• 제목/요약/키워드: Dependence of a patient

검색결과 63건 처리시간 0.028초

Fundamental Study of nanoDot OSL Dosimeters for Entrance Skin Dose Measurement in Diagnostic X-ray Examinations

  • Okazaki, Tohru;Hayashi, Hiroaki;Takegami, Kazuki;Okino, Hiroki;Kimoto, Natsumi;Maehata, Itsumi;Kobayashi, Ikuo
    • Journal of Radiation Protection and Research
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    • 제41권3호
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    • pp.229-236
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    • 2016
  • Background: In order to manage the patient exposure dose in X-ray diagnosis, it is preferred to evaluate the entrance skin dose; although there are some evaluations about entrance skin dose, a small number of report has been published for direct measurement of patient. We think that a small-type optically stimulated luminescence (OSL) dosimeter, named nanoDot, can achieve a direct measurement. For evaluations, the corrections of angular and energy dependences play an important role. In this study, we aimed to evaluate the angular and the energy dependences of nanoDot. Materials and Methods: We used commercially available X-ray diagnostic equipment. For angular dependence measurement, a relative response of every 15 degrees of nanoDot was measured in 40-140 kV X-ray. And for energy dependence measurement, mono-energetic characteristic X-rays were generated using several materials by irradiating the diagnostic X-rays, and the nanoDot was irradiated by the characteristic X-rays. We evaluated the measured response in an energy range of 8.1-75.5 keV. In addition, we performed Monte-Carlo simulation to compare experimental results. Results and Discussion: The experimental results were in good agreement with those of Monte-Carlo simulation. The angular dependence of nanoDot was almost steady with the response of 0 degrees except for 90 and 270 degrees. Furthermore, we found that difference of the response of nanoDot, where the nanoDot was irradiated from the randomly set directions, was estimated to be at most 5%. On the other hand, the response of nanoDot varies with the energy of incident X-rays; slightly increased to 20 keV and gradually decreased to 80 keV. These results are valuable to perform the precise evaluation of entrance skin dose with nanoDot in X-ray diagnosis. Conclusion: The influence of angular dependence and energy dependence in X-ray diagnosis is not so large, and the nanoDot OSL dosimeter is considered to be suitable dosimeter for direct measurement of entrance surface dose of patient.

만성 알코올 의존에서 대칭적인 피각부위 병변이 동반된 Marchiafava-Bignami 병 사례 (A Case of Marchiafava-Bignami Disease with Symmetrical Lesions of the Putamen in a Patient with Chronic Alcohol Dependence)

  • 주소연;최태영
    • 생물정신의학
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    • 제16권2호
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    • pp.127-132
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    • 2009
  • Marchiafava-Bignami disease(MBD) is a rare complication of chronic alcoholism characterized by symmetrical demyelination of the corpus callosum. We report a case of MBD in a Korean patient having chronic alcohol dependence. The patient exhibited mental depression, weakness of all four limbs and dysarthria. Laboratory data showed mild hyponatremia. Magnetic resonance imaging(MRI) revealed unusual symmetrical resolving lesions of the putamen in addition to the typically observed lesion of the corpus callosum. The neurologic disturbances were gradually improved with the normalization of low plasma sodium levels. Marked improvement of abnormal MRI findings was noted after thiamine supplement, though the patient still exhibited severe cognitive impairment.

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류마티스 관절염 환자 배우자의 부담감 (A Study on Burden of Middle Aged Spouses of Rheumatoid Arthritic Patients)

