• Title/Summary/Keyword: Clinical nursing

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A study on cow's milk and nursing method in relation to iron deficiency (모유 수유아와 생우유를 먹인 아기의 철분결핍에 관한 연구)

  • Kang, Ji Ung;Jin, So Hee;Choi, Kyung Dan;Jang, Young Taek
    • Clinical and Experimental Pediatrics
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    • v.49 no.2
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    • pp.144-149
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    • 2006
  • Purpose : This study investigated the breast-feeding period, the milk bottle-using period, the age of cow's milk, introduced and the amount of cow's milk consumed in relation to anemia. Methods : Over the course of three years, 930 children(12 months to 36 months) who went to the Presbyterian Medical Center, Chonju, Korea were tested for anemia and their parents were surveyed for a history of their children's milk consumption. Results : Anemia appeared more likely between 30 months and 36 months, however, iron-deficiency anemia appeared more likely between 18 months and 23 months. Anemia, low serum ferritin levels and iron-deficiency anemia appeared more likely in children breast fed less than 6 months and greater than 12 months. Although there were survey reports of side effects with cow's milk, including constipation, diarrhea and skin rash, the milk bottle-using period, age of cow's milk introduced and amount of cow's milk consumed had no connection with anemia, serum ferritin levels and irondeficiency anemia. Conclusion : The data showed no correlation between the cow's milk, milk bottle-using period and iron deficiency. But the data revealed that iron deficiency anemia is more likely in children who are breast fed for less than 6 months and over 12 months, so we suggest careful attention during this period to prevent iron deficiency anemia.

A Survey on the Ethical Issues and Needs for Ethics Education of Nurses in Long-term Care Hospitals (요양병원 간호사의 윤리적 이슈와 윤리교육 요구조사)

  • Shin, Ja-Hyun;Seo, Myoung-Hee
    • The Journal of the Korea Contents Association
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    • v.18 no.6
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    • pp.180-192
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    • 2018
  • Purpose: This study is aimed to identify the ethical issues and needs for ethical education of nurses in long-term care hospitals. Methods: Data were collected in 2015. Participants were 142 nurses working in nine long-term care hospitals. The Ethical Issues in Clinical Practice Tool was used. Data analysis was performed using SPSS WIN 24.0. Results: The degree of experienced ethical issues was 1.23 out of 3, and 'Providing care with a possible risk to your health' was an ethical problem most frequently experienced in nurses. In addition, the ethical problem that the nurse most disturb was identified by 'Determining when death occurs'. The degree of needs for ethical education was 3.11 out of 4, and the highest ethical topic was 'Legal/ethical issues in the use of restraints'. Ethical issues and needs for ethical education were not statistically significant differences according to the characteristic of participants. Conclusion: In this study, we identified the ethical problems and necessity of ethics education experienced by nurses working in long-term care hospitals. The results of this study can be used as basic data for the development of customized ethical education contents for nurses in long-term care hospitals.

Smart-Phone Addiction, Depression/Anxiety, and Self-Esteem with Attention-Deficit Hyperactivity Disorder in Korean Children (주의력결핍 과잉행동장애와 스마트폰 중독, 우울, 불안, 자존감)

