Long-term hemodialysis(HD) patients manifest various signs of protein and caloric malutrition due to poor intake of nutrients and other causes. Poor nutritional status increases the mortality and morbidity rates in HD patients. Thus, mataintnance of adequate nutritional status has been a major task in taking care of patients receiving HD. This study was to evaluate the nutritional status of HD patients and to clarify the degree of nutritional deficit based on usual dietary intake, anthropometric and biochemical indicators. Sixty HD patients comprised a HD group, while the control group consisted of 60 healthy adults whose age and sex matched those of the HD group. Nutritional status was evaluated by dietrary intake using instant nutritional scale, anthropometric measures, serum protein concentrations and the number of lymphocytes. The data were analyzed by using Chi-square test and unpaired t-test. The results are as follows. 1. Regarding usual dietary intake of HD group. 1) Estimated caloric intake was significantly lower than the recommended daily allowance(RDA) and among them, 35% were taking calories less than 85% of the RDA. 2) Estimated protein intake was significantly higher than the RDA and among them 40% were taking protein more than 115% of the RDA. 3) Estimated fat intake was lower than the RDA. 4) Vitamin A, B, $B_1,\;B_2$, C and niacin in take was lower than the RDA respectively. 5) Estimated ferrous intake was within the normal limit the RDA while estimated calcium intake was higher than the RDA. 6) Both calorie and protein intake were higher for the 10 patients who had been under continuous ambulatory peritoneal dialysis than for the patients under HD from the beginning. 2. Regarding anthropometric measures : 1) Body mass index(BMI), midarm circumference(MAC), and triceps skinfold thickness(TSF) were lower in the HD group than in the control group. 2) Among HD group, 47.1% were within the normal limit of BMI, while 86.7% were within the same limit in the control group. 3) Among HD group, 35.0% were within the normal limit of MAC, while 83.3% were within the same limit in the control group. 4) Among HD group, only 8.3% were normal, 30.3% were mild deficit status of TSF, while 50% were normal and 48.3% were mild deficit status in the control group. 3. Regarding biochemical laboratory tests 1) Albumin, transferrin concentrations and the number of lymphocytes were lower in HD group than in the control group. 2) Among HD group, 98.3% were within the normal limit of albumin concentration and all were within the same limit in the control group. 3) Among HD group, only 11.7% were within the normal limit of transferrin concentration, while 81.7% were within the same limit in the control group. 4) Among HD group, 25% were within the normal limit, while 93.3% were within the same limit in the control group. The above findings suggest that HD patients were in nutritional deficit status. Adequate diet therapy and periodical evaluation of the nutritional status in HD patients are needed. Accordingly, it turned out that anthropometric measures were very reliable parameters and easy to use to evaluate nutritional status. So nurses are encouraged to adopt anthropometric measures to examine nutritional deficit status of HD patients.
The purpose of this study was to identify the effect of structured patient education on knowledge of Hepatitis B type and behavior about self care in chronic hepatitis B patients, and to fine the strategy to promote their self care behavior. The research design was quasi-experiment research. The study method had been done by investigating the experimental group and control group through the questionnaire on 50 patients who had been out patient medicine department in U university hospital in Ulsan from september 1st 1997 to the end of October, 1997. The analysis of the collected material had been done for the homogeneity test in which general characterics of experimental group and control group had been tested by $x^2-test$ and the homogeneity test of the knowledge of hepatitis B type and self care behavior before by t-test. To test the hypothesis the t-test had been given for the difference of the knowledge of hepatitis B type and self care behavior between the two groups and the correlation between knowledge of hepatitis B type and self care behavior performance had been tested by Pearson's correlation coefficient. The results as follows : 1. The 1st hypothesis 'The experimental group which received the structured education should be higher in the knowledge of hepatitis B type than the control group' was supported(t=-6.25, P=.000). 2. The 2nd hypothesis 'The experimental group which received the structured education whould be higher in the self care behavior performance than the control group' was supported(t=-5.15, P=.000). 3. The 3rd hypothesis 'The higher the knowledge of hepatitis B type in the patient the higher the self care behavior performance degree' was supported(r=.492, P=.001). In conclusion, the patients who received the structured education showed the increase in the degree of knowledge of hepatitis B type and self care behavior performance. so the structured education had been judged the nursing intervention had been prerequisite in increasing knowledge of hepatitis B type and self care behavior performance of the chronic hepatitis B patients.