  • 최경숙;은영;함미영
    • 근관절건강학회지
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    • 제7권2호
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    • pp.241-257
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    • 2000
  • Rheumatoid arthritis as one of the chronic illness requiring management in long period of time puts great burden to patients, their family and society. For patients with chronic illnesses, providing a social support is important and the most important source comes from spouses. Therefore we assessed burden of husbands of female rheumatoid arthritic patients and also found out the factors affecting burden. The sample of study was 107 female rheumatoid arthritic patients and their spouses. The tool of assessing spouses' burden was the revised version of subjective and objective parameters developed by Montgomery et al.(1985). The results are as follows: 1. General characteristics of patients and spouses: The mean age of the patients was 48 years. Educational level of patients was high school 41.1%. The mean age of the spouses was 51years. Educational level of spouses was mostly high school(40.2%) and college(29.9%) graduate. The mean marital period was 23.4years. Average income per month was 1,609,000 won. The average duration since diagnosis was 9.4years. As a therapy, 67.3% chose standard drug therapy. Average rating of discomfort by patient was 3.05(range 1-5) and that of severity was 3.48 and that of dependency was 2.58. The husband's rating of their spouses disease severity was 3.68. 2. Husbands' burden: The average burden in subjective items was 21.61(range 6-36) and objective items was 35.24(range 10-60). The average of total burden was 56.59(range 16-96). 3. Husband's total burden correlated with patient's age, educational level of patients, therapy method, patient's level of discomfort, patient's severity, patient's level of dependence, husband's recognition of level of severity in statistical level. Husband's objective burden correlated with patient's age, educational level of patient, patient's level of discomfort, husband's recognition of level of severity. Husband's subjective burden correlated with patient's age, educational level of patients, therapy method, patient's severity, patient's level of dependence, husband's recognition of level of severity. 4. Linear correlation analysis on burden: The husbands' total burden is explained in 37 7% by husband's recognition of level of severity and husband's age. The husbands' objective burden is explained in 31.2% by patient's level of dependence, husband's age, husband's recognition of level of severity. The husbands' subjective burden is explained in 26.7% by husband's recognition of level of severity and patient's age. In conclusion, husbands' level of burden is affected by many factors and therefore nursing strategy for relieving burden of middle aged husbands should be individualized taking these factors into consideration.

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뇌졸중환자의 자가간호 수준에 따른 보호자의 스트레스 (A Study of Caregiver Stress as related to the Level of Self-care in Patients Who had a Cerebro Vascular Accident(CVA))

  • 최은숙;소희영
    • 대한간호학회지
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    • 제23권4호
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    • pp.602-616
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    • 1993
  • The purpose of this study was to explore the degree of stress in caregivers caring for patients who had had a cerebro vascular accident as the stress is related to the self- care ability of the patient. The subjects for the study were caregivers of 111 CVA patients, hospitalized at two University affiliated hospitals and two general hospitals in Daejon. The survey instruments used in the study were Kang’s ADL Check List and a modified form of Lee’s Stress Inventory. The survey was conducted from July 16th to August 30th, 1992. The survey results were analyzed using the Statisitical Package for Social Sciences (SPSS) and can be sumerized as follows: 1. The level of self- care for the CVA patients was : 1) complete dependence (M=34.7, 31.2%), 2) complete independence (M=14.8. 13.3%), 3) in-complete independence ( M=17.5, 15.8% ), 4) in-complete dependence (M=14.8, 13.3%) and 5) dependence and independence (M=14.1, 12.7%). The items for which there was a high level of self-care were 1) drinking (M=3.640), 2) returning (M=2.351) and 3) eating (M=2.351) : and the items for which there was a low level of self -care were : 1) ascending and descending stairs (M=2.351), 2) dressing and undressing trousers (M=2.514) and 3) dressing and undressing jacket (M :2.532). 2. There was a statistically difference between the paralytic status and the level of self- care accord-ing to their demographic characteristics ( F=24. 7056, p(.001). 3. There was no significant difference in the degree of caregiver stress according to patient's demo-graphic characteristics. 4. There was a statistically significant difference in the degree of caregiver stress according to the following demographic characteristics : age (F=7.4189, p(.001), education level (F=5.8336, P(.01), family structure (t=2.10, p(.05) and their relationship with the patient (F=6.5099, P〈.01). 5. There was no significant difference in the degree of caregiver stress according to the level of patient self - care.

