• Title/Summary/Keyword: Hospitalization Days

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A Study on the Perceived Stress of Mothers in Neonatal Intensive Care Unit (신생아 중환자실에 입원한 환아 어머니의 스트레스)

  • Choi Sung Hee
    • Child Health Nursing Research
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    • v.4 no.1
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    • pp.60-75
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    • 1998
  • The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

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Limited Open Repair Technique of Achilles Tendon Ruptures - Operative Technique and Early Results - (최소 절개 봉합술을 이용한 아킬레스건 파열의 치료 - 수술 방법 및 초기 결과 -)

  • Lee, Keun-Bae;Park, Yu-Bok;Kim, Byung-Soo;Choi, Jin;Jung, Sung-Taek
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.37-41
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    • 2006
  • Purpose: To investigate the early results of limited open repair technique of Achilles tendon ruptures, and to describe the surgical technique. Materials and Methods: From October 2004 to February 2005, a total of 10 patients with Achilles tendon rupture underwent limited open repair. The average age of the patients was 39.3 years, and the average follow-up period was 9 months. The causes of injury were sports injuries in 8 cases, and slip down in 2. The mean interval between the injury and the operation was 9 days. The clinical results were assessed by patient's satisfaction, incision length, hospitalization, the ankle-hindfoot scale of American Foot and Ankle Society (AOFAS), and complications. Results: Of 10 patients, 8 were very satisfied, and the remaining 2 were satisfied. The mean incision length was 2.0 cm, and the mean hospitalization was 2 days. The mean AOFAS score was 97 points, and there was no complications such as infection, rerupture, or nerve injury. All patients returned to work at approximately 2 months, and resumed light exercise such as jogging at approximately 3 months. Conclusion: Limited open repair technique of Achilles tendon ruptures is provided for better cosmetic results, high patient's satisfaction, and functionally successful results without postoperative complications.

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Stereotactic Hematoma Removal of Spontaneous Intracerebral Hemorrhage through Parietal Approach

  • Kim, Jeong Hoon;Cho, Tack Geun;Moon, Jae Gon;Kim, Chang Hyun;Lee, Ho Kook
    • Journal of Korean Neurosurgical Society
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    • v.58 no.4
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    • pp.373-378
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    • 2015
  • Objective : To determine the advantages of parietal approach compared to Kocher's point approach for spontaneous, oval-shaped intracerebral hemorrhage (ICH) with expansion to the parietal region. Methods : We divided patients into two groups : group A had burr holes in the parietal bone and group B had burr holes at Kocher's point. The hematoma volume, Glasgow coma scale (GCS) score, and modified Barthel Index (mBI) score were calculated. At discharge, we evaluated the patients' Glasgow outcome scale (GOS) score, modified Rankin Scale (mRS) score, motor grade, and hospitalization duration. We evaluated the patients' mBI scores and motor grades at 6 months after surgery. Results : The hematoma volume in group A was significantly less than that in group B on postoperative days 1, 3, 5, 7, 14, and 21. Group A had significantly higher GCS scores than did group B on postoperative days 1 and 3. Group A had higher mBI scores postoperatively than did group B, but the scores were not significantly different. No differences were observed for the GOS score, mRS score, motor grade at discharge, or duration of hospitalization. The mBI score of group A at 6 months after surgery was significantly higher, and more patients in group A showed muscle strength improvement. Conclusion : In oval-shaped ICH with expansion to the parietal region, the parietal approach is considered to improve the clinical symptoms at the acute phase by removing the hematoma more effectively in the early stages. The parietal approach might help promote the long-term recovery of motor power.

Disc and underwriting - A proposal of life underwriter in terms of insurance benefits - (디스크질환과 언더라이팅 -보장급부를 중심으로 고찰한 생명보험 언더라이터의 제안-)

  • Byun, Hye-Jin
    • The Journal of the Korean life insurance medical association
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    • v.27 no.2
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    • pp.96-106
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    • 2008
  • Herniate disc disease is one of the biggest problem in claim of insurance as well as in medical. Herniate disc disease have recently increased, and it is ranked 8th in claim reasons recently. As an underwriter and physical therapist, I want to study interrelationship of insurance and disc disease. I think it is necessary to know about knowledge of medical, so this study is given some space to structure of spine, cause of herniated disc disease, role of disc, methods of classification of disable (McBride method and AMA method), and spine disability stage. disc surgery is divided laparoscope disc surgery and spine surgery. I analysis it some factors- gender, age, occupation, re-surgery, and state of after surgery - through searching medical papers. I suggest below conclusion to underwriter because it can be useful to make questionnaire, and underwriter can expect prognosis. conclusion The negative factors of disc surgery (compare to other cases) were as follows: 1. endoscope disc surgery: $20{\sim}40year$ old man, hospitalization period more than 5 days. 2. spine surgery: $45{\sim}70year$ old woman, hospitalization period more than 15 days. 3. re-surgery experience: exist 4. working condition: a person who draws a small income, non-regular worker, working period is less than 1 year. 5. method of surgery: pedicle screw fixation. spine fusion surgery, artificial disc surgery. 6. post surgery condition: appearance of muscle weakness, paralysis, reference pain, lordosis, kyphosis, and complication. smoker or take a drink.

