• 중환자간호학회지
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• 제14권3호
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• pp.141-156
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• 2021

Purpose : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane's revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=-0.22, 95% CI : -0.51~0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33~1.40, p=.295). Among the non-pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients.

• Child Health Nursing Research
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• 제25권2호
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• pp.103-111
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• 2019

Purpose: This study aimed to investigate incidence of delirium in the pediatric intensive care unit (PICU) and to analyze associated risk factors. Methods: The participants were 95 patients, newborn to 18 years, who were admitted to the PICU. The instruments used were the Richmond Agitation Sedation Scale (RASS), and the Cornell Assessment of Pediatric Delirium. Data analysis was performed using the descriptive, $x^2$ test, t-test, and logistic regression analyses. Results: The incidence of delirium in children admitted to the PICU was 42.1%. There were significant differences according to age ($x^2=14.10$, p=.007), admission type ($x^2=7.40$, p=.007), use of physical restraints ($x^2=26.11$, p<.001), RASS score ($x^2=14.80$, p=.001), need for oxygen ($x^2=5.31$, p=.021), use of a mechanical device ($x^2=9.97$, p=.041), feeding ($x^2=7.85$, p=.005), and the presence of familiar objects ($x^2=29.21$, p<.001). Factors associated with the diagnosis of delirium were the use of physical restraint (odds ratio [OR]=13.82, 95% confidence interval [CI]=4.16~45.95, p<.001) and the presence of familiar objects (OR=0.09, 95% CI=0.03~0.30, p=.002). Conclusion: Periodic delirium assessments and intervention should be actively performed. The use of restraints should be minimized if possible. The caregiver should surround the child with familiar objects and ensure a friendly hospital environment that is appropriate for the child.

• 지역사회간호학회지
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• 제32권1호
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• pp.51-63
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• 2021

Purpose: This study aimed to develop an integrated health promotion program for cancer survivors residing in the community based on the shared care model, and evaluate its effectiveness. Methods: A quasi-experimental trial was conducted. The participants consisted of 35 cancer survivors with completed intensive cancer therapy at the cancer hospital. The intervention group (n=20) and the control group (n=15) were recruited from among a district home cancer patient registrations. The intervention group participated in an integrated health promotion program based on the MAPP (Mobilizing for Action through Planning and Partnership) development process. The program consisted of physical, psycho-social and body image units. The participants were assessed before the program, and immediately after the program. Data were collected between July 1 and September 2, 2018 using FACT-G quality of life (QOL), distress thermometer (DT), and resilience. The data were analyzed by performing a χ2 test, Fisher's exact test, Mann-Whitney test, and ranked ANCOVA using SPSS. Results: The intervention group reported a higher QOL overall and significantly higher social/family well-being than the control group. Distress was significantly lower in intervention group than in the control group. Resilience had no significant difference between the two groups. Conclusion: These findings indicate that the integrated health promotion program base on the shared care model and MAPP development process could be effective intervention for improving social/family well-being and the QOL, and reducing distress of cancer survivors at home. Community health center nurses need to provide intervention to support self-care competency for cancer survivors' comprehensive care with physical, psycho-social, and body image to help them adjust their life to a moderate risk group in the community.

• 중환자간호학회지
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• 제16권1호
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• pp.71-86
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• 2023

Purpose : This study aims to investigate the status of delirium intervention in adult intensive care unit (ICU) patients and the perception of this delirium by medical staff. Methods : This retrospective study involves 185 patients, whereas, a descriptive survey is conducted with 197 medical staff members. Results : The delirium group includes 100 patients (54.1%). The incidence of delirium is 64.9% in the medical ICU, 65.9% in the surgical ICU, 42.4% in the neuro ICU, and 46.5% in the cardiac ICU. The percentages of delirium prevention intervention differs between the two groups: 65.0% in the delirium group and 95.3% in the non-delirium group. The medical staff recognize that delirium is a common problem in the ICU (100.0%) and requires active medical intervention (98.5%). Conclusion : The length of stay at the ICU is longer in the delirium group than in the non-delirium group. It is necessary to standardize delirium prevention and treatment protocols to be equally applicable to all ICU patients.

