• The Korean Journal of Health Service Management
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• v.13 no.2
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• pp.107-119
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• 2019

Objectives: This study is a descriptive research to investigate the predictors of intention to quit smoking in patients with acute coronary syndrome(ACS). Methods: A total of 192 ACS patients hospitalized for an angiogram during symptom management were conveniently recruited from a university hospital cardiovascular care unit. Data were collected from January to December in 2018 and were analyzed using binominal logistic regression. Results: The predictors of intention to quit smoking in patients with ACS were drinking(odds ratio[OR]=0.315, p=.006), experience of smoking cessation education(OR=0.325, p=.007), depression(OR=0.739, p<.001), and smoking-related self-efficacy(OR=1.091 p=.006). Conclusion: The findings suggest that the alleviation of depression and enhancement of smoking-related self-efficacy can prevent recurrence and enhance the treatment of ACS.

• Journal of Korean Academy of Nursing
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• v.48 no.4
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• pp.465-474
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• 2018

Purpose: This study aimed to determine the effect of hand massage in patients who underwent transradial percutaneous coronary intervention. Methods: This was a quasi-experimental study with a nonequivalent control group and non-synchronized design. The study included 30 patients in the experimental group and 30 in the control group. Hand massage was performed 2 times for 5 minutes each in the experimental group and the control group only received usual nursing interventions. Pain, level of discomfort, and vital signs were defined as key outcome measures, and the data were analyzed using the chi-square test, an independent t-test, Mann-Whitney U test, repeated-measures analysis of variance, and Friedman test. Results: Significant differences were observed between the 2 groups in the pain score (F=7.91, p=.003), discomfort score (F=18.15, p<.001), pulse (F=12.92, p<.001), and respiration rate (${\times}^2=19.35$, p<.001). Conclusion: Hand massage can be a helpful nursing intervention for transradial percutaneous coronary intervention by reducing pain and discomfort to a considerable degree.

• Tuberculosis and Respiratory Diseases
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• v.77 no.1
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• pp.6-12
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• 2014

Severe sepsis is the most common cause of death among critically ill patients in non-coronary intensive care units. In 2002, the guideline titled "Surviving Sepsis Campaign" was published by American and European Critical Care Medicine to decrease the mortality of severe sepsis and septic shock patients, which has been the basis of the treatment for those patients. After the first revised guidelines were published on 2008, the most current version was published in 2013 based on the updated literature of until fall 2012. Other important revised guidelines in critical care field such as 'Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit' were revised in 2013. This article will review the revised guidelines and several additional interesting published papers of until March 2014, including the part of ventilator-induced lung injury and the preventive strategies.

• Journal of Preventive Medicine and Public Health
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• v.50 no.1
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• pp.29-37
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• 2017

Objectives: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

• Korean Journal of Adult Nursing
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• v.23 no.1
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• pp.100-109
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• 2011

Purpose: This study was conducted to identify the factors that predict a current smoking behavior and higher emotional stress among male patients with acute coronary syndrome (ACS). Methods: The study was approved by an institutional review board from a university hospital, 2010. A face to face interview using questionnaires was performed with 185 first-time ACS male patients who were undertaken a percutaneous coronary intervention at a cardiovascular care unit. Data were analyzed using SPSS/WIN 15.0. Results: About 54% of the study subjects were currently smoking. The current smokers had dyslipidemia and reported bad eating habits compared to the non-smokers. The current smokers were younger, living alone, and reported lower perceived benefit on smoking cessation than the non-smokers, and 15% of them did not consider quitting (precontemplation stage). Smoking status was not significantly related to emotional stress. Logistic regression analysis revealed that being employed including professional or labor increased the odds of current smoking four or three times compared to the non-employed or retired. Low income or dyslipidemia also increased the likelihood of current smoking 2.8 and 2.1 times, respectively. Blue collar workers or heavy drinkers had 2.9 and 2.8 times more risks of having higher level of stress. Conclusion: An occupational background and health habits should be considered to develop an effective educational strategy for smoking cessation and stress reduction among male patients with ACS.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.1
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• pp.74-78
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• 2007

