• Title/Summary/Keyword: Hospital evaluation program

Search Result 477, Processing Time 0.028 seconds

Inhaler Competency and Medication Adherence in Older Adults and Adults with Obstructive Lung Disease (폐쇄성 폐질환 노인 환자와 성인 환자의 흡입제 사용 숙련도와 투약이행도)

  • Kim, Soo Jin;Shin, Yong Soon
    • Korean Journal of Adult Nursing
    • /
    • v.27 no.6
    • /
    • pp.665-672
    • /
    • 2015
  • Purpose: The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease. Methods: We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses. Results: Older adults (${\geq}65$) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, $x^2=14.06$, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers. Conclusion: Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.

Analysis of Pre and Post-Operative Speech In Combined Operation of Type I Thyroplasty and Arytenoid Adduction for Unilateral Vocal Cord Palsy (편측성대마비에 대한 제 1형 갑상성형술과 피열연골내전술의 동시수술시 술전 및 술후 음성언어분석비교)

  • 최홍식;정유삼;김성국;김영호;김광문
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.9 no.1
    • /
    • pp.66-70
    • /
    • 1998
  • Background and Objectives : The managements of unilateral vocal cord palsy include type Ⅰ thyroplasty and arytenoid adduction. One type operation has been shown no satisfactory effect. We evaluated preoperative and postoperative speech of unilateral vocal cord palsy patients who received combined operation of type Ⅰ thyroplasty and arytenoid adduction to help for the management plan of unilateral vocal cord palsy patients. Materials and Methods : We reviewed the postoperative results and complication of 17 surgically treated patients of unilateral vocal cord palsy at Severance hospital from Nov. 1996 to Dec. 1997 retrospectively. They were received combined operation of type Ⅰ thyroplasty and arytenoid adduction. Their pre and post-operative speech were analyzed with MDVP(Multi-Dimension-Voice analysis Program) of CSL(Computerized Speech Lab). Results : After the operation, MPT(Maximal Phonation Time) was increased and MFR(Mean Flow Rate) was decreased in all patients. NHR(Noise to Harmonic Ratio) and VTI(Voice Turbulence Index) were decreased : liner, RAP(Relative Average Perturbation Quotient), PPQ(Pitch Period Perturbation Quotient), sPPQ(smoothed Pitch Period Perturbation Quotient), vFo(fundamental frequency Variation) were decreased : Shimmer, APQ(Amplitude Perturbation Quotient), sAPQ(Smoothed Amplitude Perturbation Qoutient), vAm(Peak Amplitude Variation) were decreased in all the patients. Conclusions : In unilateral vocal cord pals), combined operation of type Ⅰ thyroplasty and arytenoid adduction could obtain satisfactory postoperative voice. MDVP has many parameters and good method for evaluation of voice surgery.

  • PDF

Nutrient Intake of the Rural Elderly Living in Kyungnam -Focusing on Health and Aging Status, and Life-Satisfaction- (경남 일부지역 농촌노인의 영양섭취조사 -건강과 노화상태 및 생활만족도를 중심으로 -)

  • 이경혜;박미영
    • Korean Journal of Community Nutrition
    • /
    • v.6 no.5
    • /
    • pp.773-788
    • /
    • 2001
  • The purpose of this study was to investigate the difference in nutrient intake according to the level of self-perception of health status, aging status and life satisfaction of the rural elderly. The factors for the study were surveyed by interview method. The subjects were 270 people(71 male, 129 female) aged over 65 years(73.5 $\pm$ 5.6ys) in the Ham-an area. The obtained results as follows : By evaluation of self-perception of health status, 57.5% of subjects answered they are in a bad health condition. The 91.5% of subjects had diseases(rheumatitis & arthritis 31.4%, cardiovascular disease 20.2%, gastric disease 10.2%). The women had more diseases than the men(p < 0.01). The subjects took medical treatment in private hospital(40.5%) and public health centers(35.0%). The men showed better level of aging status(p < 0.001) and life satisfaction index(p < 0.01) than the worsen. Living with spouse influenced the aging status(p < 0.05) and the more pocket money influenced life satisfaction(p < 0.05) and aging status(p < 0.05). The elderly who eat regularly 3 times a day(p < 0.05) and have a good appetite(p < 0.001) appeared to have positive effect on the self perception of health status and aging status. An increasing level of the self-perception of health status and regular exercise worked to improve aging status(p < 0.001). The habits of smoking and alcohol drinking, however had no effect on any index. The self-perception of health status affected the nutrient intake, but only in female elderly. The aging status and the life satisfaction index related overall positively to the intake of nutrients. In conclusion, the study shows that gender did influence nutrient intake in the elderly. The women who live alone rated lowest in social resources and health condition therefore their nutrient intake was also extremely in deficit. For successful aging, a program for rural elderly is needed, i.e. actions to provide minimum economic life, food delivery and psychological/physical health care through regional public health centers.

