• Title/Summary/Keyword: Effective intervention

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Clinical Experience of Rigid Bronchoscopy in Single Center

  • Kim, Hyun-Jin;Kim, Sei-Won;Lee, Hye-Yeon;Kang, Hyeon-Hui;Kang, Ji-Young;Kim, Ju-Sang;Kim, Myung-Sook;Kim, Seung-Soo;Kim, Jin-Woo;Yun, Hyeong-Gyu;Kim, Chi-Hong;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Cho, Kwang-Jae;Moon, Seok-Hwan;Lee, Sang-Haak
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.6
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    • pp.486-492
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    • 2012
  • Background: The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders. Methods: We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine. Results: Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication. Conclusion: Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

A Systematic Review of Modified Constraint- Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy (뇌성마비 유형 중 편마비 아동을 위한 수정된 강제유도 운동치료의 효과에 대한 체계적 고찰)

  • Hong, So-Young;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.10 no.2
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    • pp.11-22
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    • 2012
  • Objective : This research investigated the intervention effects, protocol of modified constraint-induced movement therapy in children with hemiplegic cerebral palsy. Methods : For the key words of a database search, "Cerebral Palsy", "Hemiplegia", "Constraint Induced Movement Therapy", "modified Constraint Induced Movement Therapy" were used. We examined papers published in journals from January 2001, when the modified Constraint Induced Movement Therapy was first suggested, to May 2011, using PubMed, Medline. Ovid. Results : A total of 10 papers were analyzed and results of modified Constraint Induced Movement Therapy were an effective therapeutic method to improve motor function, quality of movement and that they also increased the frequency of functional use of the affected hands of hemiplegic cerebral palsy. Conclusion : This paper conducted a systematic review of the research literature reporting on the effects of modified constraint-induced movement therapy in children with hemiplegic cerebral palsy. Analysis of the fewer number of papers, there was limitation that we consider studies at all levels of evidence. However the restraint methods should be decided according to the characteristics of the individually and apply a variety of therapeutic activities, there is positive support for the use of modified constraint-induced movement therapy to improve the recovery of the paretic upper extremity with cerebral palsy.

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Streets of Relaxation Therapy and Exercise Therapy on Catecholamine and Heart Rate Response for Job Stress of White Color Workers (사무직 근로자에 대한 운동요법과 이완요법이 스트레스 반응으로 카테콜라민과 심박수에 미치는 영향)

  • Kim In-Hong
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.2
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    • pp.240-254
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    • 1999
  • The purpose of this study was to investigate the effect of exercise therapy and relaxation therapy on catecholamine and heart rate in people in white color jobs and to determine this information the effectiveness of applied exercise therapy and relaxation therapy as a nursing intervention method for stress patients. The subjects were divided into an exercise therapy group, a relaxation therapy group, and control group and the research design was a nonequivalent control group pretest-post test design(exercise therapy : n= 12, relaxation therapy : n=12, control group, the group without any treatment in exercise on relaxation therapy : n=12), The subjects in the exercise therapy group were given a particular intensity for each kp during 30min, bicycle ergometer which is using an LX PE training system before & after 4weeks of training. The exercise therapy that was used was Astrard load method which tested absolute exercise load of heart rate before & after four weeks, and resting heart rate was tested for exercise and relaxation therapy before, after four weeks, and at eight weeks. The results of each kp & absolute exercise load were calculated with the target rate formula(maximal heart rate-rest heart rate) x exercise intensity(%) + rest heart rate so the subjects could continue 60-70% exercise intensity for exercise therapy over eight weeks. The relaxation therapy subjects were trained using a modified Jacobson's relaxation technique for eight weeks. The exercise and relaxation therapy were trained at the following intensity for eight weeks(3times/week, 30min/day) to see changes in catecholamine & heart rates. After eight weeks, statistical analysis of exercise & relaxation therapy were carried out Two-way ANOVA and multiple range test(SNK : Student Newman Keul) were used. The results are as follows : 1. The change of epinephrine & norepinephrine in the exercise therapy, relaxation therapy, and control group was statistically significant at the .05 level after four weeks & eight weeks. Also, exercise therapy was statistically significant at .05 level over that of the control group after 4weeks. 2. The change of heart rate in relaxation therapy was statistically significant at the .05 level, and was statistically significant at the .05 level over that of the exercise therapy and control group. In conclusion, it is obvious that exercise therapy and relaxation therapy should be one of the most effective stress treatment and desirable nursing interventions methods for job stress in people in white color jobs.

