• Title/Summary/Keyword: Effective intervention

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An Effect of the Self-Regulation Program for Hypertensives -Synthesis & testing of Orem and Bandura's theory- (본태성 고혈압 환자의 자가간호증진을 위한 자기조절 프로그램 효과 -Orem이론과 Bandura이론의 합성과 검증-)

  • Park, Young-Im;Hong, Yeo-Shin
    • Research in Community and Public Health Nursing
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    • v.5 no.2
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    • pp.109-129
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    • 1994
  • Chronic health problems has become a major concern and challenge to the health care professionals today. Especially hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Self-care is an essential factor that keeps chronic patients in control of their health and wellness. Thus this study was conducted to identify the effect of the comprehensive self-regulation program as a nursing intervention on the promotion self-care performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi-experimental research with pre and post test design was used. The subjects of the study was consisted of thirty persons with mild or moderate essential hypertension from two companies in Cheong-ju city. The whole program was carried out from October, 1993 to February, 1994. The self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The instruments used for data collection in this study were as follows : 1) Instruments used for measuring the knowledge about hypertension, multiple health locus of control, and perceived benifits and barriers were adapted from previous studies and modified by author to be fit for the subjects. 2) Self-efficacy scale and self-care performance record were developed by the author. 3) Physiological parameters included systolic / diastolic blood pressure, body weight, level of blood cholesterol, and 24hour ambulatory blood pressure. The post-experimental Cronbach's Alpha as the reliability test of scales were 0.703-0.897, an appropriate level of confidence. The effect of the program was analyzed by experimental stages ; the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t-test and t-test, repeated measure ANOVA, and pearson's correlation to de termine the effect of program. The results were as follows : 1) After the self-regulation program, scores on knowledge(t=-2.41, p=.011), perceived self-efficacy (F=5.60, p=.001), self-care performance(F=22.31, p=.0001) were significantly higher than those before the program. 2) After the program, both systolic and diastolic blood pressure were significantly lower than those before the program(F=10.89 -13.11, p=.0001). However in 24hour ambulatory blood pressure, systolic mean pressure was nearly significantly lower, but not in diastolic mean pressure. 3) After the program, the body weight was significant decresed(t=5.53, p=.0001), but the blood cholesterol level was not decreased significantly except in those cases with higher cholesterol level. 4) There were significant relationships between changes in self-care performance and diastolic pressure at 1st week (r=.3389, p=.033) and changes in self-care performance and systolic pressure at 9th week(r=.3651, p=.024). 5) There were significant relationship between perceived self-efficacy and self-care performance at 5th week(r=.5313, p=.001) and 9th week (r=.3026, p=.052). 6) After the program, internal health locus of control and perceived benefits did not show significant change, but perceived barriers was significantly lower than those before the program (t=3.57, p=.0001). From the above results, it can be concluded that 1) The self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives and to lower the blood pressure. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings. 2) The synthesis of Orem's self-care theory and Bandura's self-regulation & self-efficacy theory in this study was proved to enhance explanation and prediction of the change of self-care behavior. Thus the result of the study would contribute in development of the self-care theory and an expansion of practice-theory.

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The Short Term and Intermediate Term Results of using a T-tube in Patients with Tracheal Stenosis (기관 협착 환자에서의 T-튜브의 중단기 결과)

  • Sa, Young Jo;Moon, Seok-Whan;Kim, Young-Du;Jin, Ung;Park, Jae-Kil;Kim, Jae Jun;Kim, Chi-Kyung;Jo, Keon Hyon;Park, Chan Beom;Yim, Hyeon Woo
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.63-71
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    • 2009
  • Background: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. Material and Method: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. Result: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. Conclusion: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.