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Clinical Observation of Stroke Patients Admitted to Hospital of Oriental Medicine (한방병원에 입원한 중풍 환자에 대한 임상적 관찰)

  • Kim, Dong-Min;Kim, Hyee-Kwon;Ha, Seon-Yun;Kim, Yong-Suk;Nam, Sang-Soo
    • Journal of Acupuncture Research
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    • v.24 no.5
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    • pp.43-52
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    • 2007
  • Objective : The purpose of this study is to present the epidemiological data on stroke patients admitted to Department of Acupuncture & Moxibustion, Kang-Nam Korean Medicine Hospital Kyunghee University and comparison to past stroke patient studies. Methods : Research was conducted by surveys and charting of patients with a stroke admitted to Department of Acupuncture & Moxibustion Gang-Nam Korean Medicine Hospital Kyunghee University from Jan. 1. 2005 to Dec. 31. 2006. Results : There was 2.3 times more cerebral infarction than cerebral hemorrhage and 1.5 times more female patients. Older patients showed more infarction than hemorrhage. Patient range was mostly in the 70year old range. Preceding diseases were hypertension>diabetes>hyperlipidemia. Gait condition improved during hospitalization. Most patients were admitted after 61 days of stroke onset and hospitalization period exceeded 71days. 76% of patients received treatment from other medical facilities before admittance. Most patients came from western medicine hospitals. Triglyceride levels were high at 32.3% at the time of admittance. The most common symptom in admission time was headache. Conclusion : Acute stroke patients decreased, long term patients increased, and patients who came from other medical facilities increased.

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Selected Characteristics and Degree of Physical Disability of Stroke Survivors at Discharge from Five General Hospitals in Seoul, 1975 (중추 신경계 혈관질환(C. V. A)환자 중 퇴원환자의 신체기능장애정도와 그 특성에 관한 고찰)

  • 이선옥
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.23-28
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    • 1976
  • This study was undertaken to obtain information about selected characteristics and the degree of physical disability of patients with a diagnosis of cerebrovascular accident upon their discharge from a general hospital. It was hoped that this information would contribute to the assessment of their needs for follow-up nursing care. Nurse's and Physician's Progress Notes of all stroke patients discharged from five general hospitals in Seoul from January to December 1975 were analysed using a prepared check list. Patients with other complicating diagnosis such as diabetes, tuberculosis or heart disease were excluded from the sample. According to six factors used to grade the total sample of 334 stroke victims degree of physical ability at discharge, 144 (43%) of the Survivors had good functional ability, 72 (22%) fair, 62 (18%) poor, and 57(17%) very Poor. Certain clinical diagnosis correlated with the degree of physical ability. Intra cranial Hemorrhage and Subarachnoid Hemorrhage tended to be related to poor and very poor outcome categories. There was no significant correlation between nae and ability outcome, women had revealed a significantly positive correlation with poor and very poor ability outcomes. The hospitalization period was less than three days for 37.5% of the total group, and more than one month for 4.7%. Those patients with less than three days hospitalization accounted for the highest relationship with poor and very poor ability outcomes. Of the total groups 175(50.99%), were discharged with a diagnosis of condition improved (though not necessarily with good physical ability). The results suggest serious need for comprehensive follow- up nursing care for stroke survivors discharged a from general hospitals in Seoul.

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Use of an Artificial Neural Network to Predict Risk Factors of Nosocomial Infection in Lung Cancer Patients

  • Chen, Jie;Pan, Qin-Shi;Hong, Wan-Dong;Pan, Jingye;Zhang, Wen-Hui;Xu, Gang;Wang, Yu-Min
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5349-5353
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    • 2014
  • Statistical methods to analyze and predict the related risk factors of nosocomial infection in lung cancer patients are various, but the results are inconsistent. A total of 609 patients with lung cancer were enrolled to allow factor comparison using Student's t-test or the Mann-Whitney test or the Chi-square test. Variables that were significantly related to the presence of nosocomial infection were selected as candidates for input into the final ANN model. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the performance of the artificial neural network (ANN) model and logistic regression (LR) model. The prevalence of nosocomial infection from lung cancer in this entire study population was 20.1% (165/609), nosocomial infections occurring in sputum specimens (85.5%), followed by blood (6.73%), urine (6.0%) and pleural effusions (1.82%). It was shown that long term hospitalization (${\geq}22days$, P= 0.000), poor clinical stage (IIIb and IV stage, P=0.002), older age (${\geq}61days$ old, P=0.023), and use the hormones were linked to nosocomial infection and the ANN model consisted of these four factors. The artificial neural network model with variables consisting of age, clinical stage, time of hospitalization, and use of hormones should be useful for predicting nosocomial infection in lung cancer cases.