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간호사의 가정간호를 위한 교육요구 분석 (A study on educational need of nurses for home care)

  • 문정순
    • 한국보건간호학회지
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    • 제5권2호
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    • pp.5-25
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    • 1991
  • This study was conducted from July to December 1990, in order to diagnose nurses' educational need for home care. The study subjects consisted of 145 nursing educators, and the 3 groups of nurses, namely 250 senior nursing students of diploma and collegiate program, 235 health center nurses, 521 university' hospital nurses in Seoul. Four types of questionaires were formulated by Delphi method. Two questionaires for the nursing educators were designed to measure their expectations of nurses' knowledge and of their skill for home care, and another two questionaires for the nurses to measure their actual home care knowledge and skill. The results of the study were as follows : 1) The mean scores of educators' expectation for home care knowledge were 17.68 for the care of dependence on medical equipment, 17.44 for the care of mobility impairment patient, 16.56 for the care of cardiopulmonary impairment patient, 16.40 for the care of nutrition and elimination impairment patient, '1.20 for the care of psychiatric disorder patient and 9.03 for the care of cancer and terminally ill patient,. 2) The mean scores of nurses' home care knowledge tested by 20 items were 14.36 for the care of mobility impairment patient, 13.28 for the c8;re of dependence on medical equipment, 13.78 for the care of cardiopulmonary impairment patient, 12.92 for the care of nutrition and elimination impairment patient, and those of tested by 10 items were 7.08 for the care of psychologic disorder patient, 7.80 for the care of cancer and terminally ill patient. The sum of means marked 69.23. As for the nurses' home care knowledge categorized by tasks in terms of the group, significant difference were shown in the care of mobility impairment(P=0.00), cancer and terminally ill(P=0.03), nutrition and elimination impairment(P=0.00) and psychologic disorder patient(P=0.00). No significant difference were shown in the care of dependence on medical equipment and cardiopulmonary impairment patient. 3) Regard to educational need of nurses' home care knowledge categorized by task according to the group it was found that all sampled nurses had educational need in the care of mobility impairment, dependence on medical equipment, cardiopulmonary impairment, cancer and terminally ill patient. It was found that health center nurses had educational need in the care of psychologic disorder. No educational need were found in the health center nurses whose career less than 2 years, in the care of mobility impairment, cardiopulmonary impairment and psychologic disorder patient, and in those of career with 2-5 year in the care of psychologic disorder patient. No educational need were found in the hospital nurses whose career more than 15 years, in the care of cardiopulmonary impairment patient and in those of career with 11-15 year, in the care of cancer and terminally ill patient. 4) The mean scores of educators' expectation for home care skill measured by Likert 5 points scale were 4. 21 for assessing, 4.49 for planning, 4.29 for basic care, 4.42 for curative care, 4.40 for rehabilitative care, 4.36 for emergency care, 4.53 for medication, 4.31 for nutritional care, 4.32 for other means for care, and 4.38 for evaluation. 5) Regard to nurses' home care skill measured by Likert 5 points scale of self evaluation, there was a significant difference between the nurses' home care skill and group(P=0.00l). The higher scores reported by students were vital sign checking and basic care while the scores of below medium were curative care and emergency care. The higher scores reported by health center nurses were vital sign checking, other means for care and care of specimen while the scores below medium were curative, emergency and nutritional care. The higher scores reported by hospital nurses were vital sign checking, care of specimen and basic care, while the score below medium was emergency care. 6) Regard to educational need of nurses' home care skill by nursing process activity according to the group it was found that health center nurses had educational need in all nursing skills including vital sign checking, care of specimen, health assessment, socioeconomic assessment, nursing diagnosis, care plan, basic care, curative care, rehabiitative care, psychological care, emergency care, medication, nutritional care, other means for care and evaluation. And students had educational need in all nursing skills except vital sign checking, and hospital nurses had educational need in all nursing skills except vital sign checking, care of specimen and basic care. 7) In short, the result of this study suggests that the curriculum should be organized in accordence with nurses' educational background and their career for the education of nurses for home care. It should be considered to develop the short term educational program focused on curative and rehabilitative care for health center nurse or community health nurse practitioner and which was focused on family care for hospital nurse. Concerning about this field practice for home care nurse, they are required not only community practice but also . clinical practice including emergency, curative and rehabilitative care.

