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The Effect of Supportive Nursing Care on Depression, Mood and Satisfaction in Military Patients with Low Back Pain (지지간호가 군 요통환자의 우울ㆍ기분ㆍ만족에 미치는 영향)

  • 김정아
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.324-340
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    • 1990
  • Support has always been considered an important nursing concept. However, there is no agreement among nurse researchers as to a conceptual definition of supportive nursing or meaningful supportive behaviors. Clarification of the concept, support in nursing, is necessary to promote communication among nurses on nursing behaviors that are effective in providing support and on understanding the relevant properties and charcteristics of the concept, supportive nursing care. The objectives of the study were : 1. to analyse the concept, support in nursing, in order to provide a definition of supportive nursing care, and 2. to operationalize the definition of supportive nursing care and use it as an experimental nursing intervention for patients with low back pain. The first part of the study used the concept analysis approach developed by Walker and Avant(1983) to define the concept of supportive nursing care. The properties of supportive nursing care, defined by this analysis, included perception of supportive need, reciprocal interaction(Transaction), listening, providing empathy and information related to health, and confirmation of the patient's verbal and non - verbal response. The second part, the experimental part of the study, was done using King's(1970) Interpersonal Theory for Nursing. The concept, supportive nursing care, as defined in the concept analysis was operationalized and used as the experimental intervention. The experiment tested the effectiveness of the independent variable, supportive nursing care on the dependent variables, depression, mood and patient satisfaction, in the patients with low back pain in army hospitals. The instruments used to measure the dependent variables were Zung's(1965) Self- Rating Depression Scale, Ryman and Colleagues'(1974) Mood Questionnaire and LaMonica and Colleagues'(1986) Patient Satisfaction Scale. The experimental design used for this study was a Solomon 4 group experimental design. This design has the strength of allowing for observation of the main effects of supportive nursing care and pretesting, and for observation of the interaction effects of pretesting and supportive nursing care. The design includes one experimental group and three control groups. The Subjects of this study were 150 young male patients with low back pain on Neuro - Surgical Wards in three general army hospitals. There were 35 in the experimental group, 39 in the pre - posttest control group, 36 in the treatment - posttest control group and 40 in the posttest only control group. Supportive nursing care, as operationalized by the researcher according to the concept analysis, was given to the patients in the experimental group and the treatment -posttest control group, individually for 30 minute sessions, every other day for 5 days. Data collection was done using a questionnaire. The data were collected in a pretest one week before the supportive nursing care sessions, a posttest immediately after the sessions and follow- up test one week later. Hypotheses testing was done using 2×2 factorial analysis of variance and Meta analysis(Stouffer's Z method). The results of this study are summarized as follows : 1. Hypothesis Ⅰ, “There will be a difference on depression level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F=8.49, p<.05). 2. Hypothesis Ⅱ, “There will be a difference on mood level between the patients with low back pain who receive supportive nursing care and those who to not receive supportive nursing care”, was supported (Z meta=2.17, p<.05). 3. Hypothesis Ⅲ, “There will be a difference on satisfaction level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F=13.67, p<.05). 4. ANOVA, done to examine the interaction effect of history and maturation, showed no significant difference on the dependent variables between the observations of the pretest scores of the experimental group, the pretest scores of the pre- posttest control group and the posttest score of the posttest only control group. 5. To test for continuing effect of supportive nursing care, paired t-test was done to compare the scores for the dependent variables at the posttest and at the one week later follow-up test. No significant difference on the scores for the dependent variables was found between the posttest scores and the follow-up test scores for the two groups that received supportive nursing care, the experimental group and the treatment-posttest control group. In conclusion, it was found that in the case of young soldiers with low back pain in army hospitals, their depression level was decreased, their mood state was changed positively and their satisfaction level was increased by receiving supportive nursing care. Further, the effectiveness of the supportive nursing care lasted for at least one week in this study. The significance of this study to nursing is in the analysis of the concept of supportive nursing care and the demonstration of the effectiveness of supportive nursing care as an intervention within the limits of the study.

