• Journal of Trauma and Injury
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• 제34권1호
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• pp.13-20
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• 2021

Purpose: Nutritional therapy in the intensive care unit is an essential factor for patient progress. The purpose of this study was to compare resting energy expenditure (REE) calculated by prediction equations (PEs) to the REE measured by indirect calorimetry (IC) in trauma patients. Methods: Patients admitted to the trauma intensive care unit who received mechanical ventilation between January and December 2015 were enrolled. REE was measured by IC (CCM Express, MGC Diagnostics) and calculated by the following PEs: Harris-Benedict, Fleisch, Robertson and Reid, Ireton-Jones, and the maximum value (25 kcal/kg/day) of the European Society for Clinical Nutrition and Metabolism (ESPEN). All patients were ventilated at a fraction of inspired oxygen (FiO2) below 60%. Results: Of the 31 patients included in this study, 24 (77.4%) were men and seven (22.6%) were women. The mean age of the patients was 49.7±13.2 years, their mean weight was 68.1±9.6 kg, and their mean Injury Severity Score was 26.1±11.3. The mean respiratory quotient on IC was 0.93±0.19, and their mean FiO2 was 38.72%±6.97%. The mean REE measured by IC was 2,146±444.36 kcal/day, and the mean REE values calculated by the PEs were 1,509.39±205.34 kcal/day by the Harris and Benedict equation, 1,509.39±154.33 kcal/day by the Fleisch equation, and 1,443.39±159.61 kcal/day by the Robertson and Reid equation. The Ireton-Jones equation yielded a higher value (2,278.90±202.35 kcal/day), which was not significantly different from the value measured using IC (p=0.53). The ESPEN maximum value (1,704.03±449.36 kcal/day) was lower, but this difference was likewise not significant (p=0.127). Conclusions: The REE measured by IC was somewhat higher than that calculated using PEs. Further studies are needed to determine the proper nutritional support for trauma patients.

• 한국보육지원학회지
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• 제10권6호
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• pp.391-412
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• 2014

유보연계형 인정어린이원은 유치원과 보육소의 일체화 시설로서 2013년 현재 595개가 설치되어 있으며, 이를 더욱 확산시키고자 일본정부는 2012년에 인정어린이원법을 개정하고, 2014년 4월에는 유보연계형 인정어린이원의 설비 운영의 기준 및 보육, 교육내용을 발표하였다. 유보연계형 인정어린이원의 설비 및 운영의 기준은 유치원과 보육소의 기준보다 높은 기준을 적용하고 있다. 따라서 현재 유치원과 보육소에서 제공하고 있는 보육의 질적 수준은 유지될 수 있을 것으로 예상된다. 그러나 보육, 교육내용의 경우, 초등학교 교육의 준비단계로서의 교육적인 면을 지나치게 강조하였다. 0-5세의 영유아가 하루생활의 대부분을 유보연계형 인정어린이원에서 생활하게 된다는 점을 고려해 볼 때, 양호적인 측면의 내용이 한층 보강되어야 할 것이다.

• 근관절건강학회지
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• 제12권2호
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• pp.143-154
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• 2005

Purpose: The aim of this study was to investigate the effects of home care exercise program on knee joint function(WOMAC) and the quality of life in patient with total knee replacement arthroplasty. Method: Forty-one subjects were sampled according to research criteria, and divided into two groups : 21 out of experimental group and 20 out of control group. The patients having treatment of total knee replacement arthroplasty were out of the hospital. After surgery executed, it took 8days for them to recovere their health conditions since 10th day, the experimental group received the home care exercise program per regularly four days interval. Results: 1) After applying home care exercise program, the total score on the WOMAC Index for the control group was $3.09{\pm}.76$. The score of the experimental group was $3.55{\pm}.55$ which is statistically higher than that of the control group. (P=.007). 2) After applying home care exercise program, the score of the quality of life for the control group was $3.09{\pm}.50$. The score of the experimental group was $3.46{\pm}.35$ Which is statistically higher than that of the control group. (P=.007). Conclusion: This figures show that home care exercise program has good results. These findings also indicate that the services of home care exercise program are alternatives for the hospitalization.

