Journal of Korean Academy of Fundamentals of Nursing
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v.5
no.1
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pp.107-124
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1998
Based on King's goal attainment theory, this research deals with applying nursing intervention of mutual goal settings to gastrectomy patients. It tests the effects of nursing intervention, according to the patients' health locus of control, suggested as external boundary criteria for the theory by employing a quasi-experimental design which consists of a pretest-posttest non-equivalent control and experimental groups. The subjects of this research were 62 gastrectomy patients hospitalized at Y medical center and the experimental and control groups consisted of 31 subjects. The experimental group received nursing intervention at the mutual goal setting of 5 times from the day before the surgery to the 5th day after the surgery, while the control group received only routine nursing care. Recovery indicators of both groups were measured and compared. Measurement variables included patients' characteristics, health locus of control, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, bowel movement recovery, mobility recovery, level of pain, patients' stress and patients' satisfaction. Data were analyzed using SPSS statistical package and the hypotheses were tested by ANOVA and ANCOVA. Results of the analyses are summarized as follows : 1) Internal health locus of control had higher effects of the nursing intervention of mutual goal setting than external health locus of control on pulmonary ventilatory functions of forced vital capacity, forced expiratory volume in one second, and peak expiratory flow. 2) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the bowel movement recovery between the internal and external health locus of control. 3) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the mobility recovery between the internal and external health locus of control. 4) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of pain between the internal and external health locus of control. 5) There was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of stress between the internal and external health locus of control. 6) There was a statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of satisfaction with provision of nursing information between the internal and external health locus of control, and there was no statistically significant difference in the effects of nursing intervention of mutual goal setting on the level of satisfaction with outcome of nursing between the internal and external locus of control. On the basis of the research results, the following are recommended : 1) Repeated research on responses to health locus of control is necessary. 2) Not only the effectiveness of nursing intervention in acute recovery periods, but also the long term effects are to be investigated. 3) The development of instruments is needed to accurately measure mutual goal setting regarding postoperative deep breath, coughing, early ambulation, etc. so that the relationship among the postoperative recovery indicators may be explored. 4) It is required that an instrument be developed to measure perception which facilitates goal attainment in the interactive setting between patients and nurses.
Mechanical ventilation in children has some differences compared to in neonates or in adults. The indication of mechanical ventilation can be classified into two groups, hypercapnic respiratory failure and hypoxemic respiratory failure. The strategies of mechanical ventilation should be different in these two groups. In hypercapnic respiratory failure, volume target ventilation with constant flow is favorable and pressure target ventilation with constant pressure is preferred in hypoxemic respiratory failure. For oxygenation, fraction of inspired oxygen($FiO_2$) and mean airway pressure(MAP) can be adjusted. MAP is more important than FiO2. Positive end expiratory pressure(PEEP) is the most potent determinant of MAP. The optimal relationship of $FiO_2$ and PEEP is PEEP≒$FiO_2{\times}20$. For ventilation, minute volume of ventilation(MV) product of tidal volume(TV) and ventilation frequency is the most important factor. TV has an maximum value up to 15 mL/kg to avoid the volutrauma, so ventilation frequency is more important. The time constant(TC) in children is usually 0.15-0.2. Adequate inspiratory time is 3TC, and expiratory time should be more than 5TC. In some severe respiratory failure, to get 8TC for one cycle is impossible because of higher frequency. In such case, permissive hypercapnia can be considered. The strategy of mechanical ventilation should be adjusted gradually even in the same patient according to the status of the patient. Mechanical ventilators and ventilation modes are progressing with advances in engineering. But the most important thing in mechanical ventilation is profound understanding about the basic pulmonary mechanics and classic ventilation modes.
The Occupational Safety and Health Research Institute is currently evaluating spirometry tests used for worker health examinations by applying the 2005 American Thoracic Society (ATS) and European Respiratory Society (ERS) spirometric test standardization guide and reviewing the application of the 2019 ATS/ERS guide. To compare results obtained using the new evaluation criteria with previous results and determine whether it is appropriate to apply them to Korean workers' health examinations, we reviewed spirometry results from 325 special health examination institutions. Although evaluation criteria such as extrapolation volume, correction error, and forced inspiratory vital capacity were applied more strictly, institutions had higher reliability scores. Primarily because the acceptability and repeatability of forced expiratory volume in 1 second and forced vital capacity were judged separately, and thus, deduction width was reduced. The study shows that adopting the new evaluation criteria would reduce the possible use of inappropriate data, increase tester and doctor understanding of result selection and interpretation, increase result reliability, and reduce the testing burden.