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Usefulness of Bronchoscopy for the Diagnosis of Nontuberculous Mycobacterial Pulmonary Disease (비결핵 항산균 폐질환의 진단에서 기관지내시경술의 유용성)

  • Jeon, Kyeongman;Koh, Won-Jung;Kwon, O Jung;Kang, Eun Hae;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kim, Tae Sung;Lee, Kyung Soo;Lee, Nam Yong;Han, Joungho
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.242-249
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    • 2004
  • Background : Because of the low sensitivity of sputum smear and culture, diagnosis of nontuberculous mycobacterium (NTM) pulmonary disease, especially in patients with bronchiectasis, is often difficult. We investigated the usefulness of bronchoscopy for the diagnosis of NTM pulmonary disease including M. avium complex (MAC) and M. abscessus in patients with bronchiectasis and multiple pulmonary nodules on chest computed tomography (CT). Methods : We reviewed 48 cases of patients who were performed bronchoscopic bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) under suspect of NTM pulmonary disease based on CT findings of bronchiectasis and multiple nodules from April 2002 to June 2003. Results : Twenty five of the 48 patients (54%; 12 MAC, 14 M. abscessus) were diagnosed as NTM pulmonary disease on the basis of the American Thoracic Society diagnostic criteria for NTM pulmonary disease. Sixteen of the 21 patients (76%; 5 MAC, 11 M. abscessus) with 3 or more positive sputum cultures of NTM were confirmed tissue invasion by TBLB. Five of the 24 patients (21%; 4 MAC, 1 M. abscessus) who could not be diagnosed with sputum cultures were diagnosed by bronchoscopic BAL and TBLB. Conclusion : Bronchoscopy is helpful for the diagnosis of NTM pulmonary disease and confirmation of tissue invasion by NTM, not only MAC but also M. abscessus, in patients with bronchiectasis and multiple nodules on chest CT scan.

Clinical Usefulness of Ambulatory Blood Pressure Monitoring in Children and Adolescents (소아 및 청소년에서 24시간 활동 혈압 측정의 임상적 유용성)

  • Hwang, Young-Ju;Park, Hyo-Jung;Yang, Eun-Ae;Cho, Min-Hyun;Ko, Cheol-Woo;Yang, Dong-Heon;Hwang, Hyun-Hee
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.154-162
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    • 2011
  • Purpose: With increasing prevalence of hypertension (HTN) in children and adolescent, pediatricians have become more interested in blood pressure (BP) measurements. The ambulatory blood pressure monitoring (ABPM) is known to be useful to differentiate true HTN and white coat HTN. The object of this study is to assess the clinical usefulness of ABPM in Korean children and adolescents. Methods: A retrospective review of 51 patients in Kyungpook National University Hospital from January 2002 to February 2010 was done. All patients were 6-18 years old and underwent ABPM. We calculated the mean value of ABP, BP load, nocturnal dip and compared the results with the patients' diagnosis and characteristics. Results: The mean age of the 51 patients was $17.8{\pm}1.8$ years and 19 children were obese. 37 patients (72.5%) were truly hypertensive and 1 patient was diagnosed as masked HTN and 7 children (14%) as white coat HTN. The rest of the patients were normotensive. Among patients with white coat HTN, 5 were in a prehypertensive state. Mean systolic and diastolic BP load of patients with true HTN were significantly higher than non-hypertensive children (P<0.001). Although the nocturnal dip of all patients were below 10%, there was no statistical significance. The obese patients showed higher systolic and diastolic BP. Their systolic and diastolic BP load were significantly higher than non-obese patients (P<0.001). Conclusion: ABPM in children and adolescents seems to be a valuable tool in the assessment of white coat HTN and in the confirmation of true HTN. A considerable number of white coat HTN patients are revealed to be in a prehypertensive state and need close follow-up.

Assessment of Patency of Coronary Artery Bypass Grafts Using Segmented K-space Breath-hold Cine Cardiovascular Magnetic Resonance Imaging: A Clinical Feasibility Study (호흡멈춤상태에서 K-space분할 CINE 자기공명 영상기법을 이용한 관상동맥우회로의 혈류개방성의 검사)

  • Oh-Choon Kwon;Sub Lee;Jong-Ki Kim
    • Investigative Magnetic Resonance Imaging
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    • v.7 no.1
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    • pp.22-30
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    • 2003
  • Purpose : The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). Materials and Method s : Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented K-space cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. Results : MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. Conclusion : Evaluation of patency of the bypass graft was clinically feasible by 2D-FASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.