The purpose of this study was to identify levels of activity of daily living, self-efficacy. stroke specific quality of life and need for self-help management program for patients with hemiplegia in the home. Data were collected from June to November, 2000 and subjects were 88 poststroke patients who lived in Seoul and Kyunggi-do. The questionnaire consisted of 5 scales: activities of daily living, self-efficacy, stroke specific qulaity of life and need for a self-help management program. Data were analyzed using frequencies, percent, paired t-test, and Pearson's correlation coefficient with the SAS(version 6.12) program. The results are as follows ; 1) Most of subjects were Partially independent in ADL, but they needed assist once to do dressing, bathing meal preparation and house keeping work. 2) The mean self-efficacy score was 54.89(range : 1 to 80) and the individual differences were large. 3) Subjects responded that they were satisfied on the stroke specific quality of life scale totaled 65.8%. This value is comparatively low, especially for social role(51.4%), family functioning(58.3%) and mood (62.2%). 4) The highest needs for self-help management programs were for physical therapy, stress management, and range of motion exercise and the lowest needs were for elimination management and training, family counseling, and speech therapy. 5) On the demographic variables, sex showed significant differences for the dependent variables. Females had higher scores than males for IADL, self-efficacy, stroke-specific quality of life, and need for self-help management. 6) Age had high negative correlation with ADL, self-efficacy and stroke specific quality of life. Age was also correlated with need for self-help management. In conclusion, there was a high correlation for ADL, Self-efficacy and Quality of life in poststroke patients of home. The patient with a stroke also had a strong need for self-help management programs especially physical therapy and stress management. Therefore rehabilitation programs based on self-efficacy enhancement need to be developed in order to promote independent living for patients with hemiplegia.
The purpose of this research was to determine whether or not a education program of low back pain would have benificial effect on nurses. Nonequivalent control group pre-post test research was designed. Subjects for this study were 50 selected from nurses who work at a general hospital in Taegu. Of them, twenty seven were assigned to experimental group, twenty-three to control group. The data were collected during the period from June 27 to August 31, 1994. The instruments used in this study were Visual Analog Scale for low back pain, Sit-and-reach test for trunk flexibility, and 1 min sit up test for abdominal muscle endurance. Data related to general chracteristics and factors of low back pain were collected with questionnaire developed by this reseacher. The data were analyzed by $X^2-test$, t-test and paired t-test, using the SAS package program. The results of this study are summerized as follows : 1. The numbers of the experimental group with low back pain were not a statistically significant difference from pre to posttesting($X^2=0.77$, p=.379), and the numbers of the control group with low back pain were also not a statistically significant difference from pre to posttesting($X^2=0.09$, p=.767). 2. The severity of low back pain of the experimental group was not a statistically significant difference from pre to posttesting(t=-0.55, p=.5857), and the severity of low back pain of the control group was also not a statistically significant difference from pre to posttesting(t=-0.70, p=.3101). 3. The trunk flexibility of the experimental group was not a statistically significant difference from pre to posttesting(t= 1.08, p=.2835), and the control group's trunk flexibility was also not a statistically significant difference from pre to posttesting(t=0.85, p=.4026). 4. The abdominal muscle endurance of the experimental group was a statistically significant difference from pre to posttesting(t=-2.42, p=.0190), but the control group's abdominal muscle endurance was not a statistically significant difference from pre to posttesting(t=-0.06, p=.9556) This study suggest that replication of study with more sample and more rigid treatment should be needed. And furthermore, the longitudinal research is needed to determine the effectiveness of education program.