  • PDF

Related Quality Evaluation a Study on the Analysis of Hospital Selection Motive (일개 병원 의료서비스 품질평가와 전원동기 분석연구)

  • Park, Hyoo-Soon;Lee, Moo-Sik;Na, Bak-Ju;Hong, Jee-Young;Jang, Min-Young
    • Proceedings of the KAIS Fall Conference
    • /
    • 2010.05b
    • /
    • pp.743-748
    • /
    • 2010
  • 본 연구는 환자의 의료기관 선택기준에 관한 조사를 실시하는데 있다. 외래, 중 병원에서 검사한 사항을 CD로 담아 타 병원 진료 후 현 병원에 내원한 대상자와 본 병원에서 진료 후 CD를 가지고 타 병원으로 전원 하는 환자 및 보호자를 대상으로 2009년 10월 5일부터 10월 26일까지 본 연구에 동의하는 대상자 302명을 대상으로 하였다. 내원 전원 환자의 물리적 특성에서 주차시설, 주위시설, 의료진 서비스 품질에서는 간호사 친절도, 전문성, 설명, 의료 서비스 품질 특성에서는 의료기기 최신설비, 병원 평판에서는 의료인력 의술, 주위 환경, 병원 외적 요인에서는 진료의 권유 항목이 유의하였다(p<0.05). 내원 시 병원 선택 변수 평균치 검정 결과 중 성별에서는 만족도, 연령별에서는 의료진 서비스품질, 거주지에서는 병원외적요인, 병원지역에서는 병원평판, 만족도, 진료기관에서는 병원평판, 만족도, 진료구분에서는 만족도에서 유의하였다(p<0.05). 전원 시 병원 선택 변수 평균치 검정결과 중 연령별에서는 의료진 서비스 품질, 거주지에서는 병원외적요인, 병원지역에서는 병원평판, 만족도, 진료기관에서는 병원평판, 만족도, 진료 구분에서는 만족도가 유의하였다(p<0.05). 본 연구에서는 내원 전원 환자는 물리적 환경, 의료서비스 품질, 병원 평판 등 을 병원 선택에 중요한 요인들로 지각 하고 있으며 간호사와 주위 사람들의 권유에 의하여 병원을 선택한다고 나타났다. 내원 환자는 의료진 서비스 품질, 병원 평판, 만족도에서 평균치가 높게 나타났다. 전원 환자는 물리적 환경, 의료진 서비스품질, 의료 서비스 품질, 병원 평판, 만족도에서 평균치가 높게 나타났다. 자료 분석은 SPSS 12.0 Window Program을 이용하였다.