  • Lee, Hyo Chul;Hong, Min Ha;Oh, Chang Keun;Shim, Se Hoon;Jun, Yeon Joo;Lee, Seog Bum;Lee, Kyung Kyu;Paik, Ki Chung;Baek, Hea Soon;Lim, Myung Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.3
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    • pp.159-164
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    • 2015
  • Objectives : The current study investigated the risk of smartphone addiction among children and adolescents with or without attention-deficit hyperactivity disorder (ADHD), risk of depression, anxiety, and self-esteem using the Smartphone Addiction Scale Proneness, Kovac's Children's Depression Inventory, State-Trait Anxiety Inventory, and Rosenberg Self-Esteem Scale, commonly used in clinical medicine. Methods : Ninety five students with ADHD who visited psychiatry outpatient clinics completed the questionnaire. At the same time, 592 middle and high school students living in a similar area regardless of ADHD diagnosis, completed the questionnaire as control subjects. Results : Overall, 40.0% of 95 ADHD and 12.8% of 592 control subjects were classified as the smartphone addiction proneness group, 26.3% of the ADHD subjects and 8.3% of the control group were classified as the depression group, and 32.6% of the ADHD subjects and 16.2% of the control group were classified as the anxiety group. Significant differences were observed between the two groups. Conclusion : The results of this study suggest that ADHD subjects are more prone to smartphone addiction, becoming depressed or anxious than those in the control group. From this study, we could suggest that students with ADHD are more easily affected by smartphone addiction than normal control subjects. In addition, we might understand how some psychiatric problems like depression, anxiety, and low self-esteem are related to ADHD and smartphone addiction.

Comparison between Subjective and Actigraphic Measurement of Sleep in Psychiatric Inpatients (주관적 수면평가와 활동기록기를 이용한 수면평가의 비교 - 정신과입원환자를 대상으로 -)

  • Jeong, Hyun-Ghang;Lee, Moon-Soo;Ko, Yong-Hoon;Lim, Se-Won;Kim, Seung-Hyun;Jung, In-Kwa;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.1
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    • pp.30-39
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    • 2010
  • Objectives:Assessment of sleep disturbance is an essential part of the diagnostic criteria used for several psychiatric disorders. Change in sleep patterns over time may indicate response to treatment. In clinical practice, sleep is usually evaluated subjectively by patient self-report. This study was aimed to compare subjective sleep assessment with objective sleep measurement by actigraphy in psychiatric inpatients. Methods:A total of 32 psychiatric inpatients were studied. Patients were asked to wear a wrist actigraphy for three consecutive days and nights and to fill out a sleep log each morning. The severity of depression and anxiety was evaluated according to Beck Depression Inventory and State-Trait Anxiety Inventory on the first day of the study. The subjective level of satisfaction with quality of sleep was also evaluated according to visual analog scale. Nurses assessed sleep at one hour interval between 10:00 PM and 6:00 AM for three consecutive nights. Results:There was statistically significant difference of sleep latency between patient's sleep log and acti-graphic measurement. Nursing reports were more consistent with actigraphic measurement than sleep log. Interestingly, subjectively poor sleepers show no significant difference in sleep parameters compared with those of good sleepers. Subjectively poor sleepers report longer sleep latency than that of actigraphic assessment. The discrepancy between subjective and objective assessment of sleep latency was significantly correlated with scores of Beck Depression Inventory and State-Trait Anxiety Inventory. Conclusion:These results show that there are discrepancies between subjective and objective assessment of sleep. The discrepancy of sleep assessment could be influenced by severe depression and anxiety. Especially objective sleep measurement is needed to assess sleep in psychiatric inpatients with severe depression or anxiety and the subjectively poor sleepers for more reliable measurements.

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Measuring Effects of Quality Improvement through the Development of Critical Pathway for Gamma Knife Radiosurgery (당일 감마나이프수술 환자의 표준진료지침 개발을 통한 질 향상 효과 측정)