Treatment of Refractory Lateral Epicondylitis with Platelet-Rich Plasma (불응성 주관절 외상과염에 대한 혈소판 풍부 혈장 주입 치료의 임상적 결과)

  • Ko, Sang-Hoon;Lee, Chae-Chil;Kang, Byeong-Seong;Lee, Ki-Jae;Lee, Seon-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.58-63
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    • 2010
  • Purpose: To evaluate clinical results of a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis. Materials and Methods: Between Jan and Dec 2009, fifteen patients (5 male, 10 female) received a diagnosis of lateral epicondylitis of the elbow and were evaluated in this study. Their average age was 43.5 years. All patients were initially given a variety of non-surgical treatments for more than 1year. All patients were considering surgery. These patients were given a single percutaneous injection of 3cc of platelet-rich plasma. To assess pain, we used a visual analogue scale (VAS) at rest and during work & the Patient-Rated Tennis Elbow Evaluation (PRTEE) score. We compared the score before treatment with scores 4 and 12 weeks after treatment. Results: Average VAS scores at rest improved from 4.6 before treatment to 2.5 at week 4, and 1.8 at week 12. The average VAS score while working also improved from 7.8 before treatment to 6.2 at week 4, and 4.25 at week 12. The average PRTEE score improved from 60.13 before treatment to 46.12 at week 4 and 24.6 at week 12. Conclusion: Treatment using a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis appears to be an effective treatment modality. Platelet-rich plasma should be considered before surgical intervention.

Comparison of Efficacy of Steroid Oint with Different Potency in Phimosis (생리적 포경 치료를 위한 역가가 다른 스테로이드 연고의 효과 비교)

  • Hwang, In Ok;Lee, Eun Sil;Park, Yong Hoon
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.594-598
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    • 2005
  • Purpose : Phimosis is the inability to retract the foreskin of the penis over the glans of the penis. Even though phimosis is not pathogenic, the presence of phimosis is known to increase the risk of urinary tract infection in infancy. The use of topical steroids has been advocated as a safe and economical alternative to surgical intervention. The purpose of the study was to assess the effectiveness of topical steroids for the treatment of phimosis in young boys. Methods : A total of 53 boys with phimosis were divided into two groups to distinguish between the efficacy of low-potency topical steroid(group 1, 27 cases) and of high-potency topical steroid (group 2, 26 cases). Results : The success rate increased in the process of time. After 6 weeks, the success rate was 21 cases in group 1 and 22 cases in group 2. There was no significant differences in treatment outcomes between the two groups. The age of the boys, the appearance of prepuce prior to treatment, and the presence of previous symptoms, including symptoms of UTI, and ballooning of the prepuce at micturation had no significant difference on treatment outcomes. Conclusion : Topical steroid was effective in treatment of phimosis in boys younger than 4 years old. Although treatment outcomes between low- and high-potency topical steroids were not significantly different, those treated with a high-potency steroid cream showed more fast improvement. Further studies are necessary to assess systemic side effects of steroid treatment, duration of treatment and prevention of genitourinary tract infection in male infants.

The Effects of Dimethyl Sulfoxide and Sodium Thiosulfate for the Prevention of Tissue Necrosis due to Extravasaion of Mitomycin-C (혈관외로 유출된 Mitomycin-C에 의한 조직괴사 예방을 위한 Dimethyl Sulfoxide와 Sodium Thiosulfate의 효과)

