• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.3
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• pp.414-433
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• 1999

The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

• Proceedings of the Korea Institute of Fire Science and Engineering Conference
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• 2012.04a
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• pp.190-193
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• 2012

The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$,.734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$,.612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

• Clinical and Experimental Pediatrics
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• v.55 no.8
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• pp.272-279
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• 2012

Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

• The Korean Nurse
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• v.33 no.1
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• pp.37-51
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• 1994

The cutaneous stimulation is an independent nursing intervention used in various painful conditions, and is explained by gate control theory. This study was aimed at identifying the effect of cutaneous stimulation on reduction of arteriovenous fistula puncture pain of hemodialysis patients. One group repeated measurement post test research was designed. Forty-five hemodialysis patients who received arteriovenous fistula puncture regulary in hemodialysis units of an attacted D hospital to K university have been studied from August 16 to 21, 1993. First the arteriovenous fistula puncture pain of control period was measured, and then the arteriovenous fistula puncture pain of experimental period(with cutaneous stimulation) was measured. The instrument used for this study were visual analogue pain scale as subjective pain measurement, objective pain behavior checklist and Spielberger's Trait Anxiety Inventory as intervening variables. Analysis of data was done by use of paired t-test, t-test, ANOVA and Perarson correlation coefficient. The results of this study were summarized as follows; 1) The first hypothesis that the subjective pain score of arteriovenous fistula puncture pain in experimental period(with cutaneous stimulation) will be lower than in control period was partly supported. The subjective pain score of arterial line was rejected(paired t=-0.28, p=0.77) and the subjective pain score of venous line was supported(paired t=2.61, p=0.01). 2) The second hypothesis that the objective pain behavior score of arteriovenous fistula pain in experimental period(with cutaneous stimulation) will be lower than in control period was rejected(arterial line paired t=-0.45, p=0.65; venous line paired t=-0.36, p=0.72). 3) The third hypothesis that the cardiopulmonary signs of arteriovenous fistula puncture pain in experimental period(with cutaneous stimulation) will be lower than in control period was rejected(pulse paired t=-0.8, p=0.42; systolic BP paired t=0.98, p=0.33; diastolic BP paired t=0.43, p=0.66). Further experimental studies with simple intravenous injection patients will be recommended in order to identify the effect of cutaneous stimulation.

• International journal of advanced smart convergence
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• v.10 no.2
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• pp.145-150
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• 2021

Patients with Pressure injuries (PIs) may have pain and discomfort, which results in poorer patient outcomes and additional cost for treatment. This study was a part of larger research project that aimed at prediction modeling using a big data. The purpose of this study were to describe the characteristics of patients with PI in critical care; and to explore comorbidity and diagnostic and interventive procedures that have been done for patients in critical care. This is a secondary data analysis. Data were retrieved from a large clinical database, MIMIC-III Clinical database. The number of unique patients with PI was 2,286 in total. Approximately 60% were male and 68.4% were White. Among the patients, 9.9% were dead. In term of discharge disposition, 56.2% (33.9% Home, 22.3% Home Health Care) where as 32.3% were transferred to another institutions. The rest of them were hospice (0.8%), left against medical advice (0.7%), and others (0.2%). The top three most frequently co-existing kinds of diseases were Hypertension, not otherwise specified (NOS), congestive heart failure NOS, and Acute kidney failure NOS. The number of patients with PI who have one or more procedures was 2,169 (94.9%). The number of unique procedures was 981. The top three most frequent procedures were 'Venous catheterization, not elsewhere classified,' and 'Enteral infusion of concentrated nutritional substances.' Patient with a greater number of comorbid conditions were likely to have longer length of ICU stay (r=.452, p<.001). In addition, patient with a greater number of procedures that were performed during the admission were strongly tend to stay longer in hospital (r=.729, p<.001). Therefore, prospective studies focusing on comorbidity; and diagnostic and preventive procedures are needed in the prediction modeling of pressure injury development in ICU patients.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.69-79
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• 2023

Purpose: This study aimed to investigate the involvement of patients who died from hematologic neoplasms in the decision-making process surrounding the withdrawal of life-sustaining treatment (LST). Methods: A total of 255 patients diagnosed with hematologic neoplasms who ultimately died following decisions related to LST during their end-of-life period at a university hospital were included in the study. Data were retrospectively obtained from electronic medical records and analyzed utilizing the chi-square test, independent t-test, and logistic regression. Results: In total, 42.0% of patients participated in the decision-making process regarding LST for their hematologic neoplasms, while 58.0% of decisions were made with family involvement. Among these patients, 65.1% died in general wards and 34.9% in intensive care units (ICUs) as a result of decisions such as the suspension of LST. The period from the LST decision to death was longer when the decision was made by the patient (average, 27.15 days) than when it was made by the family (average, 7.48 days). Most decisions were made by doctors and family members in the ICU, where only 20.6% of patients exercised their right to make decisions regarding LST, a rate considerably lower than 79.4% observed in general wards. Decisions to withhold or withdraw LST were more commonly made by patients themselves than by their families. Conclusion: The key to discussing the decision to suspend hospice care and LST is respecting the patient's self-determination. If a patient is lucid prior to admission to the ICU, considerations about suspending LST should involve the patient input.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1400-1410
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• 2000

