  • Purpose: The purpose of this study was to identify factors that can affect transition shock in newly-graduated nurses. Methods: The first descriptive written survey was conducted on 450 graduate students from five nursing colleges. After their employment, the second survey was conducted on 316 participants who had responded to the first survey. A total of 158 respondents were used for the final analysis. Data were analyzed using an independent t-test, ANOVA, Tukey test, Pearson's correlation coefficient, and hierarchical multiple regression analysis with the SPSS Win 25.0 Program. Results: The average age of the participants was 24.25±4.47. Of the participants, 126 (79.8%) were satisfied that they had majored in nursing. The average score for transition shock was 2.61±0.55 points. Factors influencing the transition shock of newly-graduated nurses were the working department, working period, and working environment. The more positively the newly-graduated nurses perceived the nursing work environment, the less of a transition shock they experienced. Grade point average, clinical competence, confidence in performing core nursing skills, and nursing professionalism did not affect their transition shock. It could be confirmed that there is a gap between college nursing education and the clinical field. Conclusion: In order to reduce the transition shock of newly-graduated nurses, it is necessary to improve the nursing work environment and apply educational and emotional support strategies according to the characteristics of each work department and the period of work.