• 제목/요약/키워드: Hope Care Center

검색결과 62건 처리시간 0.028초

Clinical Outcomes of Heart-Lung Transplantation: Review of 10 Single-Center Consecutive Patients

  • Yun, Jae Kwang;Choi, Se Hoon;Park, Seung-Il
    • Journal of Chest Surgery
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    • 제49권3호
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    • pp.157-164
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    • 2016
  • Background: Heart-lung transplantation (HLT) has provided hope to patients with end-stage lung disease and irreversible heart dysfunction. We reviewed the clinical outcomes of 10 patients who underwent heart-lung transplantation at Asan Medical Center. Methods: Between July 2010 and August 2014, a total of 11 patients underwent HLT at Asan Medical Center. After excluding one patient who underwent concomitant liver transplantation, 10 patients were enrolled in our study. We reviewed the demographics of the donors and the recipients' baseline information, survival rate, cause of death, and postoperative complications. All patients underwent follow-up, with a mean duration of $26.1{\pm}16.7months$. Results: Early death occurred in two patients (20%) due to septic shock. Late death occurred in three patients (38%) due to bronchiolitis obliterans (n=2) and septic shock (n=1), although these patients survived for 22, 28, and 42 months, respectively. The actuarial survival rates at one year, two years, and three years after HLT were 80%, 67%, and 53%, respectively. Conclusion: HLT is a procedure that is rarely performed in Korea, even in medical centers with large heart and lung transplant programs. In order to achieve acceptable clinical outcomes, it is critical to carefully choose the donor and the recipient and to be certain that all aspects of the transplant procedure are planned in advance with the greatest care.

청년기에 시작된 거리노숙인의 힘겨운 시기에 대한 체험 - Parse의 인간되어감 연구방법을 적용하여 - (Lived Experience of Difficult Times for Young Adult Street Homeless - Application of Parse's Human Becoming Research Method -)

  • 김현경;이옥자
    • 한국사회복지학
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    • 제63권2호
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    • pp.31-56
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    • 2011
  • 본 연구는 청년기에 시작된 거리노숙인 다섯 명이 힘겨운 시기를 어떻게 견디어갔는지 그 과정을 탐색하여 청년노숙인의 체험의 구조를 파악하는데 있다. 또한 청년노숙인이 신체적 정신적 사회구조적으로 건강성을 회복할 수 있도록 기여할 수 있는 사회복지전문직의 실천이론을 확인하고 개발하고자 Parse의 인간되어감 방법을 적용하였다. Parse 연구방법의 패러다임에 따라 청년노숙인의 체험을 담은 2차 자료를 선택하여 분석하였다. 청년기에 시작된 노숙인의 힘겨운 시기에 대한 체험은 세 개의 핵심구조인 1) 일을 해도 빈곤함, 2) 경제적 빈곤으로 가족이 해체되어 노숙인이 됨, 3) 사회적 낙인과 단절에서 벗어나고자 자활을 향해 분투노력함으로 나타났다. 구조적인 전환은 불안한 미래에 대한 절망과 두려움 가운데 도전과 기회를 기다리며 잠재적인 독립의지를 발휘하는 과정으로 제시되었다. 개념적 통합은 연결-분리의 가치화를 강화와 변형시켜 나가는 과정으로 표현되었다. 연구결과를 토대로 청년기에 시작된 거리노숙인의 신체적-정신적-사회적 측면을 토대로 논의하였다.

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RAND 방법으로 합의한 임상진료지침의 정의와 질 평가 기준 (Consensus on definition and quality standard of clinical practice guideline using RAND method)

  • 지선미;김수영;신승수;허대석;김남순
    • 보건행정학회지
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    • 제20권2호
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    • pp.1-16
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    • 2010
  • Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as "scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances." Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.