• 한국식품영양학회지
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• 제24권4호
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• pp.607-616
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• 2011

We identified the intake pattern and consumption propensity of milk and sought improvements to promote consumption of milk. We targeted 362 preschool children aged 5~7 years old who attended nursery school in the Bucheon area. Questionnaires were distributed and 328 questionnaires were collected. Approximately 36.2% of boys and 31.2% of gorls drank milk six times per week. A total of 32.9% of the preschool children drank more than 2 cups of milk/day. Approximately 72.9% of them currently drink white milk, and 46.0% preferred milk to processed milk. The reasons why they drink milk included 'want to be tall'(66.5%) and 'good health'(52.4%). Mothers(54.6%)and preschool children(39.3%) were the purchasers with the greatest impact on product purchases. Consumer propensity to buy milk was shown in the order of expiration date(4.80 points), and nutrition facts(4.01 points). (4.88 points) and enhanced nutrients(4.59 points) should be promoted for milk consumption. Therefore, it is thought that continuous nutrition education should be made together in order to increase consumption of milk of children and education targeting teachers and school parents should be conducted as well. And in order for children to drink milk without repulsion, the development of various products satisfying both symbolic aspects and nutritional aspects should continue to be made.

• 중환자간호학회지
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• 제14권3호
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• pp.128-140
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• 2021

Purpose : This study aimed to identify the incidence of peripheral cyanosis and the characteristics and clinical results of patients with therapeutic hypothermia after a cardiac arrest. Methods : Data were collected from April to June 2021 via the electrical medical records of 95 patients with therapeutic hypothermia for 72 hours after a cardiac arrest admitted to an acute care unit at a tertiary hospital between January 1, 2016, and December 31, 2019. The data were analyzed using descriptive statistics and a t-test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, and logistic regression using SPSS/WIN. Results : The incidence of peripheral cyanosis was 20%. In the peripheral cyanosis group, peripheral vascular disease, fibrinogen, vasopressor, infection, disseminated intravascular coagulation, acute physiology, chronic health evaluation II score on the second hospital day, nursing intervention, and mortality on the seventh hospital day were higher. The level of fibrinogen and use of vasopressors affected the occurrence of peripheral cyanosis. Conclusion : Considering the influencing variables, careful observation is necessary for patients with high fibrinogen levels and vasopressor use. These results provide basic data to recognize the need for nursing intervention for peripheral cyanosis and encourage nurses to deliver them during therapeutic hypothermia.

• Tuberculosis and Respiratory Diseases
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• 제70권1호
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• pp.28-35
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• 2011

Background: The aim of the study was to describe the characteristics, treatments, and outcomes of critically ill patients with pandemic Influenza A/H1N1 2009 at a major medical center in Korea. Methods: This retrospective observational study examined critically ill adult patients with pandemic Influenza A/H1N1 2009, who were admitted to the AMC between August and December 2009. Results: 27 patients with confirmed pandemic Influenza A/H1N1 2009 were admitted to the intensive care unit (ICU) at the Asan Medical Center (AMC). The median age (IQR) was 59 years (41~67), and 66.7% of the patients were older than 51 years. A total of 81.5% of the patients had 2 or more co-morbidities. The median time (IQR) from symptom onset to presentation was 2 days (1~4), and the median time from presentation to ICU admission was 0 days (0~1.5). All patients received oseltamivir (300 mg/day) and 13 patients received triple combination therapy (oseltamivir, amantadine, ribavirin). Twelve patients required mechanical ventilation on the first day of ICU admission. A total of 6 patients (22.2%) died within 28 days of admission. The patients who died had significantly higher acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores at presentation. There were no significant differences in age, co-morbidities, or antiviral regimens between survivors and non-survivors. Conclusion: Critical illness related to pandemic Influenza A/H1N1 2009 was common in elderly patients with chronic co-morbidities. All patients were given high-dose oseltamivir or triple combination antiviral therapy. Nonetheless, patients with critical illnesses associated with pandemic Influenza A/H1N1 2009 had a death rate of 22.2%.

