• 기본간호학회지
• /
• 제7권3호
• /
• pp.415-428
• /
• 2000

The purpose of this study was to identify side effects of the vesicant chemotherapy. The study was designed to be a descriptive survey. The subjects of this study were 88 patients with various types of cancer, primary lung cancer(25.0%), advanced gastric cancer(25.0%), breast cancer(20.5%), etc. The mean age was 44.8 years old(range: 16-68). The questionnaire was completed by nurses of the outpatient unit and chemotherapy ward, and intravenous nurse specialist. The results of the study were as follows: 1) Chemotherapy was administered with a 23G scalp needle and 24G insyte. Injection site was dorsum of hands(64.7%), cephalic vein(19.3%). Successful rate for the first attempt was 88.6%. The first & second cycle chemotherapy was 29.5% each.. Mainly used drugs were Navelbine(34.1%), Adriamycin(20.5%). 2) Venous Problems after chemotherapy were pain(13.6%) incurred by venous, mainly due to the administration of Navelbine; redness at the inravenous site(12.5%) and itching sense 2.3% Non-venous problems were nausea (18.2%), dullness(14.8%), vomiting(8.0%), facial flushing(6.8%), anxiety(5.7%). Subjective discomforts after chemotherapy were generalized arm pain at the injection side(14.8%), dizziness(6.8%), weakness(5.7%) and general bodyache(5.7%). Systemic anaphylactic reaction and extravasation did not occur. 3) Non-venous problem after chemotherapy were nausea, vomiting & anorexia. Frequency of chemotherapy related to side effects were itching, facial flushing, and nausea(p< .05). Day of chemotherapy related to side effects were nausea & vomiting(p< .05). Site of chemotherapy related to side effects were redness(p< .05). Frequency of venipuncture related to side effects were redness(p< .05). Conclusively, cancer chemotherapy patients have had some venous problem. They need appropriate venous access devices for chemotherapy. And other non-venous problem will be managed appropriately. Further research was required to identify the rate of venous complication or side effects of vesicant chemotherapy.

• 대한간호학회지
• /
• 제27권1호
• /
• pp.178-188
• /
• 1997

As a descriptive survey, this study was attempted to get basic data necessary to recognize the factors that disturb the therapeutic atmosphere of hospital wards as perceived by nurses and hospitalized patients, to identify differences between the perceptions of the nurses and of patients. The subjects, 159 patients in Pusan National Hospital and 68 nurses working there were sampled between March 18 and April 13, 1996. The tool used to measure the disturbing factors was an amended form of the one developed by Kim, Mae Ja(1983). The differences between each subject's score for each factor were analyzed using means & SD. and the highest 3 items above the mean score for each factor were collected and compared. The results are described below : 1. Subject's perception of main disturbing factors : patients reported that the main factors were 'loss of role & economic trouble', 'the prognosis of disease', 'the change of daily life' but nurses replied that the main factors were' the prognosis of disease', 'the communication trouble with the medical team & interpersonal relationships'. 'The change of daily life' was not a perceved factor by nurses, but ranked third by the patients. 2. Subject's perception degree of each disturbing factor : (1) among the items related to interpersonal relationship. the patient group reported that the worst disturbance was dur to severely ill patients in the same room' but the nurse group regarded 'greed to monopolize wheelchairs or other supplies' as the worst disturbance. (2) among the items related to physical factors. the patient group regarded 'limitations to wash their body, physical pain and limitations in physical activity' as the worst disturbance, but the nurse group regarded' physical pain', and 'limitations to activity or change of appearance' as the worst disturbance. (3) among the items related to the change of daily activity, the patient group regarded 'the boredom of hospitalization or infavorable diet' as the worst disturbance, but the nurse group regarded 'too much noise or unclean room' as the worst disturbance. (4) among the items related to the communication trouble with medical team, the patient group regarded 'the ignorance of their disease due to poor information. the inability to understand the language of the medical team or the difficulty in seeing physician in time' as the worst disturbance, but the nurse group regarded 'the inability to trust physicians and physician's poor attention to patients' as the worst disturbance.