ERG 이론에 근거한 한국 중년여성의 행복에 관한 구성요인 도출 연구 (Meaning of Happiness Based on ERG Theory in Middle-Aged Korean Women)

  • 신희진;김증임
    • 여성건강간호학회지
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    • 제25권3호
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    • pp.315-328
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    • 2019
  • Purpose: The purpose of this study was to explore the components and nature of happiness in middle-aged women in Korea. Methods: Thirty middle-aged women living in metropolitan Seoul and Gyeonggi and Chungcheong provinces agreed to participate in this study. The data were collected through in-depth interviews with the participants in one-on-one settings. The data were analyzed qualitative using Colaizzi's method of phenomenology. Results: The three theme clusters were extracted from the raw data, along with 13 themes and 138 meaningful sentences and phrases. The three happiness theme clusters in middle-aged women were "live healthy for stability," "rule one's mind for harmony," and "activate hopes for self-esteem." The first theme cluster included healthy life, economic stability, physical youth, and positive thought. The second theme cluster included that harmonious family, ruling of mind, my position as invisible person in social relationships, and precious relationships to support. The last theme included the center of one's life is oneself, a sense of accomplishment, self-improvement, recognition of one's worth and rest for one self. The three theme clusters were associated with the existence, relatedness, and growth (ERG) of ERG areas, respectively. Conclusions: We conclude that the core components of happiness in middle-aged women are to live healthy and mind-ruled and activate hope. The nature of happiness is egocentric stability in middle-aged women. The results suggest that theme clusters might be used to develop a scale for measuring happiness in middle-aged women. This will be helpful to assess the psychosocial status of middle-aged women in Korea.

30-40대 여성의 미병상태에 따른 월경양상 비교연구 (A Study on comparison of menstrual pattern according to Mibyeong Index of Korean women in their thirties and forties)

  • 박민영;오현주;황민우
    • 대한예방한의학회지
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    • 제23권1호
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    • pp.61-72
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    • 2019
  • Introduction : The aim of this study was to investigate menstrual pattern according to Mibyeong Index(MBI) and compare Mibyeong symptom score according to severity of menstrual pain. Mibyeong Index was designed to measure inconvenience and resilience of subject's complains including four physical symptoms(fatigue, pain, low sleep quality, indigestion) and mental distress including anxiety, anger, depression. Method : We used the clinical data of Korean medicine Date Center(KDC) for subjects who participated in the study of 'Clinical research for collecting of clinical cases based on the personal type of Mibyeng' conducted in Seoul, from June 26, 2015 to June 26, 2017. A total of 566 fertile women aged 30 to 50 who completed the questionnaires were included in this study. In this study, we used items of Mibyeong Index and the menstrual pattern by self-report questionnaires. The date were analyzed through Kruskal Wallis test, Pearson's chi-square test, and one-way ANOVA using SPSS statistics 19.0. Results : Mibyeong status was significantly associated with severity of menstrual pain(p<0.001), worst day of menstrual pain(p<0.05), and type of menstrual pain(low back pain, nausea, depression, and none (respectively, p<0.05)). In addition, The 7-subtype score (fatigue (p<0.001), pain(p<0.001), low sleep quality(p<0.001), indigestion(p<0.001), anxiety(p<0.05), anger(p<0.05) and depression(p<0.05)) of Mibyeong index and total score of Mibyeong Index (p<0.001) showed significant difference for severity of menstrual pain. Conclusion : This result indicates that a close relationship between Mibyeong status and severity of menstrual pain. Further studies are needed but, we hope that this results will be used as the basic data to improve mibyeong status through health care to alleviate dysmenorrhea.

암환자의 대체요법 시행경험 (The Experiences of Trial Alternative Therapies for Cancer Patients)