• Perspectives in Nursing Science
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• 제9권1호
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• pp.45-50
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• 2012

Purpose: Despite poor cognitive function in heart failure (HF), few studies have examined cognition and its probable implication in self-care among Korean HF patients. The purposes of this study were (1) to describe cognition in the domains of global, memory, and executive functions, (2) to explore the relationship between cognition and self-care, and (3) to determine the amount of dietary sodium intake among Korean HF patients. Methods: A pilot study was conducted: 7 HF patients (3 men, mean age 68 years) completed face-to-face interviews for neuropsychological tests of cognition and self-care including dietary sodium intake. Results: More than half of the patients had impaired global cognition, memory, or executive function; patients with more severe HF were at higher risk of poor cognitive function. Korean HF patients exhibited poor self-care, with a high dietary sodium intake (5.6 g/day), approximately twice more than the suggested guideline of 2~3 g/day for patients with stable HF. Conclusion: Cognitive dysfunction and inadequate self-care with noncompliance with dietary sodium restriction were evident in Korean HF patients. More studies are warranted that examine the prevalence of cognitive impairment and areas of deficit using neuropsychological tests in a larger sample and that examine how cognition affects self-care and compliance in salt-intake.

• 간호행정학회지
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• 제3권2호
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• pp.61-80
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• 1997

The purpose of this study is to measure the direct and indirect nursing care hours with establishment of nurse substations and compare the experimental nursing units with the existing nursing units For this study, two experimental nursing units: (1) a medical nursing unit and (2) a surgical nursing unit with a nurse substation were selected. And two control nursing units : (1) a medical nursing unit and (2) a surgical nursing unit without a nurse substation were selected. After a three-month experimental operation from June 1 to August 31,1996, research data were collected for three days from September 2 to 4, 1996. We investigated the effects of the direct & indirect nursing care hours with establishment of the nurse substations (improved nursing environment) without adding the staff nurses. The effect of establishment of the nurse sub-station was measured for the differences direct & indirect nursing care hours between experimental and control nursing units. An investigator measured the time for a staff nurse to practice each nursing activity and recorded it every minute. Percentage, average, standard deviation, t-test and ANOVA were used for data analysis. The results are as follows: 1. There was no significant difference between the experimental and control nursing units in staffs' working hours during their shift. 2. There were significant diffferences between the experimental and control nursing units in dierct nursing care hours (t=0.0288, p=0.0001) and indirect nursing care hours (t=0.3886, p=0.0103) per patient. 3. There was significant difference between the experimental and control nursing units in direct nursing care hours done by nurses(t=0.0012, p=0.0111) and aids(t=0.3011, p=0.0027). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0051, p=0.0253), nurses(t=0.0071, p=0.0024) and aids (t=0.3227, p=0.0351). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by nurses(t=0.0005, p=0.0015) and aids(t=0.2400, p=0.0013) per patient. There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0005, p=0.0379) and nurses (t=0.0035, p=0.0198) per patient. 4. Thre were significant differences between the experimental and control nursing units in direct nursing care hours (t=0.1134, p=0.0010) and indirect nursing care hours (t=0.7106, p=0.0008) per staff during the day shift. There were significant differences between the experimental and control nursing units in direct nunsing care hours during the day(t=0.0723, p=0.0003) and evening shift (t=0.0004, p=0.0285) per patient, and indirect nursing care hours during the day shift(t=0.5565, p=0.0036) per patient. 5. There were differences between the experiemental and control nursing units in dircet nursing activities including measurement and observation, medication, communication, teratment, hygiene, and nutrition, and in indirect nursing activities including confirmantion, communication, record, computer work, management of goods. But it was not statistically proven. 6. There was difference between the experimental and control nursing units in unmet-need nursing care hours per patient, but not statistically proven.