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Study on the Usefulness about Molecular Breast Imaging In Dense Breast (치밀형 유방에서 Molecular Breast Imaging 검사의 유용성에 관한 고찰)

  • Baek, Song Ee;Kang, Chun Goo;Lee, Han Wool;Park, Min Soo;Choi, Young Sook;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.42-46
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    • 2016
  • Purpose Mammography is the most widely used scan for the early diagnosis since it is possible to observe the anatomy of the breast. however, The sensitivity is markedly reduced in high-risk patients with dense breast. Molecular Breast Imaging (MBI) sacn is possible to get the high resolution functional imaging, and This new neclear medicine technique get the more improved diagnostic information through It is useful for confirmation of tumor's location in dense breast. The purpose of this study is to evaluate the usefulness of MBI for tumor diagnosis in patients with dense breast. Materials and Methods We investigated 10 patients female breast cancer with dense breast type who had visited the hospital from September 1st to Octorber 10th, 2015. The patients underwent both MBI and Mammography. MBI (Discovery 750B; General Electric Healthcare, USA) scan was 99mTc-MIBI injected with 20 mCi on the opposite side of the arm with the lesions, after 20 minutes, gained bilateral breast CC (CranioCaudal), MLO (Medio Lateral Oblique) View. Mammography was also conducted in the same posture. MBI and Mammography images were compared to evaluate the sensitivity and specificity of each case utilizing both image and two images in blind tests. Results The results of the blind test for breast cancer showed that the sensitivity of Mammography, MBI scan was 63%, 89%, respectively, and that their specificity was 38%, 87%, respectively. Using both the Mammography and MBI scan was Sensitivity 92%, specificity 90%. Conclusion This research has found that, The tumor of dense tissue that can not easily distinguishable in Mammography is possible to more accurate diagnosis since It is easy to visually evaluation. But MBI sacn has difficulty imaging microcalcificatons, If used in conjunction with mammography it is thought to give provide more diagnostic information.

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Antioxidant, Anti-inflammatory and Anti-allergenic Effects of Citrus Junos seed Oil and its Human Skin Protection (유자씨 오일의 항산화, 항염, 항알러지 효과 및 인체 피부보호 효과에 대한 연구)

  • Ko, Eun Ah;Nam, Seung-Hee;Jeong, Hana;Kim, Bo Yun;Kwak, Sang Hwa;Kim, Sunyoung;Hong, In Ki;Kang, Hakhee
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.46 no.3
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    • pp.283-294
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    • 2020
  • In this study, in order to increase the utilization of Citrus junos seeds, which account for 13% of the weight ratio of Citrus junos ripened fruit, but are mostly discarded and not utilized, the efficacy of skin beauty of Citrus junos seed oil extracted by cold pressing was studied. Citrus junos seed oil was found to contain approximately 74% of unsaturated fatty acids consisting mainly of oleic acid and linoleic acid, and limonene, which is mainly contained in Citrus junos peel, contained a very low content of about 0.0187%. As a result of evaluating the DPPH radical scavenging activity of Citrus junos seed oil, 26% of DPPH radical scavenging ability was confirmed at 5% concentration of Citrus junos seed oil. To confirm the anti-inflammatory effect, as a result of testing RAW 264.7 cytotoxicity test and NO production for Citrus junos seed oil, NO production was suppressed by 53% at a concentration of 0.05% that does not show cytotoxicity. In addition, in the RBL-2H3 cytotoxicity and β-hexosaminidase release inhibitory efficacy test for anti-allergic efficacy confirmation, it was confirmed that β-hexosaminidas release was suppressed by 26% at a concentration of 0.05% that did not show cytotoxicity. Lastly, in the human skin application test result of O/W emulsion containing 5% of Citrus junos seed oil, it showed higher skin moisturizing effect than the control emulsion containing the same amount of caprylic/capric triglyceride. Therefore, it is thought that Citrus junos seed oil might be used as a excellent skin care material.

