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A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal- (퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로)

  • Choi, Yun Soon;Kim, Dai Hyun;Storey, Margaret;Kim, Cho Ja;Kang, Kyu Sook
    • The Korean Nurse
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    • v.31 no.4
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    • pp.77-99
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    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

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Perfusion MR Imaging of the Brain Tumor: Preliminary Report (뇌종야의 관류 자기공명영상: 예비보고)

  • 김홍대;장기현;성수옥;한문희;한만청
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.119-124
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    • 1997
  • Purpose: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. Materials and Methods: We performed perfusion MR imaing preoperatively in the consecutive IS patients with intracranial masses(3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurocytoma, 1 metastasis, 2 abscesses, 1 radionecrosis). The average age of the patients was 42 years (22yr -68yr), composed of 10 males and S females. All MR images were obtained at l.ST imager(Signa, CE Medical Systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media. (contrast media: IScc of gadopentate dimeglumine, about 2ml/sec by hand, starting at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(CE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE SOms, flip angle $90^{\circ}$, FOV $240{\times}240mm,{\;}matrix{\;}128{\times}128$, slice-thick/gap S/2.S). After data collection, the raw data were transferred to CE workstation and rCBV maps were generated from the numerical integration of ${\Delta}R2^{*} on a voxel by voxel basis, with home made software (${\Delta}R2^{*}=-ln (S/SO)/TE). For easy visual interpretation, relative RCB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Cd-enhanced images with focus on the degree and extent of perfusion and contrast enhancement. Results: Two cases of glioblastoma multiforme with rim enhancement on Cd-enhanced Tl weighted image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin. In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion of moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. Conclusion: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade gliomas. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.

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Incidence and Clinical Manifestations of Rotaviral Infections in a Neonatal Intensive Care Unit (신생아중환자실 내 로타바이러스 감염의 발생 및 임상 양상)

  • Baek, Jae-Moon;Kim, Hee-Young;Lee, Jang-Hoon;Choi, Byung-Min;Lee, Jung-Hwa;Lee, Kwang-Chul;Hong, Young-Sook
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.55-63
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    • 2009
  • Purpose: This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods: Neonates diagnosed wit rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results: Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion: Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.

A Study on the Association of Thin Glomerular Basement Membrane Abnormality with Minimal Change Nephrotic Syndrome (사구체 기저막 비박화 소견을 보인 미세변화 신증후군에 관한 고찰)

  • Kim, Chang-Woo;Cho, Min-Hyun;Ko, Cheol-Woo;Koo, Ja-Hoon;Kwak, Jung-Sik
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.48-55
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    • 2002
  • Purpose: Thin glomerular basement membrane nephropathy (TGBMN) is recognized as the leading cause of microscopic hematuria in both children and adults. However thinning of glomerular basement membrane (TCBM) has been found in healthy adult and also is known to be associated with various renal diseases such as Alport syndronh, IgA nephropathy and mesangial proliferative glomerulonephritis. The association of TGBM with minimal change nephrotic syndrome (MCNS) has been very rare so that the present study was undertaken to determine the relationship between TGBM and MCNS. Methods: The study population consisted of 49 children with biopsy- proven MCNS who have been admitted to the pediatric department of Kyungpook University Hospital during the past 5 years from 1997 to 2001. Group I consisted of 8 children associated with TGBM and Group II 41 children without TCBM. Various parameters such as age of illness, duration from discovery of illness to the time of biopsy, family history of hematuria and other laboratory tests were compared between these two groups and the following results were obtained. Results: Age distribution showed slightly older age in Group I ($7.1{\pm}3.5$ years) compared to Group II ($4.8{\pm}2.9$ years). However this was not statistically different (P=0.056). Family history of hematuria was noted in 2 cases in Group II. Though statistically not significant, hematuria was seen in 2 out of 8 cases ($25\%$) in MCNS children with TGBM, compared to 7 out of 41 cases ($17\%$) with MCNS children without TGBM. Other parameters such as BUN, creatinine, 24 hours urine protein excretion, serum protein, albumin, cholesterol, and T4/T8 ratio, showed no difference. Also renal biopsy finding showed no significant difference and the thickness of glomerular basement membrane in Croup I was $188{\pm}30nm$. Conclusion: TGBM was found in 8 out of 49 children with MCNS ($16.3\%$). And this high frequency of occurrence indicates that these association is not an incidental findings. Typical clinical findings of TCBMN was not noted in all of the 8 children with MCNS associated with TGBM, suggesting that thinning of glomerular basement membrane (TCBN) is secondary to rather than the cause of MCNS. (J Korean Soc Pediatr Nephrol 2002;6: 48-55)