The effects of Physical exercise, gymnastics and sports on the cardiopulmonary function were studied in the middle and high school toys. The subjects were divided into 4 groups; non-training group and training group in both middle school and high school boys. In the above groups, pulmonary function studies were performed, and blood pressure and the heart rate were also checked to evaluate physical fitness during and immediately after running exercise on the tread-mill, with the speed of 5 MPH and elevation of 9% and 11.25%. The types of sports in the training group were base ball, body building, Taekwondo (Korean style boxing) and hand ball. The results obtained were as followings: 1) In the training group, cardiopulmonary function showed some tendency of the increase comparing to the non-training group. 2) The increase in cardiopulmonary function was observed according to the age became older, but the clear changes on cardiopulmonary function was not observed as the difference of the group between the training and the non-training. 3) The expiratory volume was decreased as the increase of age except 17 years of age for the value of the per kg body weight. 4) In the non-training group, the mean value of oxygen consumption under maximum work load was increased, while those in the training group was decreased. But it may be noted that oxygen consumption for the expiratory volume was increased in the training group, and that the oxygen cost in the training group was .higher than that of the non-training group. 5) The pulse pressure of the high school group during and immediately after running exercise was observed in the higher value comparing with that of the middle school group It was suggested that the changes of the pulse pressure was owing to the method of determination and that to the decrease of diastolic pressure caused by the decrease of peripheral vascular resistance up to critical closing pressure. 6) Any differences of the changes in the heart rate between the training group and non-training group was not observed during and immediately after running exercise. 7) The relative value of the expiratory volume to the heart rate was decreased in the elder age group.
Kang, Young Ae;Kwon, In Sun;Won, Ho-Ryun;Chang, Jae Won;Koo, Bon Seok
Phonetics and Speech Sciences
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v.12
no.2
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pp.73-80
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2020
Breathing is the voice's driving force and also acts as a regulator of larynx function and efficiency. Respiratory distress is a side effect of general anesthesia in thyroid surgery. Therefore, this study's objective was to provide practical and complementary information for voice recovery after thyroid surgery, based on aerodynamic evaluation pre- and post-thyroidectomy. From May 2014 to July 2015, aerodynamic evaluations were performed on 34 female patients diagnosed with thyroid papillary cancer one week before surgery (PRE), one month after surgery (P1), and three months after surgery (P3). The Phonatory Aerodynamic System (model 6600, KayPENTAX, USA) was employed for this purpose, and a total of 29 analysis parameters were selected. The results showed statistically significant differences in peak expiratory airflow (p=0.004), mean pitch (p<0.01), expiration airflow duration (p=0.001), and expiratory volume (p=0.018), based on time factors. In the comparison of time factors, peak expiratory airflow and mean pitch parameters were different in PRE-P1 and PRE-P3. Expiration airflow duration and expiratory volume parameters were different in PRE-P3 and P1-P3. The interaction effect of time and surgical range was significant only for expiratory volume (p=0.024). Female patients who undergo thyroidectomy require post-operative breathing training, and exhalation improvement is considered to reflect a positive lifestyle after surgery.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.14
no.2
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pp.88-93
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2003
Whether respiratory muscle training is of benefit to the singing students is controversial. The purpose of the study is to investigate pulmonary function and the maximal inspiratory(MIP) and expiratory pressure(MET), and maximum phonation time in five female singing students before and after the specially programmed respiratory muscle training during 2 months. All singing students had average 4.8 years of formal classical voice training. Respiratory muscle training machine (Ultrabreath) was used to train respiratory muscle. Pulmonary function test data on simple pulmonary function, flow volume curve, static lung volumes are obtained from Vmax 6200. The MIP and MEP were measured using Spirovis, and the MPT were measured using hand-held stopwatch. Any pulmonary function test variables are not changed after respiratory muscle training. However, MIP and MEP were significantly increased between before and after respiratory muscle training. MPT increased significantly after training, compared to the pre-trained. MIP, MEP, and MPT after training in female singing students were 26%, 25% and 33% higher than those before training. The result indicated that the specially programmed respiratory muscle training is beneficial to improve respiratory muscle strength and vocal function without an increment in pulmonary function.