The purpose of the study was to investigate the effects of Warming Therapy used with patients consistantly before and during surgery to on changes in their body temperatures. The data were collected from patients in a university hospital in Taegu between December 1, 1998 and May 31, 1999. The subjects were selected from patients who were hospitalized for total hip replacement surgery. Thirty participants were assigned to two groups : experimental(Warming Therapy) group and control group. Each group consisted of 15 patients. The research design was a repeated measurement design, using a nonequivalent control group. The Warming Therapy, using a forced-air warming blanket, that is a, 'Bair Hugger' was applied to subjects in the experimental group. The subjects in the group were treated with the 'Bair Hugger' to warm up the whole body for 40 minutes before surgery and upper body and face during the operation. The core temperature was measured using a tympanic thermometer. The body temperature of the patients was measured 13 times every 15 minutes during the surgery. After the operation the body temperature of the patients was measured 4 times every 15 minutes, from the time of arrivial in the recovery room to the time of leaving the recovery room. The SPSS Win 9.0 program was used for data analysis. Specific methods tested were done using ${\chi}^2-test$, t-test, repeated measures ANOVA. The findings of the study are as follows. 1. The first hypothesis, 'The level of tympanic temperature for the experimental group which received Warming Therapy will be higher than that of the control group during the operation', was supported (F=32.16, p=.000). 2. The second hypothesis, 'The level of tympanic temperature for the experimental group which received Warming Therapy will be higher than that of the control group after the operation', was supported.(F=33.36, p=.000) 3. During recovery, shivering was observed one patient in the experimental group and seven patients in the control group. In summary, the findings of the study suggest that the 'Warming Therapy' applied before and during the surgery was a very effective treatment for surgical patients in maintaining the core temperature during surgery
Purpose: The purpose of this study was to help enhance the quality of life for women with urinary incontinence. Self-esteem, urinary symptoms, peak pressure and duration in seconds for vaginal contraction after pelvic muscles exercise were examined. Method: One-group pretest-posttest design was employed participants were 27 married women from G city. The instrument for this study were : the self-esteem scale developed by Rosenberg(1965). the Urinary Symptom Questionnaire, a subjective measurement of urinary incontinence, developed by Jackson et al.(1996) and the Perineometer used as an objective measurement of peak pressure and duration in seconds. Result: 1. Self-esteem showed significant improvement after the exercise (t=-3.832, p= .001). 2. Comparison of results before the pelvic muscles exercise and after showed that there was a statistically significant difference for several urinary symptoms including enuresis (t=2.833, p=.009), frequency of incontinence (t=2.964, p= .006), incontinence volume (t=2.280, p= .031), incontinence before getting to the restroom (t=3.035, p= .006), incontinence with no reason or feeling (t= 3.051, p= 005) burning sensation (t= 2.132, p=.043), and a sense of residual urine (t=2.267 p=.032). The mean scores showed improvement in the urinary symptoms of management of incontinence (M=$0.04{\pm}0.22$), daily frequency of incontinence management (M=$0.13{\pm}0.85$), urinary control (M=$0.15{\pm}0.86$), running to the restroom (M=$0.15{\pm}0.60$) incontinence caused by coughing or physical activities (M=$0.19{\pm}0.57$) and hesitancy (M=$0.07{\pm}0.55$). Overall urinary symptoms decreased significantly (t =3.073. p= .007). 3. Peak pressure showed an increase from a mean of $24.26{\pm}16.20mmHg$ before the exercise to a mean of $28.63{\pm} 17.79mmHg$ after (t=-2.399, p=.024). Duration in seconds also increased from a mean of $6.00{\pm}4.95sec$ to $9.15{\pm}5.83sec$ (t=-4.400, p= 000). Conclusion: These findings suggest that pelvic muscle exercise serves to decrease urinary problems, improve self-esteem and increase peak pressure and duration in seconds.