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Regional Disparity of Ambulatory Health Care Utilization (시공간 분석을 이용한 외래 의료이용의 지역적 차이 분석)

  • Shin, Ho-Sung;Lee, Sue-Hyung
    • Journal of the Korean Association of Geographic Information Studies
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    • v.15 no.4
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    • pp.138-150
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    • 2012
  • The purpose of this study was to examine the regional disparity of ambulatory health care utilization considering spatio-temporal variation in South Korea during 1996-2008(precisely, in 1996, 1999, 2002, 2005, and 2008) using bayesian hierarchial spatio-temporal model. The spatial pattern uses an intrinsic gaussian conditional autoregressive (CAR) error component. Ornstein-Uhlenbeck method was applied to detect the temporal patterns. The results showed that substantial temporal-geographical variation depending on diseases exists in Korea. On the Contrary to the pattern of total outpatient utilizations, for example, the areas that chronic diseases distributed relatively high were most in rural where the proportion of elderly population was higher than in the urban. Chungcheongnam-do, Junlabuk-do, and Kyeongsangbuk-do had higher risks in hypertension, whereas arthritis was higher risk in the Kyeonggi-do, Chungcheongbuk-do, Junlanam-do, and Junlabuk-do. The results of this study suggested that the effective health intervention programmes needed to alleviate the regional variation of health care utilization. These outcomes also provided the foundation for further investigation of risk factors and interventions in these high-risk areas.

The Comparative Study of Family Dynamics between Families of Problem Students and of Normal Students (문제학생가족과 정상학생가족의 가족역동 비교연구)

  • 김윤희;문희자
    • Journal of Korean Academy of Nursing
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    • v.23 no.2
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    • pp.187-206
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    • 1993
  • The study was done to better understand problem behavior in high school students as described in family system theory, which explains the individual’s problem within the family interactions. The purpose of the study 1. To analyze the difference in the parents’ relationship as a couple between the two groups. 2. To analyze the difference in the parent-adolecent relationship between the two groups. 3. To analyze the difference in the family function (cohesion adaptability) between the two groups. The method of the study The staudy subjects consisted of a total of 176 families (528 persons), 109 high school students (End grade) with problem behavior and their parents (problem family group) ,and 69 high school students (same grade) with normal behavior and their parents (normal family group) residing in the Seoul area. Data were gathered from structured, self-reporting qestionaires which included a Couple Relation measurement (95 items) , Parent-Adolescent communication measurement (20 items), Family Cohesion Adaptability Scale (20 items) by DavidH. Olson et al., and a behavior evaluation tool. The results of the study 1. The results as related to the hypothesis were as follows. Hypothesis 1 : “satisfaction within The couple's relationship of the parents of problem family group will be lower than the normal family group was supported significantly(t=3.07, p=.005). Hypothesis 2: “The parent-adolescent relationship of the problem family group will be more negative and problematic than the normal family group” was supported significantly(t=4.06, p=.000). Hypothesis 3: “The family function (cohesion adaptability) of the problem family group will be lower than the normal family group" was supported significantly(t=2.20, p=.022) 2. The results of related analysis were as follows 1) Analysis of a causal relation between the couple’s relationship, the parent-adolescent relationship, family function and adolescent behavior showed that the Above 3 variables influenced adolescent behavior.. In cases where couple’s relation-ship, the parent-adolescent’s relationship, the family function are the better, their adolescent’s behavior is better. 2) Discriminant analysis of the research tool showed The discriminant ability of couple’s relationship tool was 75.57%, the Parent-Adolescent communication tool, 67.05, the family adaptability cohesion tool.67. 61%. In summary, interpersonal relationships in the family subsystems are interactive and their relation influences the behaviors. of adolescents in the family. Therefore, family therapy would be a more effective method than individual therapy, to resolve negative problem for adolscents, and the research tool used in this study are very useful for family system diagnosis and nursing intervention.

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The Effect of a Telephone follow-up on the Self-care and the Satisfaction on Nursing Care in G-I Surgical Patients (전화추후관리가 위,장관계 수술환자의 자기간호수행 및 환자만족도에 미치는 효과)

  • Na, In-Jae;Lee, Byung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.355-368
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    • 1999
  • This study was a quasi-experimental study to investigate the effect of a telephone follow-up on the self-care and the satisfaction on nursing care in G-I surgical patients. The subjects of the study were 38 patients, 19 in experimental group and 19 in control group, who discharged after gastrointestinal surgery at a university hospital in Taegu between August 11. 1998 and October 16, 1998. The telephone follow-up program for the experiment was developed by the researcher, which contained consultation, support and encouragement for self-care after discharge. Number of the instruments used for measurement of the outcome variables were 5, self-care after discharge, satisfaction(1)${\sim}$(2) on Nursing care. intention to visit the hospital again. intention to recommend the hospital to others. The results of this study were as follows ; 1. The first hypothesis, "The subjects of experimental group will show a higher level of self-care than the subjects of control group" was rejected (F=.48. p=.4937). 2. The Second hypothesis. "The subjects of experimental group will show a higher level of satisfaction than the subjects of control group" was accepted partly as follows. 1) The hypothesis 2-1, "The subjects of experimental group will show a higher level of satisfaction(1) than the subjects of control group" was accepted(F=4.04. p=.0496). 2) The hypothesis 2-2. "The subjects of experimental group will show a higher level of satisfaction(2) than the subjects of control group" was accepted(F=8.48. p=.0064). 3) The hypothesis 2-3, "The subjects of experimental group will show a higher level of intention to visit hospital again than the subjects of control group" was rejected(F=1.95. p=.1723). 4) The hypothesis 2-4. "The subjects of experimental group will show a higher level of intention to recommend the hospital to others than the subjects of control group" was rejected(F=1.43. p=.2411) . From the results of this study, the telephone follow-up can be regarded as an effective nursing intervention for the discharged patients.