  • Woo, Sang-Hyun;Choi, Byung-Cheol;Kim, Ki-Hyung;Seul, Jung-Hyun;Jung, Tae-Eun
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.243-250
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    • 1996
  • Extravasation of toxic chemotherapeutic agents cause severe skin ulceration and necrosis which often need secondary surgical intervention. Still, there were not established antidote agent in case of extravasation with mitomycin-c. Dimethyl sulfoxide is known as an effective chemical scavenger of toxic hydroxyl free radical and sodium thiosulfate also was demonstrated significant protector from mitomycin-c induced ulceration by a few experimental studies. Author investigated necrotic area of mitomycin-c injected site and compare to the effectiveness of topical treatment with dimethyl sulfoxide and intradermal injection of sodium thiosulfate according to starting times, forty five mice were divided into 3 groups. Control group(n=5) had no treatment after subcutaneous injection of mitomycin-c. Experimental group I and II were 20 mice treated dimethyl sulfoxide and sodium thiosulfate, respectively. Depending on the starting time of treatment, group I and II were subdivided into 1, 2, 3 and 4 as immediate, 6 hours, 12 hours and 24 hours after mitomycin-c injection. Histologic studies of the necrotic area and survival area after treatment were performed using hematoxylin-eosin staining. The mean necrotic area of group I was significantly decreased depending on the starting time of treatment compared with control group(p<0.01). The results means there was no necrosis area which was treated with topical sodium thiosulfate within 6 hours, and it showed also significant decrease of necrosis area within 24 hours. There was also no necrosis area in group II-1 and significant decrease of necrosis area II-2 and III-3. But, effctiveness of intradermal injection of sodium thiosulfate was not found in group II-4 which was started after 24 hours. Hisotolgic findings showed a bland coagulative necrosis without inflammatory changes and no granulation tissue. The significant difference that cytoplasmic loss of subcutaneous fat and decrease number of hair follicles between two groups resulted from the methods of treatment by topical application and intradermal injection. In conclusion, immediate treatments with topical dimethyl sulfoxide or intradermal injection of sodium thiosulfate signifcantly prevents necrosis by extravasation of mitomycin-c.

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Alcohol Problems and Related Service Needs in Urban Korean Community (경기도 일지역의 문제음주실태와 알코올 미충족욕구 조사연구)

  • Yang, Jaewon;Whang, Soo Yeon;Hwang, In-Sook;Kim, Sun-Mee;Bae, Gi-Hye;Lee, Hong-Jae;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.62-71
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    • 2013
  • Objectives : The purpose of this study is to investigate the characteristics of drinking patterns and the prevalence of hazardous drinking and alcohol use disorder with the assessment of alcohol policy needs in community population of urban city in Korea. Methods : Data was collected from 1,000 residents in a single urban city in Korea, from June 1 to July 31, 2011 by a questionnaire. As research tools, socio-demographic characteristics composed of variables based on study purpose, alcohol problems and alcohol use disorder state scales composed with Alcohol Use Disorder Identification Test(AUDIT) and Cut down, Annoyed, Guilty, Eye-opener(CAGE), and the assessment of alcohol policy needs in community population questions were used. Results : The lifetime experience of alcohol drinking was 97.4%. For the frequency of drinking, 21.9% of population responded 2 to 4 times per weekly. 24.4% of male had one time or more high risk drinking, defined as having four or more drinks in a sitting, per week. 51.6% experienced the first time drinking of alcohol in adolescence. The lifetime prevalence of hazardous drinking and alcohol use disorder were 14.9% and 3.3%, respectively using AUDIT. Alcohol use disorder were 9.6% with the CAGE scale. Problem drinking were 8.4% in this study. They requested the program such as prevention education(57.2%), construction of liaison system to treatment facilities(50.1%), alcohol counseling and intervention(41.7%), and rehabilitation program(39.8%). Conclusions : These results demonstrate that alcohol problem and alcohol use disorder were much prevalent, and these problem started in the earlier age. It is necessary to develop an effective alcohol prevention program or policy with considering the needs in community population.