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Evaluation of Treatment Efficencies of Pollutants in Juksancheon Constructed Wetlands for Treating Non-point Source Pollution (비점오염원 저감을 위한 죽산천 인공습지의 오염물질 정화효율 평가)

  • Choi, Ik-Won;Seo, Dong-Cheol;Kang, Se-Won;Lee, Sang-Gyu;Seo, Young-Jin;Lim, Byung-Jin;Park, Jong-Hwan;Kim, Kap-Soon;Heo, Jong-Soo;Cho, Ju-Sik
    • Korean Journal of Soil Science and Fertilizer
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    • v.45 no.4
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    • pp.642-648
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    • 2012
  • To evaluate the water quality in Juksancheon constructed wetlands for treating non-point source pollution, the removal rates of nutrients in water and the total amounts of T-N and T-P uptakes by water plants were investigated. Chemical characteristics of T-N and T-P in sediment were investigated. The concentrations of BOD (Biochemical Oxygen Demand), COD (Chemical Oxygen Demand), SS (Suspended Solids), T-N and T-P in inflow were 0.07~1.47, 0.60~2.65, 0.50~4.60, 1.38~6.26 and $0.08{\sim}0.32mg\;L^{-1}$, respectively. The removal rates of BOD, COD, SS, T-N, and T-P were -10, 51, 66, -3 and 5%, respectively. The maximum amount of T-N uptake by water plants in August was $368.7mg\;plant^{-1}$ in the $2^{nd}$ treatment stage by Nymphoides peltata, $1314.6mg\;plant^{-1}$ in the $3^{rd}$ treatment stage by Iris pseudacorus, $1160.4mg\;plant^{-1}$ in the $4^{th}$ treatment stage by Nymphaea tetragona GEORGI, respectively. The maximum amount of T-P uptake by water plants in August was $121.7mg\;plant^{-1}$ by Nymphoides peltata in the $2^{nd}$ treatment stage, $268.7mg\;plant^{-1}$ by Iris pseudacorus in the $3^{rd}$ treatment stage and $212.0mg\;plant^{-1}$ by Nymphaea tetragona GEORGI in the $4^{th}$ treatment stage, respectively. Organic matter contents in sediments were not different. Contents of T-N and T-P in sediments were higher in spring. Microbial biomass C:N:P ratios in sediments in spring, summer, autumn and winter were 117~140:1~4:1, 86~126:5~6:1, 68~101:2~6:1 and 47~138:2~4:1, respectively. We could conclude that Juksancheon constructed wetlands show high removal efficiencies of COD and SS. However, improvements of management in winter season should be considered to improve the removal efficiencies of pollutants.

Rice Growth and Yield at Different Cultural Methods under No-tillage Condition (벼 무경운 재배시 재배양식에 따른 생육 및 수량)

  • 박홍규;김상수;백남현;석순종;박건호;이선용
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.41 no.4
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    • pp.420-428
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    • 1996
  • This study was conducted to investigate the response of growth and yield of rice under five different cultural methods, machine transplanting(MTNT), puddled drill seeding (PDSNT), drill seeding on soil surface (DSNT) , broadcasting on soil surface (BSNT) under no-tillage paddy condition and conventional machine transplanting(MTT) in Jeonbuk series(siltyloam soil) from 1993 to 1995. Soil hardness was higher in no-tillage soil and increased with highly difference between tillaged and no-tillage soil with deeper soil depth. Bulk density was heavier in no-tillage soil and porosity was higher in tilled soil than that of the control. The rate of effective tiller was higher in MTT, following MTNT, PDSNT, DSNT and BSNT. Weed occurrence was more serious in no-tillage soil, than that of tillaged soil. The rate of lower internode length was lower in DSNT and BSNT and was similar with MTT in PDSNT and MTNT. Height of center gravity in terms of lodging tolerance was lower in direct seeding than in machine transplanting. Depth of buried culm was shorter in no-tillage soil, especially in DSNT and BSNT. Total amount of root was higher in MTT, following MTNT, PDSNT, BSNT and BSNT and the distribution rate of root in shallower soil layer was higher in no-tillage soil, especially in BSNT and DSNT. Field lodging occured highly in BSNT, following DSNA, PDSNT and MTNT with high lodging scale in DSNT and BSNT. Panicle number per unit land square meter was the highest in MTT and the least in BSNT. Ripened grain ratio was low in BSNT and DSNT due to heavy lodging. Yield of milled rice was 93% in PDSNT, 87% in DSNT, 81% in BSNT and 96% in MTNT, compared with 534kg /10a in MTT.