Purpose: Fractional exhaled nitric oxide (FeNO) and forced expiratory flow between 25% and 75% of vital capacity ($FEF_{25-75}$) are not included in routine monitoring of asthma control. We observed changes in FeNO level and $FEF_{25-75}$ after FeNO-based treatment with inhaled corticosteroid (ICS) in children with controlled asthma (CA). Methods: We recruited 148 children with asthma (age, 8 to 16 years) who had maintained asthma control and normal forced expiratory volume in the first second ($FEV_1$) without control medication for ${\geq}3$ months. Patients with FeNO levels >25 ppb were allocated to the ICS-treated (FeNO-based management) or untreated group (guideline-based management). Changes in spirometric values and FeNO levels from baseline were evaluated after 6 weeks. Results: Ninety-three patients had FeNO levels >25 ppb. These patients had lower $FEF_{25-75}$ % predicted values than those with FeNO levels ${\leq}25$ ppb (P<0.01). After 6 weeks, the geometric mean (GM) FeNO level in the ICS-treated group was 45% lower than the baseline value, and the mean percent increase in $FEF_{25-75}$ was 18.7% which was greater than that in other spirometric values. There was a negative correlation between percent changes in $FEF_{25-75}$ and FeNO (r=-0.368, P=0.001). In contrast, the GM FeNO and spirometric values were not significantly different from the baseline values in the untreated group. Conclusion: The anti-inflammatory treatment simultaneously improved the FeNO levels and $FEF_{25-75}$ in CA patients when their FeNO levels were >25 ppb.
Background: Research efforts to improve the pulmonary function of children with cerebral palsy (CP) need to focus on their decreased diaphragmatic ability compared to normal children. Real-time ultrasonography is appropriate for demonstrating diaphragmatic mechanisms. Objects: This study aimed to compare diaphragm movement, pulmonary function, and pulmonary strength between normal children and children with CP by using ultrasonography M-mode. The correlation between general characteristics, diaphragm movement, pulmonary function, and pulmonary strength was also studied. Methods: The subjects of this study were 25 normal and 25 CP children between five and 14 years of age. Diaphragm movement was measured using real-time ultrasonography during quiet and deep breathing. Pulmonary function (such as forced expiratory volume in one second; FEV1 and peak expiratory flow; PEF) and pulmonary strength (such as maximum inspiratory pressure; MIP and maximum expiratory pressure; MEP) were measured. A paired t-test and Spearman's Rho test, with a significance level of .05, were used for statistical analysis. Results: The between-group comparison revealed that normal children had significantly greater diaphragm movement, FEV1, PEF, MIP, and MEP (p<.05) than CP children. The results showed that general characteristics were significantly related to FEV1, PEF, MIP, and MEP (p<.05). Conclusion: In clinical settings, clinicians need to concern decreased diaphragm movement, pulmonary function, and pulmonary strength in CP group compared to normal children.
Journal of the Korean Society of Physical Medicine
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v.13
no.1
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pp.121-128
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2018
PURPOSE: This study assessed the effect of exercise intervention methods on diaphragm movement, pulmonary function, and pulmonary strength in children with cerebral palsy (CP). METHODS: A total of 28 children with CP were randomly allocated to the general exercise group (n=9, GEG), respiratory exercise group (n=10, REG), and intensive exercise group (n=9, IEG). The exercise intervention was performed for 12 weeks. This study measured diaphragm movement, pulmonary function, and pulmonary strength under two different conditions before and after each exercise. Ultrasonography was used for measuring diaphragm movement, and Pony Fx was used to measure the forced expiratory volume in one second ($FEV_1$), peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP). A Mann-Whitney test and ANOVA with a significance level of .05 were used for statistical analysis. RESULTS: Significant change was observed between the REG and the IEG as well as between the GEG and the IEG (p<.05). No significant difference was observed between the GEG and the REG. The diaphragm movement, $FEV_1$ PEF, MIP, and MEP were most improved in the IEG (p<.01). CONCLUSION: This study confirmed that intensive exercise is the most effective treatment method for improving diaphragm movement and respiratory function in CP children.
Background: Posterior-anterior (PA) vertebral mobilization, a manual therapy technique has been used for relieving pain or stiffness treating in spinal segment for in clinical practice, however evidence to gauge efficacy is yet to be synthesised. Objects: This study aimed to investigate the effect of PA mobilization of the thoracic spine on the respiratory function in patients with low back pain (LBP). Methods: The study participants included 30 patients with chronic LBP. They were randomly allocated to the experimental and control groups. The experimental and control groups received PA mobilization of the T1-T8 level of the thoracic spine and placebo mobilization, respectively. All patients received interventions for 35 minutes a day, five times a week, over 2-week period, respectively. Forced vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$), peak expiratory flow (PEF), forced expiratory flow 25~75% ($FEF_{25{\sim}75%}$), and chest wall expansion were measured before and after the intervention. Statistical analysis was performed using independent t-test and two-way analysis of variance, and Pearson's correlation analysis was used to compare the correlation between respiratory function and chest measurement. Results: The experimental group showed significant improvements in FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$ (p<.05), and chest wall expansion (p<.05) compared with the control group. Conclusion: PA mobilization of the upper thoracic spine may be beneficial for improving respiratory function parameters including FVC, $FEV_1$, PEF, $FEF_{25{\sim}75%}$, and chest wall expansion in patients with chronic LBP.
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