• 한국산학기술학회논문지
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• 제18권6호
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• pp.407-417
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• 2017

본 연구의 목적은 영아반 보육교사가 어린이집의 하루일과 속에서 영아권리존중보육을 어느 정도 실행하고 있는지를 살펴보는데 있다. 이를 위하여, J도 G시에 소재한 어린이집 영아반을 담당하는 보육교사 210명을 대상으로 설문 조사를 실시하였다. 연구결과, 첫째, 어린이집 하루일과에 따른 영아권리존중보육의 실행 수준을 보육교사의 학력, 경력, 연령, 전공에 따라 차이를 검증한 결과, 전체적으로 유의미한 차이는 없었다. 그러나 등원시간과 화장실 다녀오는 시간에는 4년제졸업이상 학력교사보다 전문대졸 학력교사가, 등원시간과 낮잠 재우는 시간에는 50대 이상 연령교사보다 30~40대 연령교사가 영아의 권리를 보다 존중하는 보육을 실행하는 것으로 나타났다. 둘째, 보육교사의 연령과 전공에 따라서 전체적으로 유의미한 차이가 있었다. 하위영역별로 살펴보아도, 교사의 연령에 따라서는 의사 존중, 개별성 존중, 정보 제공에서 50대 이상 연령교사보다 30~40대 연령교사가, 교사의 전공에 따라서는 자율성 존중, 개별성 존중에서 유아교육 계열 전공교사보다 보육복지 계열 교사가 영아 최우선의 원칙에 따라 영아의 권리존중보육을 보다 우수하게 실행하는 것으로 나타났다. 셋째, 두 관련변인의 관계성을 살펴본 결과, 통계적으로 유의미한 정적인 관련성이 있는 것으로 나타났다. 즉, 보육교사가 어린이집의 하루일과에 따라 실행하는 영아권리존중보육을 많이 할수록 영아 최우선의 원칙에 따른 영아권리존중보육도 많이 한다는 것을 알 수 있다. 이러한 연구결과는 양적 질적으로 우수하고 균형 있는 영아의 권리존중 내실화를 다지는데 필요한 기초자료로 활용될 수 있을 것이다.

• 대한지역사회영양학회지
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• 제19권5호
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• pp.425-435
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• 2014

Objectives: The purpose of this study was to develop a Na-reduction education program and apply it for cooks who prepare meals in day-care centers. To development of the program was based on increasing the self-awareness of salinity, eating behaviors and enforcing skills of low-Na cooking. Methods: The study was carried out from April to October in 2013, fifty five cooks participated in this program. The Na reduction program composed of 4 sessions of education which included a 90-minute lecture and self-reevaluation of personal salt-sensitivity degree and three low Na recipe cooking classes. In order to measure the effectiveness of the program, the pretest and posttest of salinity of the soups provided by day care centers was conducted at registration and 5 month after the program with the same menu. Results: After the conduct of the program, salimeter using rate was increased from 8.2% to 94.6% after the program and the other measuring instruments using rate was gradually increased. We observed that the score on eating behaviors increased 1.51 points from 38.80 to 40.31 after the intervention program (p < 0.001). Further, increased knowledge and skill provided by the intervention program resulted in improved Na-reduction cooking capability. According to the results from analyzing the soup salinity, the salinity in watery soup was significant reduced from 0.556 to 0.449 0.107 and soybean-paste soup was significant reduced from 0.669 to 0.551 after the intervention program (p < 0.001). Conclusions: As the result of fact, the intervention programs that was based on self-reevaluation, to enforce practical skill and consciousness was effective to serve low sodium menu at day care centers.