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뇌졸중환자의 일상생활 수행수준과 가족원의 스트레스 (A Study on the Stress of Family-Caregivers and Level of Daily Living Performance with Patients of Cerebra Vascular Accident(CVA))

  • 조영희
    • 지역사회간호학회지
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    • 제10권2호
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    • pp.372-386
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    • 1999
  • The purpose of this study was to explore the degree of stress in caregivers caring for CVA patients and the level of daily living performance of CVA patients. The subjects for the study were caregivers of 112 CVA patients who enter a hospital or out-patient-department (OPD) at two Oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL check list for daily living performance of patients and Choi's 4 sore scale for stress of caregivers. The survey was conducted from July 4th to August 30th in 1999. The survey results were analyzed with the Statistical Package for Social Science(SPSS) program and can be summarized as follows: 1. The level of daily living performance for the CVA patients was: 1) complete dependence (M=14.9, 13.1%), 2) complete independence (M=23.6, 20.9%), 3) incomplete independence (M=23.9, 21.0%), 4) incomplete dependence (M=26.6, 25%), 5) dependence and independence (M=23.0, 20.0%). The items for with there was a high level daily living performance were: 1) drinking (M=3.62), 2) eating(M=3.25). 3) position returning (M=3.18) : and the items for which there was a low level of daily living performance were: 1) ascending and descending stairs (M=2.08), 2) walking (M=2.47), 3) dressing and undressing trousers (M=2.55). 2. Degree of caregiver stress was: Mean=2.39 at 40 score. The items for which was a high level caregiver stress were: 1) medical fee (M=3.25), 2) being handicapped or recurrence (M=3.02) : and the items for which there was a low level of caregiver stress were: 1) discontinuity of patient's treatment (M = 1.98). 2) change of home atmosphere caused by patient's disease (M = 1.98), 3) desire of patient's knowing about disease (M= 1.99). 3. There was statistically significant difference in the degree of caregiver stress according to the following caregiver's demographic characteristics: education level (F=3.52, P=0.03). change of caregiver (F=5.41. P=0.02). 4. There was a statistically signifiant difference in the level of daily living performance according to the CVA patients demographic characteristics: patient's paralytic status (F=4.48, P=0.01), duration of disease (t=2.76, P=0.03). 5. There was significant difference in degree of caregiver stress according to the CVA patient's demographic characteristics: CVA status (F=4.75, P=0.01). 6. There was statistically significant difference in the degree of caregiver stress according to the level of daily living performance in CVA patients(r=-0.482, P<0.00).

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뇌졸중 환자 보호자의 SF-8을 이용한 신체건강관련 삶의 질 융복합적 연구 (A Convergent Study of the Physical Related Quality of Life Using SF-8 of Stroke Patient's Caregiver)

  • 김영란;김영일;김민정
    • 한국융합학회논문지
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    • 제8권12호
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    • pp.119-127
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    • 2017
  • 본 연구는 청주시와 대전광역시에 소재한 7개의 종합병원에서 뇌졸중으로 진단받은 입원환자의 보호자 226명을 대상으로 부양부담감 및 우울감과 신체건강관련 삶의 질을 융복합적으로 파악하고자 조사하였다. 삶의 질은 HRQoL의 단축형인 SF-8을 이용하였다. 다중회귀분석 결과, 환자의 일상생활 의존도가 가장 많은 영향을 주었다. 이러한 결과로 볼 때 뇌졸중 환자 보호자의 신체건강관련 삶의 질을 높이기 위해서는 노인 장기 요양 보험제도 및 간병인 제도와 보건복지부에서 실시하고 있는 보호자 없는 병실을 확대 운영하여 보호자의 간병시간을 줄이고, 질환에 대한 교육과 가족지지모임을 통해 회복에 대한 기대를 높일 필요가 있다.