The main purpose of this study was to identify the effect of hand massage on pain and anxiety related to chest tube removal in patients with a lobectomy. The research design of this study was a nonequivalent control group non-synchronized design. Of the twenty nine adult subjects, fourteen were assigned to the experimental group and fifteen to the control group. The data were obtained over 3 months from a medical center in Seoul. The instruments used to assess trait state anxiety was the Spielberger Trait-State anxiety Inventory. For pain and psychological anxiety. The Visual Analogue Scale was used. Hiko analogue sphygmo-manometer(2001) was used to check blood pressure and pulse rate as indicators of physiological anxiety Subjects in the experimental group received hand massage for 5 minutes just before chest tube was removed, and subjects assigned to the control group did not receive hand massage. Data were analysed with $x^2$-test and Mann-Whitney U test using the SPSSWIN 10.0 program. The results of the study are as follows : 1. Hypothesis 1: 'there will be a significant difference between two groups in the level of pain after chest tube removal' was supported (u = 23.00, p < 0.001). 2. Hypothesis 2: 'there will be a significant difference between the two groups in the level of psychological anxiety after chest tube removal' was supported (u = 3.00, p < 0.001). 3. Hypothesis 3: 'there will be a significant difference between the two groups in physiological anxiety(systolic, diastolic blood pressure and pulse rate) after chest tube removal' was supported(u =55.50, p = 0.01 ; u = 41.50, p = 0.01 ; u = 20.50, p < 0.001, relatively). The findings of this study indicate that hand massage is effective for pain and anxiety related to chest tube removal in patients with lobectomy. Therefore, hand massage is recommended as an effective nursing intervention for relieving pain and anxiety in patients undergoing chest tube removal. Further research is needed to identify the proper duration and timing to achieve the optimal effect of hand massage. A larger subject population is required to apply the current findings to the general population. Further research is also needed to assess the effects of hand massage in other patient subsets. Finally, it would be interesting to see if the effects of hand massaging would be attenuated when performed by a non-medical specialist.
Yu-Dong-Kong exercise is to produce heat from rubbing hands and is composed of 10 different types of exercise using warmed hands. The objective of this research is to evaluate the effect of Yu-Dong-Kong exercise on physical function and emotional state in elderly. The design of research is Nonequivalent Control Group Pretest-Posttest Design. The independent variable is Yu-Dong-Kong exercise, and the dependent variables are physical function and emotional state. Subjects are 18 elderly in the experimental group and 16 elderly in control group. All of them are above 60 year old and live in 1-city, Kyonggi-do. The exercise period was 4 weeks and data were collected from April to August in 1998. The exercise frequency was once a day. The exercise duration was from 10 to 20 minutes. The measurement tools are modified 1) Cornell Medical Index-Health questionnaire and 2) Geriatric Depression Scale. Collected data were analyzed by t-test and paired t-test based on the purposes of research using SPSS-Window package. The results are summarized as follows : 1. There was no difference in pre-exercise physical function between two groups (t=-.95, p=.35). 2. The hypothesis that 'physical function in the experimental group will be improved compared to the control group' was not supported by t-test(t=-.925, p=.362). However. the physical function in the experimental group showed much improvement than that in the control group. 3. The hypothesis that 'emotional state in the experimental group will be improved compared to the control group' was not supported by t-test(t=-1.715, p=.096). However, the emotional state in the experimental group showed much improvement than that in the control group. 4. The hypothesis that 'physical function will be improved in the post-exercise compared to pre-exercise' was not supported by paired t-test(t=.302, p=.766) However, a slight improvement in the physical function was found. For the further study, it is recommended to reevaluate the effect of Yu-Dong-Kong exercise through large number of subjects and long-term study. Also, a separate study with different type of subjects is recommended. In addition, continuation and compliance this strategy for exercise should be developed.