Purpose : To determine whether there is a discrepancy between the medical professions perception of what patients should know and that of the patients themselves, we studied patients need to be informed about different aspects of epilepsy and compared findings with medical personnels perceptions of the issue. Methods : Our study population consisted of 39 patients with epilepsy from the inpatient epilepsy unit, and 51patients from the outpatients clinic of the S. University Hospital between July and November 1997. However, the patients who declined to participate or who were not able to understand the directions and content of the questionnaire were excluded. The medical personnel participated in this study were 56 residents or nurses who were working in either Neurology or Neuro surgery Units. The questionnaire with 5 indicating the highest need. The data were analyzed with descriptive statistics, students t-tests, and chi-square. Results : Of the 90 patients and 56 medical personnel studied, the need for lifestyle information such as smoking, drinking, sleep, driving, employment, and marriage was significantly higher from medical personnel than that of the patients(p=0.00). Regarding medical knowledge about epilepsy, the patients group had higher scores in the need for information on the structure of the brain (p=0.00), whereas medical personnel had higher scores on the symptoms of epilepsy. There was no correlation between the length of epilepsy and the need for information on every item on the questionnaire. The patients had higher rank regarding diet, although it was not significantly different from the medical personnel. Regarding antiepileptic drugs and what to do when there is an attack, medical personnel scored higher. The items on which the patients group scored higher than 4.5 were the possibility of inheritance, the factors that might reduce the number of attacks, the period of usage of AED, and the food they have to avoid or the food they have to take to reduce seizure attacks. Conclusions : Our study indicates that the patients group requires higher educational need in the structure of the brain, diet, and surgical treatment, but less in lifestyles and what to do when there is an attack. The educational program for the patients with epilepsy should emphasize medical knowledge with regard to brain anatomy, what to eat and what to avoid, and details of surgical treatment.

• Journal of Hospice and Palliative Care
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• v.15 no.4
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• pp.205-211
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• 2012

Purpose: This study was performed to identify the level of stress perceived by nurses who attend dying patients in the cancer care unit; their understanding regarding end-of-life care and related training needs. Methods: A cross-sectional descriptive study was conducted with 151 nurses stationed at the cancer care units of four general hospitals located in Seoul and Gyeonggi province in Korea. Data were collected using self-reported questionnaires and the response rate was 96%. The data were analyzed using t-test, ANOVA and Pearson's correlation analysis. SPSS 12.0 was used for data analysis. Results: Nurses experienced a high level of stress in the end-of-life care settings. Their understanding of end-of-life care was above the mid-point of the scale while their training needs for end-of-life care was relatively high. The more experienced the nurses were, the more stressed they were, particularly due to excessive workload. Nurses who served longer in the cancer unit tended to show greater needs for end-of-life care training. Conclusion: This study found nurses perform end-of-life care with a high level of stress but with insufficient understanding, and thus, showed great needs for related training. Such findings can be useful to develop an end-of-life care training program for nurses.

• Clinical and Experimental Pediatrics
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• v.50 no.7
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• pp.622-628
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• 2007

Purpose : While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. Methods : All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. Results : There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/bed). Conclusion : Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.466-470
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• 2007

Purpose: Active prevention is an essential component in reducing the development of pressure sores. For the high-risk patient group, following the certified pressure sore screening scale as well as educating the patient and the nurses who care for them can lead to optimal management of these patients. Applying a risk assessment scale along with a prevention strategy can reduce medical costs and length of stays at the hospital. The purpose of this study is to evaluate the efficacy of a new pressure sore risk assessment scale based on the universally recommended Braden scale and our prevention program. Methods: From June to August, 2003, our pressure ulcer risk assessment scale was applied to a total of 1882 patients admitted to the experimental group (intensive care unit, neurosurgery, general surgery, and oncology units). It was based on Braden scale. We analysed sensitivity, specificity, positive and negative predictive value and ROC curve to evaluate its efficacy. Pressure ulcer prevention program was composed of patient's education using protocol and specific nursing care. The incidence of pressure ulcers was also measured during the 3 months period, and those were compared to the control group of 1789 patients from March to May, 2002. Results: 118(6.27%) of the experimental group were high-risk with an incidence of pressure ulcers measuring 4 (0.21%). Sensitivity, specificity, positive and negative predictive value of our scale were 100%, 94%, 4%, 100%, respectively, and AUC(area under the curve) was 0.992. In the control group, the incidence of pressure ulcers was 11(0.61%). Statistical analyses using chisquared tests with a significance level of 5%, the results were such that ${\chi }^2=3.6482$(p=0.0561). The results proved to be statistically significant in borderline. Conclusion: The results from this study proved that pressure sore risk assessment scale based on Braden scale has an excellent efficacy, and shows that our pressure ulcer prevention program is partially effective in reducing pressure ulcer incidence.