  • 고덕순;정연강
    • 가정간호학회지
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    • 제8권2호
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    • pp.109-120
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    • 2001
  • This study has been done in order to help the people understand the cancer patients and provide the basic materials for the care of cancer patients by deeply understanding the living experience of the practice of alternative therapy for cancer patients. Data were collected with several in depth interviews and observations. Collected datas were analyzed by using phenomenological method of study by Giorgi (1970). The trial experience of alternative therapy for cancer patients has been classified into the one of having concerns, following, being infatuated, and coming out by pushing, and the experience of having concerns appeared as the meaning of the limit of modern medicine, despair, loneliness. hope, emotional support. dissolution of the feeling of uneasiness. the feeling of burden of the medical expense, self-treating, the subject of treatment. and indifference while the experience of following appeared as the meaning of blind following, temptation, going outside to look for something, wandering. following unconditionally, advise of the professionals, mistaken belief. self-abandonment, powerlessness. disconnection of dialogue with the medical staff. elevation of immunity, strengthening the physical power, absence of the source of examined information, clinging, self-responsibility. the experience of being infatuated appeared as the meaning of thorough trial. affirmative experience. devotion. diverse efforts, faithful trial. affirmative self-suggestion. change of the style of life. the feeling of burden of expense, being envious, bitter feeling toward the family, considering family, family discords, and difficulty of enforcement. The experience of coming out by pushing appeared as the meaning of waiting. self-reflection. maintaining the distance. cutting attachment, throwing the greed away, coming out by pushing. being thoughtful. accepting disease. individual difference of physical quality, and ambivalence. But they return to the experience of being concerned all over again in case of recurrence or metastasis of the disease even though they come out of such stage, and they always have ambivalence even in the condition with no recurrence and metastasis. In conclusion, the trial of alternative therapy for cancer patients could be explained as the adaptive behavior to the disease which is difficult to be cured. the cancer. The cancer patients are exposed to the side effects and harm without the examined information resources. Therefore the nurse should well aware of the alternative therapy and be able to do the appropriative management through the open communication with the patients who are under the trial of alternative therapy.

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중환자실 입원환자 가족의 경험 (The Lived Experiences of Inpatients' Families in the Intensive Care Units)

  • 황혜남;김귀분
    • 성인간호학회지
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    • 제12권2호
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    • pp.175-183
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    • 2000
  • The study was done by applying a phenomenological study, which is qualitative research methods, in order to understand the meaning of the lived experiences, to confirm and describe the meaning structure, and to prepare nursing interventive strategies centering around the meanings of the inpatients' families in the intensive care units. In the study, the family members were the main important nursing providers for in the inpatients' who were admitted in the neurosurgical intensive care unit in K-university hospital and who agreed to participate in the study after being given on explanation about the purpose of the study. The data were collected from the seven participants who had feelings of trust and intimacy favorable toward the researcher as they were families of patients who had been cared for by the researcher in the ICU where the researcher has been assigned. The data were collected from April to October, 1999. The participants described their experiences as candidly as possible. The researcher described closely the lived experiences with their own words and the observations of the researcher. A tape recorder was used with the consent of the participants to prevent nursing information and communication. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi; as an unit of description, which include the participants' expressions and the researcher's observations, the analysis was used based on the data described from the expressions of the participants and the details of observations of the researcher. The conclusions of the study were as follows : The meanings of the lived experience of the inpatients' families in the ICU was confirmed by indepth interviews and observations including these of the participatants : (1) Psychological impact: confusion, impatience, surprise, insensibility; (2) Physical suffering: fatigue, discomfort, indigestion; (3) Psychological suffering: heartbreaking emotion, anxiety, annoyance, fear, compassion, grief; (4) Economical suffering: economical difficulties; (5) Psychological disagreement: escape from reality, personnel avoidance, grudge, powerlessness, carefulness, transposition of life-tract, abandonment, role-crisis, hope, lack of understanding, regret, feeling of ambivalence(progressive process, medical personnel interest); (6) Psychological dependency; self-reliance group support, family support, religious support; (7) Psychological acceptance; acquaintance, gratitude, reassurance; The study will offer better understanding of experiences therefore, based on the experiences confirmed by the study, it may facilitate more appropriate nursing interventive strategies for health maintenance and to prevent occurrence of possible problems with the inpatients' families in the ICUs.