• 대한간호
• /
• 제32권1호
• /
• pp.61-76
• /
• 1993

This study was done in order La provide basic data to a Fee System for hospital based Home Health Care services in Korea in the future. It was done by investigating activities provided to possible Home Health Care clients who could be discharged early from genera] hospitals and then estimating the nursing care fee according to each nursing activity based upon the time used for activity. The subjects of the study were selected by convenience sampling and consisted of 35 clients who might be clients for Home Nursing Care and were presently admitted to a medical- surgical ward of Y University Medical Center located in Seoul, Korea. The data collection period was from September 1, 1991 to September 30, 1991. The research in strum nets utilized for the study were a client selection criterial for Home Health Care developed by Choo(l991) and a check-list of nursing activity developed by researcher. The results of the study were as follows : 1. There were 44 different nursing activities provided in the seven days but the time was calculated for only 25 of the nursing activities. 2. Fees for the 25 different nursing activities were calculated by multipling the median of the average wage of a staff nurse having five years experience in an A grade general hospital to the Lime of the nursing activity. The results were compared with the insurance fee which the government recognized as an appropriate fee for that activity. The nursing activities with a lower calculated fee than the insurance fee were suction, catheterization, exercise education and dressing change. The nursing activities with a higher calculated fee than the government recognized fee were 1M injection and vital sign check. 3. There was a range of 1-15 nursing activities provided daily to the client. For the average number of nursing activities per day of 6.26 events the nursing care fee was calaulated at W 6136 per day. 4. Based upon the results of the study, a recommentdation for a Home Health Care fee per visit based on the nursing activities provided could be formulated for a Home Health Care fee system. It could be formulated as following: 1) Home health Care fee per visit $=[(direct{\;} nursing{\;}fee(direct{\;}nursing{\;}care{\;}time{\;}per{\;}activity{\;}{\times}{\;}average{\;}nursing{\;}wage)+indirect fee]{\times}average$ nursing activity per visit]+management fee+ materials fee+a travel fee In this way a nursing fee could be calculated based upon the result of the study of the nursing fees per visit. 2) Nursing activity fees per visit. = $([direct nursing{\;}care{\;}fee+indirect{\;}nursing{\;}fee]{\times}average$ number of nursing activities provided per visit] (W 6, 136) + travel fee(\ 5, 542) +management fee material $fee({\alpha})\{\;}16, 436+{\alpha}$ The nursing fee per visit as calculated in this research of $\{\;}15, 0000+{\alpha}$ could be adjusted according to the patient's condition or the use of high technology nursing care or according to the amount of time spent for travel. The nursing care fee per visit presented in this study can be validated through a Home Health Care demonstration project.

• Journal of Hospice and Palliative Care
• /
• 제16권4호
• /
• pp.242-252
• /
• 2013

목적: 본 연구는 의료인의 호스피스 완화의료에 대한 인식 및 지식과 죽음에 대한 태도 정도를 파악하고자 하는 것이다. 방법: 대상자는 B광역시 소재하는 의사 84명, 간호사 172명으로 총 256명을 대상으로 실시하였고, 자료수집기간은 2012년 4월 5일부터 동년 4월 30말까지 실시되었다. 결과: 호스피스 완화의료에 대한 목적에 대한 인식에서는 의사와 간호사 모두 '호스피스가 질병으로 더해오는 통증을 완화시켜주고 편안을 도모한다'는 항목에 가장 높게 인식하고 있는 것으로 나타났고, 호스피스 완화의료에 대한 필요성에 대한 인식에서는 의사와 간호사 모두 '말기 환자는 감정의 변화를 많이 겪는다' 라는 항목이 가장 높게 나타났다. 호스피스 완화의료에 대한 지식은 두 군 다 낮게 나타났고, 하위영역에서는 '통증과 증상관리'에서 두 집단 간 차이가 있었으며, 의사가 간호사보다 지식이 더 높은 것으로 나타났다(의사: $6.97{\pm}1.82$, 간호사: $5.68{\pm}1.93$, P<0.001). 죽음에 대한 태도는 두 집단 간에 통계적으로 유의한 차이는 없었다. 결론: 본 연구의 결과를 통해서 의료인의 호스피스 완화의료의 인식 및 지식의 향상과 죽음에 대한 자신의 태도를 정립할 수 있도록 돕는 교육프로그램의 개발이 마련될 것을 제안한다.