• 중환자간호학회지
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• 제17권1호
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• pp.44-56
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• 2024

Purpose : This study sought to explore intensive care unit (ICU) nurses' perceptions regarding the disclosure of patient safety incidents (DPSI) and identify the relationship between the perception of DPSI and communication barriers. Methods : This study used a descriptive research design. A total of 110 ICU nurses from a tertiary hospital were surveyed online between September 14 and October 5, 2022. The mean DPSI score ranged between 1.0 and 4.0, with a higher score indicating a higher perception of DPSI. Results : The mean score for ICU nurses' perceptions of DPSI was 2.92 (SD=0.37). Among the characteristics of ICU nurses, differences were observed in perceptions of DPSI according to gender, age, total work experience, and ICU work experience. Communication barriers among ICU nurses were negatively correlated with negative results as a sub-factor of perceptions of DPSI. Ambiguity in the nurse's position, lack of confidence, differences in perspectives with patients, and inadequate nurse-patient relationships as sub-factors of communication barriers exhibited a negative correlation with negative results as a sub-factor of perceptions of DPSI. Conclusions : ICU nurses' perceptions of DPSI and the sub-factors related to communication barriers are negatively related to DPSI. To improve ICU nurses' perceptions, open and non-punitive circumstances, staff education, practical guidelines, and support systems are required.

• Clinical and Experimental Pediatrics
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• 제63권9호
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• pp.361-367
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• 2020

Background: Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors. Purpose: The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018. Methods: This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05. Results: The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P<0.05). Parametric models showed better fitness than the Cox model in this study. Conclusion: Breastfeeding and availability of central venous catheter had protective effects against length of stay, whereas phototherapy, acute renal failure, and mechanical ventilation increased length of stay in NICU. Therefore, the identification of factors associated with NICU length of stay can help establish effective interventions aimed at decreasing the length of stay among infants.

• 한국콘텐츠학회논문지
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• 제18권12호
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• pp.75-91
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• 2018

여성이 대다수인 간호전문직에 남자간호사가 점차 증가하고 있으나, 그들은 성 고정관념에 따른 사회적 장벽에 부딪히며, 부서배치 등에서 차별을 경험하고 있었다. 본 연구는 병원 종사자들을 대상으로 성 역할 정체감과 성 고정관념이 남자간호사에 대한 편견에 미치는 영향을 확인하기 위하여 시도되었다. 연구 결과 양성성 집단은 성 고정관념과 남자간호사에 대한 편견이 다른 집단에 비해 낮았으며, 병원종사자들은 남자 간호사들이 일반인들에게 낯설고 생소하며, 응급실, 중환자실, 수술실 같은 병원의 특수 부서에서 주로 일할 것이라는 편견을 가지고 있었고, 성 고정관념은 남자간호사에 대한 편견에 양의 상관관계가 있었다. 따라서 의료기관은 남자간호사에 대한 편견을 해소하기 위해 양성 평등적인 조직문화를 구축하기 위한 계획을 수립하여 성 고정관념을 탈피하기 위해 노력하고, 간호조직 내에서 남성과 여성이 동등한 기회를 부여받을 수 있도록 해야 할 것이다.

• Acute and Critical Care
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• 제33권4호
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• pp.252-259
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• 2018

Background: The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time ($26.7{\pm}25.1$ vs. $12.1{\pm}16.0days$, P=0.003), length of stay in the general ward ($70.6{\pm}89.1$ vs. $40.5{\pm}42.2days$, P=0.008), length of total hospital stay ($107.5{\pm}95.6$ vs. $74.7{\pm}51.2days$, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010). Conclusions: Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.