  • PDF

Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients (뇌졸중 환자의 가정간호중재 프로토콜 개발)

  • Yoo Ji-Soo
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.7 no.1
    • /
    • pp.122-136
    • /
    • 2000
  • Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

  • PDF

The Influence of Thermal Head and Feet Support on Early Stage Weight Gain in Premature Neonates (미숙아의 머리 및 발 보온이 출생초기 체중에 미치는 영향)

  • Paik Seung Nam;Hong Hye sung;Sung Mi Hae;Cho Kyoul Ja;Yhee Hyun Joo
    • Child Health Nursing Research
    • /
    • v.6 no.3
    • /
    • pp.397-410
    • /
    • 2000
  • This is a nonequivalent control group pretest- posttest design in quasi experimental basis to assess how the thermal head and feet support influences on early stage weight gain in premature neonates. The clients were selected among the premature infants with the weight under 2000gms and with the gestational period under 37 weeks, admitted over 15 days in K university hospital, Seoul. The control group of 29 were selected from January 1998 to August 1998, who were without head and feet thermal support, and the experimental group of 30 were selected from September 1998 to May 1999, who were with the two thermal interventions. The results of the study follow, 1.The experimental group with thermal interventions showed more weight gain than the control group without thermal interven- tions, which was statistically significant between the two groups. 2.The physiological weight loss after birth showed less in the experimental group than in the control group. 3.The recovery of the birth weight after the physiologic weight loss showed no statistical difference between the experimental group and the control group. Consequently, the thermal head and feet supportive nursing intervention could be applied as a nursing intervention program to help the premature neonates' development. With the results above we should like to suggest the following: 1) A continuous application in the practice of our thermal supportive intervention for the premature neonates, a development of the content through evaluation, and a comparision of the results through a long time study. 2) A neccessity of deveopment of various study and cross comparision. 3) A neccessity of multi-angular study on the premature infants' characteristics influencing the thermal therapy and the study of the individual differences of the clients.

  • PDF

Development of Wireless Respiratory Air Flow and Urinary Flow Measurement System for Home Healthcare (가정용 무선 호흡기류 및 요속신호 계측 시스템 개발)

  • Cha, Eun-Jong;Lee, In-Kwang;Lee, You-Mi;Han, Soon-Wha;Han, Jeong-Su;Suh, Jae-Won;Park, Chan-Sik;Kim, Kyung-Ah
    • The Transactions of The Korean Institute of Electrical Engineers
    • /
    • v.61 no.9
    • /
    • pp.1350-1357
    • /
    • 2012
  • Medical system for personal health management recently changes its paradigm from hospital service to self home care based on ubiquitous technology for healthcare anywhere at any time. The present study developed a wireless bio-signal measurement system for patients to self manage pulmonary disease and benign prostate hyperplasia(BPH), both of which are chronic diseases with increasing frequency in modern society. Velocity-type respiratory air flow transducer adapted to develop respiratory module for pulmonary disease management was simplified in structure to measure uni-directional flow since most important diagnostic parameters are evaluated on the expiratory flow signal only. Standard weight measurement technique was introduced to obtain urinary flow signal for BPH management. Three load cell signals were acquired for averaging to minimize noise, followed by accuracy evaluation. Transmission and receiver modules were also developed with user program for wireless communication. Averaged relative errors were 2.05 and 1.02% for respiratory volume and maximal flow rate, respectively, and the relative error was 2.17% for urinary volume, demonstrating that both modules enabled very accurate measurements. Wireless communication distance was verified within 15m, long enough for home care application. The present system allows the user to select a necessary measurement module on a particular health demand and to immediately provide the self-test results, thus better quality health care would be possible.

Drug Use Evaluation of Anticholinergic Drugs Prescribed to Elderly Patients in the Ambulatory Setting Based on Beers and STOPP Criteria (Beers Criteria 및 STOPP 근거에 의거한 한국 노인 환자의 항콜린성제 약물요법의 적절성 평가)