This research identifies the ingress to egress primary factors that causes a patient to receive delayed emergency medical care. This material was collected between February 1st to 28th, 1998. Research envolved 4,118 people who visited the college emergency medical center in Kyeongido Province, South Korea. Medical records were examined, using the retrospective method. to determine the length of stay and the main cause for waiting. Results are as follows : 1. The age group with the highest admission rate was 10 and under, approximately 1,394 (33.9%). Followed by an even distribution for ages between 11-50 at 10-15% for their respective ranges. The lowest admission rate was 50 years and above. 2. From the 4,118 records examined, 3,489 received outpatient treatment (84.7%); 601 were admitted for inpatient care (14.6%); 25 arrived dead on arrival (0.6%); and 4 people died at the hospital. 3. Between 7PM to 12AM, 42.9% were admitted to the EMC. The hours from 9PM to 11PM recorded the highest admission rate and 5AM to 8AM was the lowest From 8PM to 12AM, the most beds were occupied. 4. For most patients. the average length of stay was approximately 2.2 hours. By medical department, external medicine was the longest for 2.8 hours. Pediatrics was the shortest for 1.6 hours. The average waiting period for inpatient admission was 2.6 hours. Inpatient admission for pediatrics and external medicine was 3.4 hours and 2.2 hours respectively. 5. Theses are primary factors for delay at EMC: 1) pronged medical consultations to decide between inpatient versus outpatient treatment, and delaying to be inpatient, 2) when you call physicians they are delayed to come 3) Understaffing during peak or critical hours, 4) Excessive consulting with different medical departments, 5) some patients require longer monitoring periods, 6) medical records are delayed in transit between departments, 7) repeated laboratory tests make delay the result, 8) overcrowded emergency x-ray place causes delay taking x-ray and portable x-ray, 9) the distance between EMC and registration and cashier offices is too far. 10) hard to control patient's family members. The best way to reduce EMC waiting and staying time is by cooperation between departments, both medical and administrative. Each department must work beyond their job description or duty and help each other to provide the best medical service and satisfy the patient needs. The most important answer to shortened the EMC point from ingress to egress is to see things from a patient point of view and begin from there to find the solution.
This study was to investigate the method for shortening the body temperature (BT) because it takes a long time and is impractical to measure axillary or oral BT with mercury thermometer, The first approach was to identify BT change according to the measuring time and determine the clinically not statistically avaiable and optimal BT measuring time. The second was to test the accuracy of tympanic thermometer. It can measure BT within a few seconds, so if it is approved accurate, we can save BT measuring time by substitute tympanic thermometer for mercury thermometer. This study was conducted from 1, to 30 June, 1996. The subjects were 12men students of medicalk college and 29 women students of nursing school. The results were as follows ; 1) The 3, 5, 7, 9, 11, 13minute-measured axillary BT and 3, 5, 7, minute-measured BT showed somewhat linear relationship with time. It was difficult to find the optimum measuring time which were clinically significant. 2) For axillary tempeiature, the measuring time which were not statistically different was 11 and 13minute. But the real BT difference between 3 and 13minute, or between 5 and 13minute were very small and was within the range of daily variation. 3) For oral temperature, there was no intervals which showed the statistically insignificant. But like as axillary temperature, the difference between 3 and 7, or 5 and 7 minute were trivial by $0.3^{\circ}C$ and by $0.1^{\circ}C$ respectively. 4) Tympanic temperatures were lower than oral BTs which were measured with mercury thermometer by $0.26^{\circ}C$ (with ear tug) and $0.15^{\circ}C$(without ear tug). 5) The reliability of repeated measure tympanic temperature was better than without ear tug. With above results, we can't determine the optimal and cilically significant oral and axillary measuring time using mercury thermometer. However, because the real differences between measuring times were very small, so we recommend further study for the aged, the infants and the febrile patients. And we can't sure the accuracy of tympanic temperature but the reliability was better with ear tug than without ear tug.
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