  • Kim, Moo Seong;Ha, So Young;Bae, Yoon Hyuk;Jung, Yong Tae;Kim, Sung Tae;Lee, Won Hee;Go, Yeon Joo
    • Quality Improvement in Health Care
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    • v.18 no.1
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    • pp.27-36
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    • 2012
  • Objectives : A protocol called "critical pathway" was developed to standardize the management of hospital patients the day after they underwent gamma knife radiosurgery. The quality of improvement in patient outcomes was evaluated. Methods : Critical pathway was developed, according to the regulations of the I hospital, by analyzing the medical records of 22 inpatients who underwent gamma knife surgery within the period from January to April 2011 on the day of the surgery. The study included a group of 22 patients admitted to the hospital the day after they underwent gamma knife radiosurgery, between July and September 2011. The control group included 22 patients who had surgery employing the same method within the period from May to June 2011. To measure the effects on quality improvement, the average length of stay, the execution rate of the hospital discharge notice system, daily hospital revenue, and the satisfaction of the patients and the medical team were assessed. The patient questionnaire employed a four-point Likert scale while the medical-staff questionnaire employed a five-point Likert scale. Result : The average length of stay was significantly shorter in the study group compared to the control group (2.3 days vs. 3.8 days, P<0.05). The execution rate of the hospital discharge notice system was higher in the study group (100% vs. 72%) than in the control group. Daily hospital revenues were higher by 264,178 Korean won in the study group when compared to the control group. The study group showed greater satisfaction of patients compared to the control group based on a four-point Likert scale (P<0.05). The study group showed greater satisfaction in medical team compared to the control group based on a five-point Likert scale (P<0.05). Conclusion : The development and implementation of a critical pathway protocol for hospital admission the day after gamma knife radiosurgery is an effective care process that improves the clinical quality.

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Methylation Levels of LINE-1 As a Useful Marker for Venous Invasion in Both FFPE and Frozen Tumor Tissues of Gastric Cancer

  • Min, Jimin;Choi, Boram;Han, Tae-Su;Lee, Hyuk-Joon;Kong, Seong-Ho;Suh, Yun-Suhk;Kim, Tae-Han;Choe, Hwi-Nyeong;Kim, Woo Ho;Hur, Keun;Yang, Han-Kwang
    • Molecules and Cells
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    • v.40 no.5
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    • pp.346-354
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    • 2017
  • Long interspersed nuclear element-1 (LINE-1) is a retrotransposon that contains a CpG island in its 5'-untranslated region. The CpG island of LINE-1 is often heavily methylated in normal somatic cells, which is associated with poor prognosis in various cancers. DNA methylation can differ between formalin-fixed paraffin-embedded (FFPE) and frozen tissues. Therefore, this study aimed to compare the LINE-1 methylation status between the two tissue-storage conditions in gastric cancer (GC) clinical samples and to evaluate whether LINE-1 can be used as an independent prognostic marker for each tissue-storage type. We analyzed four CpG sites of LINE-1 and examined the methylation levels at these sites in 25 FFPE and 41 frozen GC tissues by quantitative bisulfite pyrosequencing. The LINE-1 methylation status was significantly different between the FFPE and frozen GC tissues (p < 0.001). We further analyzed the clinicopathological features in the two groups separately. In the frozen GC tissues, LINE-1 was significantly hypomethylated in GC tissues compared to their corresponding normal gastric mucosa tissues (p < 0.001), and its methylation status was associated with gender, differentiation state, and lymphatic and venous invasion of GC. In the FFPE GC tissues, the methylation levels of LINE-1 differed according to tumor location and venous invasion of GC. In conclusion, LINE-1 can be used as a useful methylation marker for venous invasion in both FFPE and frozen tumor tissues of GC.

Multidisciplinary Intestinal Rehabilitation for Short Bowel Syndrome in Adults: Results in a Korean Intestinal Rehabilitation Team (성인 단장증후군 환자의 다학제 장 재활: 국내 단일 기관 다학제 장재활 클리닉의 경험)

  • Yoon, Sojeong;Lee, Sanghoon;Park, Hyo Jung;Kim, Hyun-Jung;Yoon, Jihye;Min, Ja-Kyung;Seo, Jeong-Meen
    • Journal of Clinical Nutrition
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    • v.10 no.2
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    • pp.45-50
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    • 2018
  • Purpose: Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation. Methods: In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records. Results: Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%). Conclusion: This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

Factors Associated with Ruptured Intracranial Aneurysm in a Hospital (일개 병원의 뇌동맥류 파열의 위험요인)