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Effect of Accommodation Control by Applying Fogging Method in Subjective Refraction and Auto-Refraction in Ametropia (비정시안에서 운무적용에 따른 자각적 및 자동굴절검사의 조절제어효과)

  • Lee, Kang-Cheon;Kim, Sang-Yeob;Cho, Hyun Gug;Yu, Dong-Sik;Moon, Byeong-Yeon
    • Journal of Korean Ophthalmic Optics Society
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    • v.21 no.2
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    • pp.119-126
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    • 2016
  • Purpose: To analyze the effect of accommodative control and change values between subjective refraction (SR) and auto-refraction (AR) according to application of fogging after accommodative stimulation depending on ametropia type. Methods: Myopic ametropia 76 eyes and hyperopic ametropia 52 eyes participated for this study. SR and AR values measured by three test conditions (Before accommodative stimulation; Before AS, After accommodative stimulation; After AS, and After application of fogging; After AF) were compared, respectively. Results: In myopic eyes, (-)spherical power by SR and AR in After AS test was significantly increased as compared to Before AS test, (-)spherical power in After AF test was decreased to the level of Before AS test. The differences of spherical power between SR and AR were highly measured by SR in After AS test, and highly measured by AR in After AF test, respectively. In hyperopic eyes, (+)spherical power of SR significantly decreased in After AS test compared to Before AS test, more (+)spherical power was detected in After AF test compared to Before AS test. (+)spherical power of AR have no significant difference between Before AS and After AS test, but more (+)spherical power was detected in After AF test compared to Before AS test. The differences of (+)spherical power between SR and AR were significant in all test conditions. Among 52 eyes which were measured as hyperopic ametropia, 7 eyes were measured as myopia by SR in After AS test. In case of AR, 25 eyes among 52 eyes were mismeasured as myopia of ranges from -0.25 D to -1.25 D in Before AS test, 26 eyes in After AS test, and 19 eyes in After AF test were mismeasured as myopia of ranges from -0.25 D to -1.25 D. Conclusions: Regardless of ametropia type, accommodative control by After AF test was effective on both refraction process. However, in auto-refraction for hyperopic eyes, the misdetermined proportion of refractive error's type was high due to consistent accommodative intervention in all test condition. Therefore, in order to obtain an accurate value of refractive errors, full correction should be determined by subjective refraction process after fogging method.

Analysis of newborn hearing screening using automated auditory brainstem response (자동화 청성뇌간반응을 이용한 신생아 청력선별검사 결과 분석)

  • Park, Sung Won;Yun, Byung Ho;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon;Hong, Sung Hwa
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1056-1060
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    • 2006
  • Purpose : As hearing ability affects language and cognitive development, early detection and intervention of congenital hearing defects is very important. We analyzed the result of newborn hearing screening using automated auditory brainstem response and estimated the incidence of congenital hearing defects in newborn infants in Korea. Methods : Hearing screening tests were done on 7,218 newborn infants who were delivered at Cheil General Hospital from July 1, 2004 to June 30, 2005. The first screening test was done on the second day of life with automated auditory brainstem response(AABR) using $ALGO{\bigcirc}^{(3)}$ Newborn hearing screener($Natus^{(R)}$ Medical Incorporated, San Carlos, USA) with 35 dB sound level. The newborn infants who did not pass the initial screening test took the second screening AABR test before discharge from the nursery. Infants who did not pass these screenings at the nursery were followed up at the Department of Otorhinolaryngology, Samsung Seoul Hospital. Results : Total 7,218 infants(83.3 percent of total 8,664 live births of the Cheil General Hospital) were screened in the nursery, and 55 of them failed to pass the newborn screening. Among 55 infants who were referred, six were lost during follow-up, and 14 were confirmed as hearing impaired. Six of them(42.8 percent) do not have any risk factors for hearing impairment. We can estimate that the incidence of hearing defects is about 1.9-2.8 per 1,000 live births. Conclusion : Automated auditory brainstem response is an effective tool to screen the hearing of newborn infants. Congenital hearing loss is more frequent than metabolic diseases on which screening tests are available in the newborn period. About 40 percent of infants who have hearing defects do not have any risk factors for hearing impairment. Therefore, universal newborn hearing screening must be recommended to all neonates.