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Effect of Silicate-Coated Rice Seed on Healthy Seedling Development and Bakanae Disease Reduction when Raising Rice in Seed Boxes (벼 상자육묘에서 규산코팅볍씨의 건묘육성과 벼키다리병 경감효과)

  • Kang, Yang-Soon;Kim, Wan Jung;Roh, Jae-Hwan
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.62 no.1
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    • pp.1-8
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    • 2017
  • We investigated the effect of silicate coating of rice seeds on bakanae disease incidence and the quality of seedlings raised in seedling boxes and transplanted into pots. The silicate-coated rice seed (SCS) was prepared as follows. Naturally infested rice seeds not previously subjected to any fungicidal treatment were dressed with a mixture of 25% silicic acid at pH 11 and 300-mesh zeolite powder at a ratio of 50 g dry seed - 9 mL silicic acid - 25 g zeolite powder. The following nursery conditions were provided : Early sowing, dense seeding in a glass house with mulching overnight and no artificial heating, which were the ideal conditions for determining the effect on the seed. The nursery plants were evaluated for Gibberella. fujikuroi infection or to determine the recovery to normal growth of infected nursery plants in the Wagner pot. Seedlings emerged 2-3 days earlier for the SCS than they did for the non-SCS control, while damping-off and bakanae disease incidence were remarkably reduced. Specifically, bakanae disease incidence in the SCS was limited to only 7.8% for 80 days after sowing, as compared to 91.6% of the non-SCS control. For the 45-days-old SCS nursery seedlings, the fresh weight was increased by 11% and was two times heavier, with only mild damage compared to that observed for non-SCS. Even after transplanting, SCS treatment contributed to a lower incidence of further infections and possibly to recovery of the seedlings to normal growth as compared to that observed in symptomatic plants in the pot. The active pathogenic macro-conidia and micro-conidia were considerably lower in the soil, root, and seedling sheath base of the SCS. In particular, the underdeveloped macro-conidia with straight oblong shape without intact septum were isolated in the SCS ; this phenotype is likely to be at a comparative etiological disadvantage when compared to that of typical active macro-conidia, which are slightly sickle-shaped with 3-7 intact septa. A active intact conidia with high inoculum potential were rarely observed in the tissue of the seedlings treated only in the SCS. We propose that promising result was likely achieved via inhibition of the development of intact pathogenic conidia, in concert with the aerobic, acidic conditions induced by the physiochemical characteristics associated with the air porosity of zeolite, alkalinity of silicate and the seed husk as a carbon source. In addition, the resistance of the healthy plants to pathogenic conidia was also important factor.

Effects of Senenium and Vitamin E Administration on the Semen Characteristics, Blood Chemical Values and Hormone in Hanwoo Sires I. Effects of Selenium, Vitamin E and rBST Administration on the Semen Characteristics in Hanwoo Sires (Selenium 과 Vitamin E 투여가 한우 종모우의 정액성상, 혈액성분 및 호르몬 변화에 미치는 효과 I. Selenium, Vitamin E 및 rBST 투여가 한우 종모우의 정액성상에 미치는 효과)

  • 양부근;전기준;김종복;박동헌;김정익;박춘근;이성수;박노형;원유석
    • Korean Journal of Animal Reproduction
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    • v.23 no.3
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    • pp.191-203
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    • 1999
  • The objectives of this study were to investigate 1) the effects of Selenium(Se), Vitamin E (Vit. E) or recombinant Bovine Somatotropin(rBST) administration on fresh and frozen/thawed semen characteristics and 2) the effect of taurine on frozen/thawed semen characteristics in Hanwoo sires Hanwoo sires were randomly assigned to five groups (1. control, 2. rBST, 0.09mg/kg body weight (BW), 3. Vito E 1,500IU/kg BW, 4. Se 0.l mg/kg BW, 5. Vit. E 1,500IU plus Se 0.1 mg/kg BW). The administration of Se, Vit. E and rBST for each experimental group were given 6 times at 15 days interval by intramuscular injection. The administration of Se, Vit. E or rBST in Hanwoo sires didn't affect semen volume and pH values, but sperm viability was significantly increased comparing to the control group. Also, frozen/thawed semen analysis showed that the sperm viability increased, but any other effects were not found in total sperm :lumber, motility and abnormality among treatments. The addition of taurine in semen freezing extender had a beneficial effects on frozen/thawecl semen characteristics in all groups. The administrations of rBST, Vit. E and Se did not affect the sperm capacitation and acrosome reaction, either the ratio of F pattern(uncapacitated and acrosome intact sperm) or AR pattern(capacitated and acrosome-reacted sperm), but the ratio of B patten(capacitated and acrosome intact sperm) of treatment groups was significantly higher than that of control group, These results indicated that the viability, motility and quality of semen in Hanwoo sires were slightly increased by the injection of rBST, Vit. E and Se, and the addition of taurine in semen freezing extender were also increased the semen characteristics after thawing.