  • Lee, En-Ha;Yun, So-Young;Choi, Ja-Yun
    • Journal of the Korea Convergence Society
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    • v.10 no.1
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    • pp.339-351
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    • 2019
  • This study was conducted to identify the factors associated with the ruptured intracranial aneurysm (RIA) among demographic, admission to hospital, clinical, aneurysym itself and lifestyle characteristics. Medical records of RIA patients and un-RIA patients which had been admitted to undergo treatment including surgery (From January to December 2016) were included into data analysis. Multiple logistic regression showed that two and more than warning signs (14.14 (CI: 1.25-159.40)) indicated the greatest odds ratio with RIA, was followed by headache more than 3 scores (13.95 (CI: 3.68-52.83)), the admission via emergency room (13.62 (CI: 4.85-38.26)), single marital status (9.72 (CI: 2.22-42.49)), 1 mmHg increased systolic blood pressure (1.04 (CI: 1.01-1.08)), 1 score increased GCS (0.58 (CI: 0.37-0.90)), arrythmia finding in electrocardiogram (3.70 (CI: 1.22-11.22)) and increased age (0.95 (CI: 0.91-0.99)). The risk groups having factors associated with RIA were identified. Preventive activities including routine assessment should be done before developing the rupture and urgent care should be needed after developing the rupture for risk groups.

Psychological Systematic Consideration of Breast Cancer Radiotherapy (유방암 방사선 치료 환자의 심리의 체계적 분석)

  • Yang, Eun-Ju;Kim, Young-Jae
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.629-635
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    • 2019
  • In term of the factors affecting psychosocial adjustment of breast cancer patients, their quality of life after surgical operation, radiation, and chemotherapy were systematically meta-analyzed. As a result, their qualities of life of the patients that had radiation therapy was the lowest right after the therapy, and gradually increased after the end of the therapy. However, after six months, their quality of life failed to reach the same level before the therapy. They had depression and side effects the most right after the therapy, and somewhat reduced them after the end of the therapy. In case of surgical operation, the more they were educated, the more they had psychosocial adjustment, and the more they had a medical examination and took out an insurance policy, the more they had psychosocial adjustment. In case of chemotherapy, their cognitive function is influenced so that they have impairments in memory, learning, and thinking stages. Since subjective cognitive impairment has a relationship with depression, it is necessary to monitor depression of chemotherapy patients. Given the results of this systematic meta-analysis, when three types of therapies (surgical operation, radiation therapy, and chemotherapy) are applied to patients with breast cancer, it is necessary to recognize their psychosocial adjustment, depression, anxiety, and quality of life in the nursing and radiation therapy fields and thereby to introduce an intervention program for a holistic approach.

The Effect of Psychological Intervention for Pain Reduction in Osteoarthritis Patients : A Meta-analysis (골관절염 환자의 통증 감소를 위한 심리적 중재의 효과 : 메타분석)

  • Lee, Chun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.5
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    • pp.109-117
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    • 2019
  • This study was conducted to provide for the development of psychological interventions through meta-analysis of the effects of psychological intervention for pain reduction in patients with osteoarthritis. R version 3.5.1 program was used to identify the effectiveness of psychological mediating by December 30, 2018, while the Korean and foreign literature published by PubMed, EMBASE, Ovid-MEDLINE, CINAHL, and Korean databases were searched. As a result, 12 studies with a total of 1,847 participants were analyzed in a total of 1,822 literature. The results showed that the overall effect size of psychological intervention for pain reduction in osteoarthritis patients was small effect -0.31(95% CI: -0.50, -0.11, p<.001). In the moderator analysis, the effect size showed a significant difference depending on the intervention type, intervention duration and the intervention provider. The funnel plot analysis was used to analyze the publication bias, and it was visually asymmetric but not asymmetric after the egger's regression test (bias = -3.24, p = .077). The results of this study suggest a standard of efficacy for psychological interventions to improve pain symptoms, which is a major symptom of osteoarthritis, although the number of studies included in the meta-analysis is low and has provided a clinical basis during intervention and intervention providers.