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Pain, Family Support and Quality of Life in Patients with Ankylosing Spondylitis (강직성 척추염 환자의 통증, 가족지지와 삶의 질과의 관계)

  • 임현자;문영임
    • Journal of Korean Academy of Nursing
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    • v.28 no.2
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    • pp.329-343
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    • 1998
  • This study was designed to identify the relationship between perceived pain, family support and quality of life in patients with ankylosing spondylitis. The purpose of this study was to contribute to the theoretical understanding of the relationship of these three variables and eventually to more effective adaptation of patients to their situation. The subjects for this study were the 68 patients who had been diagnosed with ankylosing spondylitis and registered as out-patients in the Rheumatism Center of one university hospital in Seoul. The data were collected during the period from October 10, 1997 to December 20, 1997, Pain was measured using the perceived pain scale(VAS : Visual Analog Scale)developed by Calm(1993), family support using the scale developed by Kang Hyun Suk (1985) and Quality of Life using the scale developed by Ro Yoo Ja(1988). The data were analyzed by descriptive statistics, Frequencies, Pearson correlation coefficient, using the SPSS program. The results of this can be summarized as followings. 1. The mean perceived pain score was 5. 13 with a range of 2 to 10. 2. The mean perceived family support score was 41.08$\pm$5.34 with a range of 20 to 50. 3. The mean perceived quality of life score was 134.07$\pm$19.82 with a range of 83 to 176. 4. Significant statistical difference was found between family support and quality of life (r=.331, p<0.001). A significant negative statistical difference was found between the family support and quality of life and pain(r=-.250, p<0.05, r=-.460, p<0.001). 5. General characteristics related to pain were exercise (t=4.72, p<0.0006). 6. General characteristics related to family support were age(F=2.65, p<0.0246), educational level (F=2.84, p<0.0282) and exercise (t=3.24, p<0.0452). 7. General characteristics related to quality of life were educational level (F=3.03, p<0.0392) and exercise (t=3.12, p<0.0465). It was found that the higher the level perceived pain, the lower the degree of perceived family support and the quality of life. It was also found that the higher the degree of perceived family support, the higher the degree of perceived quality of life. Accordingly, the conclusions from this study are that reduction of pain is achieved through the family support. Therefore, it is proposed that family support is an appropriate nursing intervention to improve the quality of life of patients with ankylosing spondylitis.

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Comparision of Group and Individual Social Support on Burden and Family Functioning in Families with Asthmatic Children (집단 사회적지지와 개별 사회적지지가 천식아동 가족의 부담감과 가족기능에 미치는 영향)

  • 전화연
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.418-428
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    • 1999
  • The main purpose of this study was to identify the effects of group social support and individual social support on the reduction of burden and improvement in family functioning of families with asthmatic children. The design of this study was a randomized pre-posttest quasi-experimental design to compare the two experimental groups. The theoretical framework for this study was derived from the study of burden in family caregivers by Suh and Oh (1993) based on the main effect model of social support theories. The data were collected from February 12, 1998 to May 29, 1998 at the pediatric out patient department of a university hospital located in Suwon city. The sample consisted of 39 family members who were identified as families with asthmatic children, Eighteen subjects were randomly assigned to the group social support group and 21 were assigned to the individual social support group. Group and individual social support members were seen for 60 to 90 minutes, four times over one to three weeks. The instruments used in this study were the Burden Scale developed by Suh & Oh(1993), the Visual Analogue Scale, and the Family Adaptability Cohesion Evaluation Scale(FACES-III) developed by Olson, Portner, and Lavee(1985). The collected data were analyzed using Mann-Whitney test, x$^2$-test, Wilcoxon sign rank test, t-test, ANOVA (Scheff), Pearson correlation coefficient. multiple regression, and social support process and content analysis. The results are as follow : 1. There was no significant difference before the experimental treatment among the subjects in the group social support group and individual social support group for general characteristics, burden, or family functioning. 2. Hypothesis 1 : “There will be a greater reduction on the burden score of the group social support group compared to the individual social support group” was not statistically significant(U=174.5, p=.683). The burden scores showed a significant decrease after participation in social support as compared to before participation for both groups. However there was a tendency for more reduction in the burden scores for the group social support than for individual social support. 3. Hypothesis 2 : “There will be a greater improvement in the family functioning scores for the group social support group compared to the individual social support group” was not statistically significant(U=153.0. p=.309). There was a tendency toward improvement in the family functioning scores of the group social support as compared to that of the individual social support. 4. According to the length of the treatment period, families with asthmatic children displayed affirmative responses, and the families set up a self-help group of mothers with asthmatic children in order to share their experiences, to get information and to solve their problems. In conclusion, it was found that group social support was the more effective nursing intervention for reducing burden and for improving family functioning of families with asthmatic children.