• 대한간호학회지
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• 제27권2호
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• pp.433-443
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• 1997

Cardiac catheterization is a diagnostic procedure which is intrusive and anxiety provoking. Patient education and information offer have been suggested as effective nursing interventions to reduce patients' anxiety and stress. Main objectives of this study are : 1) to develop concrete objective information for patients undergoing cardiac catheterization : 2) to analyze the types of information included in the newly developed concrete objective information. The subjects of this study are 11 patients who were admitted to the CCU of a general hospital in Seoul. The subjects were provided with preparatory information about cardiac catheterization by using interview and a booklet. After the procedure, the subjects were asked to describe additional information which they suggest to be added into the booklet and the physical sensations felt during the procedure. The results of the study are summarized as follows : Most subjects were satisfied with the preparatory information that was provided by interview and the booklet before the procedure. But patients suggested several problems related to the content of the booklet. First, they reported difficulty to differentiate the terms -coronary angio gram and cardiac catheterization. Also, some patients expressed that they feared after reading the information about the incision of inguinal area. Subjects responded that the information about the direct process of the test did not reduce their anxiety and the information was not detail enough. Next, most subjects would want to know about the monitor and the sound from monitor. They said that they could not hear instructions from doctor or nurse during the procedure due to tension. Considering above response results, the need for more effective way to provide information, like visual and auditory information through video tape for giving information is suggested. Sensations related to the procedure were the smell coming from sterilization of inguinal area, stinging pain in groin when the doctor inserts a needle into artery, and the sensation of pressure and moving of vessels surrounding neck when the catheter was inserted and visualized on fluoroscopy. Besides, subject reported hot sensation and burning feeling in face and chest area, and nausea when dye is injected by hand. In the analysis of information content, there was 79% agreement on the actual units of analysis that were coded. In the analysis of type of information, procedural information was 60.4%. Concrete objective information was 28.1%. and other information was 11.5%. Agreement of the coders in categorizing the units of information was determined by using Cohen's kappa which corrects for chance agreement. Cohen's kappa was .84.

• 한국간호교육학회지
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• 제6권2호
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• pp.287-302
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• 2000

The purpose of the study are to examine the perception of the importance and performance of patient education of the clinical nurse and find out the interfering factors in practicing patient education. The data were collected from convenient sample of 256 clinical nurses working in the nursing units of adult patients except the psychiatric unit, obstetric unit, dental surgical unit and intensive care unit of one University Hospital in Seoul from September 29 to October 2, 1998. Three measurement tools of self-report- questionnaires developed by researcher used. For the content validity of the questionnaires, two sessions of panel discussion and a pilot test were done and finally factor analysis was done with Varimax method. Analysis of data was done with SAS program using frequency, percentage, means, standard deviation, Pearson's Correlation Coefficients, t-test and ANOVA. The obtained results were as follows : 1. The surveyed nurses perceived the importance of patient education at higher level with mean score of 4.08 among 5 point than their perception of practice( mean score : 3.42). 2. There was positive significant correlation(r=.29, p=0.0001)between nurses' perception of the importance of patient education and it's practice 3. Among the teaching contents for patients, 'information of diagnostic procedure and operation' and 'orientation of hospitalization' were perceived most important. And 'preparation for discharge' and 'understanding of disease and health promotion' were perceived least important 4. Among the teaching contents for patients, 'orientation of hospitalization' and 'information of diagnostic procedure and operation' were perceived highly performable. And 'understanding of disease and health promotion' and 'preparation for discharge' were perceived least performable. 5. Three types of interfering factors were identified as patient-factor, situational factor, nurse-factor. The mean degree of impediment with the interfering factors was at average level(3.09 among 5). The patient and situational factors of impediments were more interfering than nurse- factor for teaching patients. 6. In older age(p<.05), married state (p<.05), higher educational status (p<.01), higher clinical experience (p<.01) and higher position(p<.01), the score of perceived importance of patients education was more high. 7. In older age(p<.01), higher clinical experience(p<.001) and surgical unit (p<.01), the score of perceived performance of patients education was more high. In conclusion, in order to activate patient education practice in the clinical setting, the continuing education for patients education should be more emphasized and the effective teaching methods and materials should be developed to help patient teaching. And an organizational support such as budgeting for patient education and reimbursement system should be administrated.