  • Cheon, Young Ju;Lim, Sung Cil
    • YAKHAK HOEJI
    • /
    • v.58 no.5
    • /
    • pp.328-336
    • /
    • 2014
  • Anticholinergic drugs are included in the efficacy group of various antidepressants, antihistamines, antispasmodics like skeletal muscle relaxants. Elderly patients are often taking anticholinergic drugs due to various diseases such as sleep disorders and dysuria. But the use of anticholinergic drugs is restricted in guidelines such as Beers Criteria or STOPP due to the anticholinergic adverse effects including dry mouth, constipation, difficult urination, delirium, hallucinations and especially cognitive impairment. In this study, we investigated the usage of anticholinergic drugs in out-of-hospital prescription of 4,442 elderly patients. Results of the study were obtained that 32% (n=1,421) of overall patients were prescribed with 1~6 products (average 1.37) of anticholinergic drugs. 70.9% of the 1,421 patients (n=1,007) were prescribed with one drug, 22.7% (n=323) were two drugs and 4.9% (n=70) were three drugs. 27.1% of the 1,421 patients (n=430) were 70~74 years old patients who were the most commonly prescribed with anticholinergic drugs. Amitriptyline, chlorpheniramine, dimenhydrinate and quetiapine were most frequent component of ACB Score 3 drugs and amantadine, baclofen, carbamazepine, cyproheptadine and oxcarbazepine were most frequent of ACB Score 2 drugs. Anticholinergic Drug Scale (ADS) of individual patients presented one point (48.5%, n=689), 2 points (15.4%, n=219), more than 3 points (36.1%, n=513), and up to maximum 12 point (n=1). More than 2 points were more than half (51.5%, n=732). Therefore, additional prospective study in the use and adverse effects of anticholinergic drugs for elderly patients will be required. And national management such as DUR program will be required for elderly drug administration from now on.

The Association between Social Support and Health Behaviors for Metabolic Syndrome Prevention among University Students: The Mediating Effect of Perceived Stress (대학생 집단에서 사회적 지지와 대사증후군 예방 건강 행동 간의 상관관계: 지각된 스트레스의 매개효과)

  • Park, Sooyeon;Cho, Suah;Lee, Eugene;Choi, Sungchul;Choo, Jina
    • Research in Community and Public Health Nursing
    • /
    • v.32 no.3
    • /
    • pp.404-414
    • /
    • 2021
  • Purpose: Health behaviors for metabolic syndrome (MetS) prevention should be emphasized from early adulthood. There is little information on psychosocial factors associated with health behaviors for MetS prevention. The aim of this study was to determine whether there would be a mediating effect of perceived stress on the association between social support and health behaviors for MetS prevention among university students. Methods: This cross-sectional and correlation study was conducted with 502 university students in South Korea. Social support, perceived stress, and lifestyle evaluation for metabolic syndrome scales were used. Online questionnaire survey was conducted between November and December 2019. The mediating effect of social support on health behaviors for MetS prevention was analyzed using PROCESS macro program with bootstrapping method to test our hypotheses. Results: Social support directly influenced perceived stress (β=-.35, p<.001) and health behaviors for MetS prevention (β=.14, p=.002). Health behaviors for MetS prevention was indirectly influenced by perceived stress (β=-.25, p<.001). The size of indirect effect of social support on health behaviors for MetS prevention was 0.06. Conclusions: The association of social support and health behaviors for MetS prevention was partially mediated by perceived stress among university students. Therefore, a university-based nursing intervention should comprise social support strategies with stress management to promote health behaviors for MetS prevention.

A Fusion Study on the Selection of Cyberknife Technique according to the Location of the Pulmonary Tumors (폐종양의 위치에 따른 사이버나이프 기법의 선택에 관한 융합적 연구)

  • Kim, Gab-Jung;Kim, Jeong-Ho;Bae, Seok-Hwan;Kim, Nak-Sang;Seo, Sun-Yeol
    • Journal of the Korea Convergence Society
    • /
    • v.10 no.7
    • /
    • pp.101-108
    • /
    • 2019
  • Depending on the location of the lung tumor, the choice of treatment technique should be considered when treating the Cyberknife. The 4DCT images of 18 lung cancer patients were analyzed, and location error values were extracted through application program. The evaluation result was lower than the average position error only in the upper and the inner. These results suggest that the Vertebral tracking technique is effective when it is close to the pulmonary attachment or near the vertebral body, and the Synchrony technique is effective at other positions. In the future, we would like to study cyber knife treatment technique according to the position of the tumor as well as the volume of the lung and the respiratory cycle.