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The Effect of the Self Efficacy Promotion and Exercise Training Program of Kidney Transplant Recipients (신장이식 환자의 수술 후 자기효능증진과 운동훈련 프로그램 효과)

  • An, Jae-Hyeon
    • Journal of Korean Academy of Nursing
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    • v.30 no.5
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    • pp.1181-1194
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    • 2000
  • This study was attempted to evaluate how the self efficacy promotion and exercise training program effect on the postoperative general conditions of transplant recipients after kidney transplantations. The subjects were selected randomly among the patients who underwent renal trans- plantations at three major transplantation hospitals in Seoul, Korea. This study was carried out between November 1999 and March 2000. The observed subjects in this study consisted of 56 patients. The exercise training group(n=16) received the self efficacy promotion and exercise training program for 12 weeks which contained general knowledge for compliance instruction, exercise training and self efficacy promotion education. The self efficacy group(n=18) received general knowledge for compliance instruction and self efficacy promotion education but no exercise training was given. The control group(n=22) were not offered any education. The knowledge for compliance, self efficacy, physical conditions(weight, muscle strength, muscle endurance, flexibility), lab studies (hemoglobin, creatinine, cholesterol), activities of daily living and quality of life were evaluated 3 times, before the experiment, at 8 weeks and at 12 weeks. The data were analyzed with mean, standard deviation, Chi-square test, ANOVA and Scheff test. The results were as follows: 1. The knowledge and self efficacy score of the exercise training group and self efficacy group were significantly increased than those of the control group(p=.0001). 2. The weight of the exercise training group was significantly decreased compared to those of the self efficacy group and the control group(p=.0001). Muscle strength (grip strength, back lift strength), and flexibility of all 3 groups were significantly changed(p=.0001). However, muscle endurance in all 3 groups showed no significant differences. 3. The hemoglobin level of the exercise training group and the self efficacy group were significantly increased compared to that of the control group(p=.0001) and the cholesterol levels of the exercise training group and the self efficacy group were significantly decreased compared to that of the control group(p=,0001). However, the creatinine levels in all 3 groups showed no significant differences. 4. The activities of daily living scores of the exercise training group was significantly increased than that of the control group (p=.0003), and the quality of life scores of the exercise training group and the self efficacy group were significantly better than that of the control group(p=.0001). It would be expected that this self efficacy promotion and exercise training program could be applied widely as an effective nursing intervention for kidney transplant recipients.

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EFFECTS OF THE MOTHER-CHILD ATTACHMENT PROMOTION PROGRAM FOR AUTISTIC CHILDREN (자폐아동을 위한 모-아애착증진 프로그램의 효과)

  • Lee, So-Woo;Hong, Kang-E;Im, Sook-Bin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.198-208
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    • 2000
  • Objectives:This study was conducted to evaluate the effects of the attachment promotion program which was designed to promote attachment between autistic children and their mothers. The program was consisted of play activity centered mother-child interaction, educational activity for mothers by lecture, video-feedback session, and emotional supports. Methods:The subjects were consisted of 11 pairs of mother and child(7 for participant group:PG, 4 for non-participant group:NPG), who were 2-4 years-old autistic children. The data were collected by video-taping, behavioral observations, and analyzed by Wilcoxon Rank(Sign) Sum Test and Content Analysis. Results:The total attachment score increased from pre test to post-test of PG was significantly higher than that of NPG. The scores of attachment behaviors indicating proximity, mutuality and affect increased significantly(p<.05), while some behaviors indicating synchrony and jointattention did not. Especially the affectionate behaviors of PG demonstrated the most notable changes and they became more active, voluntary and reciprocal. After the program, the mother's nurturing behaviors of PG increased more than that of NPG, with no significant difference between two groups. The mother's behaviors to her child of PG became more child-centered, positively responsive, supportively expressive. As the attachment was promoted, there were also positive changes in the children's autistic behaviors with a great deal of individual differences. Conclusion:Our findings suggest that Mother-Child Attachment Promotion Program could be an effective early intervention model for autistic children.

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