Relationship between Body Fat Distribution and Metabolic Risk Factors in Adolescents (청소년에서의 체지방 분포와 대사위험 인자들의 연관성)

  • Kim, Dal Hyun;Seong, Tae Jung;Hong, Young Jin;Son, Byong Kwan;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.326-334
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    • 2003
  • Purpose : The objectives of this study were to estimate the prevalence of obesity in adolescents; to study the association between obesity, blood pressure, and dyslipidemia; and to evaluate the superiority of waist circumference to waist/hip ratio(WHR) in central obesity. Methods : We selected 1382 adolescents(M : F=690 : 692) aged from 11 to 18 years(mean age; boys 15.0, girls 15.4) in Incheon. We measured weight, height, waist, waist/hip ratio, and blood pressure, with blood sampling to evaluate the dyslipidemia. Results : The prevalence of obesity was 6.7% in boys and 6.9% in girls by body mass index(BMI). The prevalence of systolic hypertension was 15.7% in normal group, 32.4% in the overweight group, and 35.4% in the obese group by BMI. The prevalence of diastolic hypertension was 4.9% in the normal group, 6.9% in the overweight group, and 14.6% the in obese group. In boys and girls, BMI, waist circumference, and WHR were positively correlated with systolic and diastolic blood pressure. respectively. In boys, triglyceride was positively correlated with waist circumference(r=0.34, P<0.05). In boys and girls, BMI was highly correlated with obesity index(r=0.98, each), with waist circumference(r=0.89, r=0.82, respectively), and with body fat(r=0.85, r=0.89) respectively. Conclusion : These data suggest the importance of the screening of blood pressure in obese adolescents, with prevention and intervention of obesity since it may be the most cost-effective way of reducing the complications related with obesity.

Effect of an abdominal obesity management program on dietary intake, stress index, and waist to hip ratio in abdominally obese women - Focus on comparison of the WHR decrease and WHR increase groups - (복부비만 관리프로그램이 성인 비만여성의 식이섭취, 스트레스지수 및 복부비만율에 미치는 영향 - 복부비만감소군과 복부비만증가군의 비교를 중심으로 -)

  • Lee, Ji-Won;Yoo, Sook-Young;Yang, So-Young;Kim, Hye-Sook;Cho, Seong-Kyung
    • Journal of Nutrition and Health
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    • v.45 no.2
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    • pp.127-139
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    • 2012
  • This study was conducted to evaluate the effects of an abdominal obesity management program on dietary intake, stress index, and waist to hip ratio (WHR) in abdominally obese women. The subjects were 195 adult abdominally obese women (WHR ${\geq}$ 0.80) who had been participating in a nutrition education (total of nine times) and dietary habits and life style modification programs (total of six times) for 12 weeks. The abdominal obesity management program focused on the nutrition provided by breakfast, lunch, and dinner, proper dietary habits, and practices to improve life style. The subjects were divided into a WHR decrease group and a WHR increase group according to changes in the WHR. Daily nutrient intake was assessed with a 3-day food record, body measurements and blood vessel age, stress index, and a health index that were measured at baseline and after 12 weeks. After the intervention, weight, waist circumference, hip circumference, WHR, and body mass index (BMI) decreased significantly in the WHR decrease group. Energy intake increased from 1486.2 kcal to 1541.4 kcal with a significant improvement in nutrient density for animal protein, total fat, animal fat, fiber, calcium, phosphorus, zinc, vitamin $B_6$, vitamin C, vitamin E, and saturated fatty acids in the WHR decrease group. Additionally, dietary diversity increased significantly in the WHR decrease group compared to that in the WHR increase group. The WHR decrease group showed a significant improvement in the stress and health indices. Changes in WHR were correlated with changes in nutrient intake (animal protein, total fat, animal fat, plant fat, fiber, calcium, iron, potassium, vitamin A, vitamin $B_2$, vitamin $B_6$, vitamin C, and folate) and medical index profiles (stress and indices) adjusted for age, birth status, baseline BMI, and baseline WHR. These results show that an abdominal obesity management program was effective not only for reducing the WHR but also to improve dietary intake and the stress index in abdominally obese women.