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Method of Environmental-Friendly Fertilization for Rice Cultivation after Vegetable Copping in Green House Soil (시설재배 후작 벼 재배를 위한 친환경적 시비 기술)

  • Jeon, Weon-Tai;Lee, Jae-Sang;Park, Ki-Do;Park, Chang-Yeong;Roh, Sug-Won;Yang, Won-Ha
    • Korean Journal of Environmental Agriculture
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    • v.24 no.2
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    • pp.191-197
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    • 2005
  • Green house soils have been intensively cultivated with excessive application of compost and chemical fertilizer for vegetable growth. The objective of this study was to establish the reasonable fertilizer application system for rice cultivation in green house soil. Field experiment was carried out with rice cv. Geumo-byeo 1 in Jisan series soil (fine loamy, mixed, mesic family of Fluventic Haplaquepts) that was previously cropped with green pepper (Capsicum annuum L.) for the last 3 years. Treatment consisted of conventional fertilization $(N-P_2O_5-K_2O=11-4.5-5.7kg\;10a^{-1})$, no basal fertilization, 50% reduction of basal fertilization no top dressing, bulk blending fertilizer, and no fertilizer. The value of pH, available phosphate, and exchangeable potassium after experiment was lower than those before experiment while organic matter content was not difference in all treatment. The value of salt elusion was the highest in no basal fertilization plot. The amount of $NH_4-N$ in soil was higher in growth stage of rice as fertilizer amount increased in 1998. The changes of plant height and tiller were higher as fertilizer amount increased. Thousand-grain weight as yield component was higher in no basal fertilization plot all the year because of decreasing panicle. There was no significant difference in rice yield between treatments in 1998. However, conventional fertilization resulted in significantly increased rice yield in 1999. Nitrogen use efficiency was the highest in no basal fertilization plot in 1998 and in conventional fertilization plot in 1998. Our results suggest that no basal fertilization be best to increase salt elusion with slightly increased yield in first year for rice cropping after vegetable harvesting, which method improves fertilization efficiency. However, conventional fertilization was good for second rice cropping after vegetable harvesting in greenhouse.

Comparison of the Content of Shizandrin, Gomisin A and Gomisin N in Schisandra Fruit by Water Extraction Condition (오미자의 물 추출조건에 따른 shizandrin, gomisin A, gomisin N의 함량 비교)

  • Kim, Hee-Soon;Moon, Hyun-Kyung;Lee, Young-Ju;Lee, Chun-Young;Hwang, Kwang-Ho;Kim, Ouk-Hee;Yoo, In-Sil;Jung, Kweon
    • Journal of Food Hygiene and Safety
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    • v.30 no.1
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    • pp.59-64
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    • 2015
  • This study compared the content change of physiological active substances according to the extraction condition when we generally drink the extractive of Schisandra fruit with using water. Physiological active substances of the Schisandra fruit, schizandrin, gomisin A and gomisin N were analysed with HPLC. The results of extracting 1 dose of the Schisandra fruit tea, which is some as 1 g of Schisandra fruit, in 100 mL of water by differing the extraction type, extraction temperature and extraction time were of the followings. The total content of schizandrin, gomisin A and gomisin N of powder type in $26^{\circ}C$ leaching was the highest (p < 0.05) as the leaching content of 24 hours (5.54 mg/g) showed difference with different times and the contents of raw type Schisandra fruit were less than 0.1 mg/g in all of extraction time. The contents of powder type Schisandra fruit in $60^{\circ}C$ heating extraction was over 4.50 mg/g except for the 5 minute (2.94 mg/g), and the contents of raw Schisandra fruit were less than 0.3 mg/g. In case of $100^{\circ}C$ heating extraction, the contents of powder type Schisandra fruit showed over 5.10 mg/g in every time zone, and the raw type Schisandra fruit was less than 1.0 mg/g.