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중·고령 초기 유방암 생존자를 돌보는 가족의 경험 (Family Members' Caregiving Experience for Middle-aged and Elderly Breast Cancer Survivors at Early Stages)

  • 박소영;박향경;구향나;백정연;노은정
    • 한국노년학
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    • 제40권1호
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    • pp.111-130
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    • 2020
  • 본 연구는 중·고령 초기 유방암 생존자를 위한 가족들의 돌봄 경험에 대해 이해하고자 한 질적 연구이다. 총 4명의 유방암 생존자 가족들을 대상으로 초점집단면접(FGI)을 실시하였고 추가로 1명의 가족에 대해 개별심층면접을 실시하였다. 초점집단면접과 개별심층면접 내용을 주제 분석한 결과, 다음 4가지 주제가 나타났다: 첫째, 살얼음 위를 걷는 듯한 일상의 감정들 (치료시기마다 서로 뒤얽히는 감정들, 생존자의 고통을 지켜볼 수밖에 없는 안타까움, 암 재발과 죽음에 대한 두려움, 관계 변화에 대한 걱정, 딸로서 겪는 다양한 감정), 둘째, 생활의 중심이 된 돌봄 (낯설고 서툴렀던 돌봄, 내 생활을 잃어감), 셋째, 회복의 시작, 생존자와 가족이 느끼는 온도 차이 (생존자가 느끼는 심연의 고통을 헤아리지 못함, 생존자가 아직 환자라는 사실을 잊고 소홀히 대함), 넷째, 앞으로 나아가기 (나아질 것이라는 희망, 지치지 않기 위한 나를 위한 돌봄). 본 연구 결과를 토대로 유방암 생존자 가족의 심리사회적 욕구를 반영하고 돌봄 과정에서 가족 지지를 지원하기 위한 사회복지서비스 및 정책 방안에 대해 제언하였다.

인공지능 기반의 TensorFlow 그래픽 사용자 인터페이스 개발에 관한 연구 (Study on Development of Graphic User Interface for TensorFlow Based on Artificial Intelligence)

  • 송상근;강성홍;최연희;심은경;이정욱;박종호;정영인;최병관
    • 디지털융복합연구
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    • 제16권5호
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    • pp.221-229
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    • 2018
  • 기계 학습 및 인공지능은 제 4차 산업혁명의 핵심 기술이다. 하지만 프로그래밍 능력을 요구하는 기계 학습 플랫폼의 특성 상 일반 사용자들의 접근이 힘들기 때문에 인공지능이나 기계학습의 대중화는 제한을 받고 있다. 본 연구에서는 그래픽 사용자 인터페이스(Graphic User Interface, GUI)를 도입하여 이러한 한계를 극복하고 인공지능 활용에 대한 일반인의 접근성을 향상시키고자 하였다. 기본 기계 학습 플랫폼으로는 Tensorflow를 채택하였고 GUI는 마이크로 소프트 사의 .Net 환경을 활용하여 작성하였다. 새로운 사용자 인터페이스를 이용하면 일반 사용자도 파이썬 프로그래밍에 대한 부담없이 직관적으로 데이터를 관리하고, 알고리즘을 적용하고, 기계 학습을 실행할 수 있다. 우리는 이 개발이 다양한 분야에서의 인공지능 개발에 기초가 되는 자료로 활용되었으면 한다.

고령사회 도래에 따른 노인보행자 교통사고 특성 및 감소방안 -제주지역을 중심으로- (The Traffic Accident Characteristics and Reduction Methods of Elderly Pedestrian in Accordance with the Advent of the Aging Society -Focused on Jeju)

  • 김경범
    • 한국콘텐츠학회논문지
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    • 제15권4호
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    • pp.197-207
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    • 2015
  • 본 연구에서는 노인의 보행중 교통사고 분석을 통하여 문제점을 파악하고, 그에 따른 노인보행자 교통사고 감소방안을 제시하였다. 따라서 노인보행자의 사망사고 특성(시간과 장소 별)과 문제점을 분석하여 그에 따른 노인보행자의 교통사고를 감소시키기 위하여 다음과 같은 정책 대안을 제시하였다. 첫째, 중앙에 보행 안전섬을 설치하여 횡단대기 공간을 제공하여야 하며, 둘째, 횡단보도 방지 가드레일과 잔여시간표시기 설치해야하며, 셋째, 보행자 작동 신호기를 확대 설치하고, 넷째, 야간 조명시설을 설치가 필요하며, 마지막으로 노인보호구역을 지정해야 한다. 이상과 같이 본 연구에서 제시된 방안이 고령사회 도래에 따른 노인을 위한 교통안전정책에 기초자료가 될 수 있기를 희망한다.