Factors Affecting Cost-Sharing Charges for Inpatients (입원환자 본인부담액에 영향을 미치는 요인)

  • An, Byeung Ki
    • Health Policy and Management
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    • v.22 no.3
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    • pp.451-465
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    • 2012
  • In order to strengthen assurance of National Health Insurance, co-payment should be reduced. This can happen with collaborative efforts of patients, medical institutes, and government altogether at the same time. This research applied Dutton(1986)'s medical service research model with high R-square, and analyzed 2008 Korea Health Panel Data (Beta Version 1), that was examined by Korea Institute for Health and Social Affairs and National Health Insurance, in order to figure out influential variables on co-payment. In result of Multiple Linear Regression Analysis, R-square was 46.7%, the older the age, the patients who had surgery, the longer days of hospital treatment are, the higher gross income of a household is, the more hospitalized in upper grade general hospitals, and the more upper grade rooms and selecting a doctor are used. The results have statistical significance. When conducting research applying medical service research model, there is a need to apply Dutton(1986)'s medical service research model with high R-square. In order to strengthen assurance of National Health Insurance, first conditions should be that patients are hospitalized in upper grade general hospital, and at the same time, are patients who had surgery with long stay of hospitalization. In addition, if proven that patients used upper grade rooms and selecting a doctor due to lack of regular treatment and rooms, for certain number of days of such hospitalization, it is suggested to be provided with health care insurance in upper grade rooms and selecting a doctor in calculating co-payment limit.

Clinical Outcomes of Perioperative Geriatric Intervention in the Elderly Undergoing Hip Fracture Surgery

  • Jang, Il-Young;Lee, Young Soo;Jung, Hee-Won;Chang, Jae-Suk;Kim, Jung Jae;Kim, Hye-Jin;Lee, Eunju
    • Annals of Geriatric Medicine and Research
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    • v.20 no.3
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    • pp.125-130
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    • 2016
  • Background: Conventionally, elderly hip fracture patients are assessed by orthopedists to decide whether they need geriatric intervention. We aimed to evaluate the effect of perioperative geriatric intervention on healthcare outcomes in patients undergoing surgery for hip fractures. Methods: Our care model for hip fracture surgery resembles a combination of a routine geriatric consultation model and a geriatric ward model. We retrospectively reviewed the medical records of patients aged ${\geq}65years$ undergoing surgery for hip fracture at a single tertiary hospital from January 2010 to December 2013. We assessed comorbidity, indwelling status, fracture type, and mode of anesthesia. We also evaluated in-hospital expenditure, duration of admission, disposition at discharge and 1-year mortality as clinical outcomes. We developed a propensity score model using the variables of age, cholesterol, and creatinine and examined the effect of perioperative geriatric intervention on intergroup differences of clinical variables. Results: Among 639 patients, 138 patients received the geriatric intervention and 501 patients received the usual care. Univariate analysis showed that factors such as age; Charlson comorbidity index; and serum levels of cholesterol, albumin, and creatinine differed significantly between these 2 groups. There was no significant difference between the groups in terms of 1-year mortality, disposition at discharge, and in-hospital expenditure in the propensity matched model. However, the duration of hospitalization was shorter in the intervention group ($8.9{\pm}0.8days$) than in the usual care group ($14.2{\pm}3.7days$, p=0.006). Conclusion: This care model of geriatric intervention for patients with hip fracture is associated with reduced hospitalization duration.

Relationship between serum vitamin D levels and clinical features of acute bronchiolitis (급성세기관지염과 혈청 비타민 D와의 상관관계)

  • Jung, Young Kwon;Woo, Byung Woo;Lee, Dong Won
    • Allergy, Asthma & Respiratory Disease
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    • v.6 no.6
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    • pp.284-289
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    • 2018
  • Purpose: Vitamin D plays an important role in calcium homeostasis and bone metabolism. It is associated with various diseases such as cardiovascular, immune, allergic and infectious disease. The aim of this study was to investigate the difference in clinical manifestations according to the concentration of vitamin D in mild bronchiolitis. Methods: We performed a retrospective review of medical records of patients with mild bronchiolitis from November 2016 to April 2017 in Daegu Fatima Hospital. Mild bronchiolitis was classified by the modified Tal's score method. Patients were divided into 2 groups according to a 25-hydroxyvitamin D level of 20 ng/mL. We analyzed the clinical characteristics and laboratory data from the 2 groups. Results: Of the 64 patients, 19 were included in the deficiency group and 45 in the normal group. Vitamin D levels were $11.7{\pm}4.9ng/mL$ in the deficiency group and $28.8{\pm}5.0ng/mL$ in the normal group. There were no differences in clinical features between both groups. However, the vitamin D deficiency group had significantly longer hospitalization than the normal group ($6.78{\pm}2.74$ days vs. $5.3{\pm}1.7$ days, P=0.045). In the deficiency group, the incidence of previous respiratory diseases was significantly higher (P=0.001). No significant difference in blood and respiratory virus tests was observed. Conclusion: Low vitamin D levels in mild bronchiolitis were associated with longer hospitalization and prior respiratory disease. Vitamin D may affect the course of mild bronchiolitis.