Frequency of Cigarette Smoking Among Psychiatric Inpatients Evaluated by the Fagerstrom Test for Nicotine Dependence

  • Tanriover, Ozlem;Karamustafalioglu, Nesrin;Tezvaran, Zehra;Kaplan, Asli;Tomruk, Nesrin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.579-582
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    • 2013
  • Background: In this study our aim was to determine the rate of smoking in a sample of psychiatric in-patients with diagnoses of schizophrenia, bipolar disorder and major depression and to examine factors related to smoking status and the level of dependence in this population. Materials and Methods: A total of 160 people were included in this descriptive study. 80 were inpatients with schizophrenia, bipolar disorder and major depression and 80 people without any psychiatric diagnoses were included as a control group. The participants were interviewed face-to face using a semi-structured questionnaire and Fagerstrom Test for Nicotine Dependence was used to define smoking habits. Results: The mean age of the participants was $37.24{\pm}12.19$ years ranging from 18 to 81 years, 54.4% of the participants were (n=87) female, and 45.6% cases (n=73) were male. 70% (n=56) of the patients and 55% of the control group were smoking and the difference was statistically significant (p<0.01). Total score of Fagerstrom Test for Nicotine Dependence in the patient group was statistically significantly higher than in the control group (p<0.01). Conclusions: In our sample, the frequency of cigarette smoking and nicotine dependence among psychiatric inpatients was high, posing a high risk for smoking related diseases including cancers; therefore there should be counseling on tobacco control and smoking cessation programming targeting this population.

복합만성질환자의 의료이용 과정에 관한 근거이론적 탐색 (An Exploratory Study of Healthcare Utilization Process among Patients with Multimorbidity)

  • 유수영;유명순
    • 근관절건강학회지
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    • 제28권2호
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    • pp.161-173
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    • 2021
  • Purpose: This study examined: 1) what it meant for patients to have multimorbidity 2) how they manage their illness using health care facilities, and 3) what contextual backgrounds exist regarding the health care system. Methods: This qualitative research obtained individual in-depth interviews from 22 patients. Participants were selected by purposive sampling among those who saw physicians more often than the national average from the 2013 medical-claim data. The transcribed data were analyzed using Ground theory. Results: Multimorbidity patients suffered from "chain-like serial symptoms" and "pain without a breakthrough". They expressed themselves as "indeed patients among patients", "my body is a general hospital", and "an incompletely normal person". There was a demand to resolve the anxiety arising from the situation in which the body keeps getting sicker without showing any signs of recovery. In a state of reduced social support and a lack of trust in the doctor, their desire to be healed led them to receive a temporary relief through dependence on medical institutions. Conclusion: This research recognized the desire of multimorbidity patients to seek temporary relief through dependence on medical institutions. A more patient-centered directed care plan, specific to the needs of the patients with multimorbidity is required.

Explainable Machine Learning Based a Packed Red Blood Cell Transfusion Prediction and Evaluation for Major Internal Medical Condition

  • Lee, Seongbin;Lee, Seunghee;Chang, Duhyeuk;Song, Mi-Hwa;Kim, Jong-Yeup;Lee, Suehyun
    • Journal of Information Processing Systems
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    • 제18권3호
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    • pp.302-310
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    • 2022
  • Efficient use of limited blood products is becoming very important in terms of socioeconomic status and patient recovery. To predict the appropriateness of patient-specific transfusions for the intensive care unit (ICU) patients who require real-time monitoring, we evaluated a model to predict the possibility of transfusion dynamically by using the Medical Information Mart for Intensive Care III (MIMIC-III), an ICU admission record at Harvard Medical School. In this study, we developed an explainable machine learning to predict the possibility of red blood cell transfusion for major medical diseases in the ICU. Target disease groups that received packed red blood cell transfusions at high frequency were selected and 16,222 patients were finally extracted. The prediction model achieved an area under the ROC curve of 0.9070 and an F1-score of 0.8166 (LightGBM). To explain the performance of the machine learning model, feature importance analysis and a partial dependence plot were used. The results of our study can be used as basic data for recommendations related to the adequacy of blood transfusions and are expected to ultimately contribute to the recovery of patients and prevention of excessive consumption of blood products.