The carbamates are a group of insecticides derived from carbamic acid, with a broad spectrum of uses as agricultural and household garden insecticides. Carbamate insecticides are reversible cholinesterase inhibitors. Their inhibitory action is mediated by reversible carbamylation of acetylcholine, as with the organophosphate insecticides. Carbamates are absorbed by the body through multiple routes, including inhalation, ingestion, and dermal absorption. Although poisoning can result from occupational exposure or accidental ingestion, in most cases there is suicidal intent. This is particularly true in developing countries, where the highest incidence of morbidity and mortality from this cause occurs. Cardiac complications often accompany poisoning by carbamate compounds, which may be serious and often fatal. The extent, frequency, and pathogenesis of cardiac toxicity from carbamate compounds has not been clearly defined. Possible mechanismsinclude sympathetic and parasymphatetic overactivity, hypoxemia, acidosis, electrolyte derangements, and a direct toxic effect of the compounds on the myocardium. Patients with carbamate poisoning should immediately be transferred to an intensive or coronary care unit where appropriate monitoring and resuscitative facilities are available. We here report a case of acute coronary syndrome resulting from acute carbamate ingestionthat resulted in a healthy discharge.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.281-284
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• 2015

We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.3
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• pp.326-335
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• 2010

Purpose: This study was conducted to develop nursing standards for medical patients with Coronary Artery Disease (CAD) patients. Methods: This study was a methodological study. The content of nursing standards for medical patients with CAD developed in this study was validated. The nursing standards of cardiovascular nursing developed by the American Nurses Association (2008), the nursing standards developed by the Korea Nurses Association (2003) and a clinical manual of patients with CAD developed by K teaching hospital were reviewed. Literature regarding CAD nursing standards was also reviewed. The basic contents of nursing standards for medical patients with CAD were selected by an expert group including two nursing faculties, a cardiovascular unit manager, and two cardiologists. A pilot study was conducted then in real clinical settings, in which includes cardiovascular outpatient clinic, cardiovascular inpatient units, and cardiac intensive care units to evaluate clinical suitability of the nursing standards. Results: The final version of the nursing standards for medical patients with CAD included 12 standards, 24 criteria, 38 indicators and 92 nursing activities. Conclusion: The nursing standards developed in this study can be used in evaluating quality of nursing service and in educating nurses who are involved in patients with CAD.

• Journal of Korean Clinical Nursing Research
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• v.17 no.1
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• pp.35-45
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• 2011

Purpose: The purpose of this study was to identify the effect of exercise therapy on low back pain, self-urination disorder, bleeding, and hematoma in Percutaneous Coronary Intervention (PCI) patients. Methods: A total of 64 PCI patients were recruited from C hospital located in C city, from June until August of 2010. The patients were divided into two groups as the exercise and control group. Thirty-two participants in the exercise group took bedrest for two hours after PCI, and then received excise therapy. The other 32 participants in the control group took the usual 8-hour bedrest with intermittent back care by the unit nurses. Results: In the relieving effect of low back pain, exercise group reported pain reduced faster than the control group. On the other hand, there were no significant differences between the two groups in alleviant of self-urination disorder, bleeding, and hematoma. Conclusion: Exercise therapy for reducing patients' low back pain showed to be an effective nursing intervention. Since there was no bleeding or hematoma after PCI in the exercise group, this study provided the ground suggesting that it might be possible to reduce the bedrest time after PCI without increased risk of bleeding or hematoma.

• Journal of The Korea Institute of Healthcare Architecture
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• v.12 no.2
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• pp.69-77
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• 2006

Angiography means that a check up to know an abnormal condition in all the blood vessels include from the heart, aortae, cerobrovascular and abdonominal artery to hands and feet. Main examples of this are cerebral angiography, abdominal, liver for urinary anomaly, renovascular angiography, and artery and vein in arms and legs. Angiography uses radial rays or angiography equipment for an image output during interventional procedure and compositive diagnosis. The acts which performed in a projection room have changed drastically. In general, it is performed by using equipment which is attached one or two C-arms and the method of inserting catheter in vein after anesthesia. For this reason, some rooms that consist of angiography room units should be planned not only for expensiveness equipment and facilities also to be germ-free. Nowadays, in the angiography unit case, it is placed independently as the central part of many hospitals. It does not belong to the imaging medical department any more as considering raising filming times and the relation between C.C.U.(coronary care unit) and operation unit. This means the acts performed are diversified and well-organized rooms in support of diagnosis are required. However, it is difficult to plan the angiography room unit due to domestic researches and data on this unit are not enough. Therefore, this study aims at bringing up basic issue for architectural planning of the angiography unit in general hospital.