A study on the state of inservice education for dental hygienists and their relevant awareness (치과위생사의 보수교육 실태 및 인식에 관한 연구)

  • Jung, Jae-Yeon;Kim, Kyung-Mi;Cho, Myung-Sook;Ahn, Geum-Sun;Song, Kyoung-Hee;Choi, Hye-Jung;Choi, Youn-Seon;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.1
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    • pp.73-89
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    • 2007
  • The purpose of this study was to examine the reality of inservice education provided to members of Korean Dental Hygienists Association, the state of relevant academic conferences, and the perception of the members about inservice education and academic conference. It's basically meant to help boost their participation in inservice education and their satisfaction with it, and to show some of the right directions for that. The subjects in this study were dental hygienists who attended a symposium on July 1, 2006. After a survey was conducted, the answer sheets from 489 participants were analyzed, and the findings of the study were as follows: 1. General hospitals and university hospitals made up the largest group(91.4%) that gave a monthly leave of absence, and the second largest group was dental hospitals(75.4%), followed by dental clinics(58.3%) and public dental clinics(48.0%). The most common closing time in dental clinics and dental hospitals was 5 p.m., and that was 12 p.m. in general hospitals and university hospitals. The dental hygienists in public dental clinics didn't work on Saturdays. By type of workplace, treatment was the most common duty for the dental hygienists in dental clinics and dental hospitals to perform, and those who worked at general hospitals, university hospitals and public health clinics were in charge of extensive range of jobs. 2. The rates of the dental hygienists who took that education stood at 94.9% in public dental clinics, 78.7% in dental hospitals and 75.3% in dental clinics, general hospitals and university hospitals. Regarding how many marks they got on an yearly basis, those who got eight marks or more made up the largest group(55.6%), followed by four marks or more(11.8%), six marks or more(3.4%), and two marks or more(1.5%). As for the usefulness of inservice education for their job performance, the largest number of the dental hygienists(40.8%) found it to be helpful, and the second greatest group(37.5%) considered its effectiveness to be so-so. The third largest group(8.4%) found it to be of great use, and the fourth biggest group(4.2%) considered it to be of no service. The fifth biggest group(l.3%) thought it was absolutely useless. By type of workplace, the workers in dental clinics, dental hospitals, general hospitals and university hospitals wanted the most to learn how to take care of clinical work(acquisition of up-to-date technology), and those in public health clinics hoped the most to learn about public dental health. By type of workplace, the workers in dental clinics had their sight set on self-development the most, and the dental hygienists in dental hospitals, general hospitals, university hospitals and public health clinics were most in pursuit of acquiring new knowledge. By type of workplace, the specific given conditions at work were most singled out by the dental clinic workers as the reason, and the dental hospital employees pointed out time constraints the most. The dental hygienists in general hospitals and university hospitals cited time constraints and financial burden the most, and the public health clinic personnels mentioned inaccessibility of a place for inservice education as the reason. 3. The public health clinic workers participated in academic conferences the most(90.8%), followed by the general and university hospital personnels(68.8%), dental hospital employees(65.6%) and dental clinic workers(65.5%). By type of workplace, the public health clinic workers(73.5%) expressed the most satisfaction, followed by the general and university hospital employees(67.7%), dental clinic workers(62.3%) and dental hospital personnels(54.1%). By type of workplace, the employees of dental clinics, dental hospitals, general hospitals and university hospitals preferred Saturdays, and the public health clinic workers had a liking for weekdays. As for a favored place, hotels were most preferred, followed by university hospitals, general hospitals, college lecture rooms, district halls and local public institutions. Hotels were most favored regardless of the type of workplace. 4. Regarding outlook on inservice education, they had the highest opinion on the facilities and given conditions of lecture rooms($3.41{\pm}0.83$), followed by the professionalism of lecturers($3.34{\pm}0.83$), procedures of receipt and attendance confirmation($3.34{\pm}0.83$) and class size($3.13{\pm}0.89$). On the contrary, they took the most dismal view of the inaccessibility of a place of inservice education($2.08{\pm}0.92$), followed by limited opportunity and limited date for that education($2.51{\pm}0.99$), extra financial burden($2.53{\pm}1.18$) and high tuition fee($2.57{\pm}0.96$).

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Fully Automated Liquid Culture System Compared with Lowenstein-Jensen Solid Medium for Rapid Recovery of Mycobacteria in Sputums (완전 자동화된 액체배양법과 기존의 고체배양법을 이용한 객담 내 mycobacterium의 신속검출에 대한 비교)

  • Park, Seung-Kyu;Kim, Seung-Chul;Kim, Deuk-Mi;Lee, Chang-Woon;Kim, Young;Cho, Sang-Nae
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.6
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    • pp.635-643
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    • 2002
  • Background : The Aim of this study was to compare the recovery of mycobacteria from sputum samples of pulmonary tuberculosis patients using the MB/BacT rapid culture system(Organon Teknika, USA) with that obtained using Lowenstein-Jensen solid medium. Methods : The two culture systems were compared using sputum samples of 99 pulmonary tuberculosis patients. Culture media were incubated at $35-37^{\circ}C$ for six weeks in the MB/BacT system and for 12 weeks in Lowenstein-Jensen solid medium. Solid media were examined macroscopically once a week, and the MB/BacT system positive vials were unloaded from the machine as soon as possible after positive signal from the connected computer was detected Confirmation of growth for mycobacteria was done by Ziehl-Neelson stained smears. Isolates were identified to differentiate Mycobacterium tuberculosis from mycobacterium other than tuberculosis(MOTT) by phenotypic and molecular methods. Results : Of the sputum samples of the 99 patients, 58 samples were smear positive and 41 in negative smear. Mycobacteria were recovered from 67(67.7%) samples by using both culture systems. The yield with MB/BacT was higher than that with Lowenstein-Jensen [67(67.7%) vs. 52(52.5%), p<0.001]. Moreover, 15(15.2%) samples were positive only in the MB/BacT, whereas none of samples was positive only in Lowenstein-Jensen. In smear-positive and smear-negative samples, the recovery rate with MB/BacT was also higher than that with Lowenstein-Jensen [sputum-positive; 56/58(96.6%) vs. 46/58(79.3%), p=0.005, sputum-negative; 6/41(14.6%) vs. 5/41(12.2%), p<0.001]. The mean times to detection of Mycobacteria were 13.3 and 27.2 days with MB/BacT and Lowenstein-Jensen respectively(p<0.001). Conclusion : This results indicate that the the MB/BacT is more efficient and faster than Lowenstein-Jensen for the recovery of mycobacteria.

Incidence of Malignancy and Its Predictive Factors in Intrapulmonary Nodules Associated with cT1-2N0M0 Non Small Cell Lung Cancer (임상적 병기 T1-2N0M0인 비소세포폐암에 동반된 폐결절의 악성여부 및 그 예측인자)

  • Yoon, Ho Il;Yim, Jae-Jun;Lee, Choon-Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.151-158
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    • 2004
  • Background : When a non small cell lung caner patient at the $_cT_{1-2}N_0M_0$ stage is diagnosed with intrapulmonary nodule(s), the treatment plan and prognosis of the patient largely depend on whether the nodule is benign or malignant. In most cases, however, it is hard to conduct a biopsy on such a nodule, due to its small size. Furthermore, the predictive factors that may imply benignancy or malignancy of the nodules remain unknown. As such, the purpose of our study was to validate the incidence of malignant nodules in such cases, and find if there are any predictive factors. Methods : Chest computed tomography(CT) scans and the medical records of 444 patients, who had undergone non small cell lung cancer surgery, between July, 2001 and September, 2003, at Seoul National University Hospital, were retrospectively reviewed. Among $_cT_{1-2}N_0M_0$ non small cell lung cancer patients, with intrapulmonary nodule(s), only those cases where a CT scan or a biopsy of the nodules had been conducted, and had been followed up at intervals of more than 6 months were included. However, patients who had received chemotherapy or radiation therapy, pre- or post-operatively, or with calcified nodules, were excluded. Results : Our study group consisted of 39 patients, divided into two groups. The first group, 33 patients, had benign nodules, and the second group, 6 patients, had malignant nodules. The two groups were compared with regard to gender, age, cell type, pathologic stage, shape, size, location and number of nodules and presence of calcification around the nodules. There was no statistically significant difference between the two groups. Conclusion : The intrapulmonary nodules in non small cell lung cancer patients at the $_cT_{1-2}N_0M_0$ stage were mostly benign. Therefore, surgical treatment for such patients can be considered. Moreover, without predictive factors, pathological confirmation of the diagnosed nodules should be sought in all patients.

The Usefulness of Integrated PET/CT to Distinguish between Benignancy and Malignancy in Solitary Pulmonary Nodule (고립성 폐결절의 악성 감별에서 Integrated PET/CT의 유용성)

  • Park, Won-Jong;Kim, Dong-Hee;Yu, Sung-Ken;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Chun, Kyung-Ah;Cho, Ihn-Ho
    • Journal of Yeungnam Medical Science
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    • v.23 no.2
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    • pp.205-212
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    • 2006
  • Background: Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. Materials and Method: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. Result: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. Conclusion: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.

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