• 한국병원경영학회지
• /
• 제21권2호
• /
• pp.13-23
• /
• 2016

Purpose: The purpose of this study is to compare the user satisfaction between 4-bedrooms and 5/6-bedrooms in a single general hospital. Methodology: To measure and compare multiple-bed ward user satisfaction between 4-bedrooms and 5/6-bedrooms, questionnaires were collected from 916 inpatients and 129 nurses in a single general hospital. The patient satisfaction questionnaire categories included environmental conditions, protection of privacy, and medical services. The nurse satisfaction questionnaire categories included space, infection control, patient safety, work load and psychologic view point. Findings: Satisfaction of patient who admitted in 4-bedroom to the environmental conditions and protection of privacy was higher than that of 5/6-bedroom group (3.91 vs. 3.25, p<0.001). Satisfaction of nurse who worked in 4-bedroom was higher than that of 5/6-bedroom (3.05 vs. 1.92, p<0.001). By the multiple linear regression analysis, patient satisfaction to the environmental conditions and protection of privacy was related with multi-bedroom type and location of beds; 4-bedrooms were higher than 5/6-bedrooms(p<0.001), window side bed were higher than hallway side bed(p=0.001). There was no satisfaction difference in comparing medical services between the two groups. By the multiple linear mixed regression analysis, nurse satisfaction who were assigned for 4-bedrooms were higher than that of 5/6-bedrooms in all categories(p<0.001). Practical Implications: Even though no difference has shown in medical services satisfaction between the two patient groups, multi-bedroom type may affect patient satisfaction in environmental condition, protection of privacy and may also affect overall nurse satisfaction. This result suggests that to improve multi-bedroom user satisfaction, 4-bedroom is recommended over 5/6-bedroom.

• Journal of Microbiology and Biotechnology
• /
• 제8권5호
• /
• pp.523-530
• /
• 1998

Rapid and quantitative analysis of physiological change and clavulanic acid production was studied by the combination of pyrolysis mass spectrometry (PyMS) and artificial neural network (ANN) in Streptomyces clavuligerus. Firstly, the continuous culture studies were carried out to get the physiological background and PyMS samples. Clavulanic acid production was inversely related to growth rate: Mycelium growth and $q_{cal}$ were optimum at 0.1 $h^{-1}\; and \;0.025 h^{-1}$ respectively. Changes in specific nutrient uptake rates ($q_{gly}$ and $q_{amn}$) also affected clavulanic acid production since clavulanic acid production appeared to be stimulated by the limitation of carbon and nitrogen. Fermentation broth containing mycelium taken from continuous cultures was analyzed by PyMS, and the PyMS spectra were analyzed with multivariate statistics. PCCV plots revealed that samples harvested under the same culture condition were clustered together but samples from different culture conditions formed separate clusters. To deconvolute the pyrolysis mass spectra so as to obtain quantitative information on the concentration of clavulanic acid, ANN was trained on Py MS data using a radial basis function classifier. The results showed that the physiological stages with different growth rate were successfully differentiated and it was possible to monitor the clavulanic acid production precisely and rapidly.

• 근관절건강학회지
• /
• 제19권1호
• /
• pp.46-56
• /
• 2012

Purpose: This study was to evaluate the effects of rehabilitation training using video game on improvement range of motion for upper -extremity, shoulder pain and stress in stroke patients with hemiplegia. Methods: The study utilized nonequivalent control group non-synchronized design. Participants are sampled from a group of people who are hospitalized in rehabilitation medicine ward at 'K' university hospital in 'S' city from January 1st 2011 to October 31th. Each 28members of control group and experimental group, total 56members were participated. One task is for 10minutes, and the video game for total 30minutes performed 5 times a week, for 3weeks. Data were analyzed by SPSS WIN 17.0. Results: The range of motion for upper-extremity in experimental group was significantly different from that in control group(shoulder flexion t=7.70, $p$ <.001, extension t=7.80, p<.001, abduction t=6.95, $p$ <.001, elbow flexion t=6.47, $p$ <.001). The shoulder pain score in experimental group was significantly different from that in control group(t=-14.58, $p$ <.001). The level of stress in experimental group was significantly different from that in control group(t=-4.89, $p$ <.001). Conclusion: The result proved that rehabilitation training using video game was an effective stroke patients to increase in range of motion for upper-extremity and decrease in the shoulder pain, stress.

• 임상간호연구
• /
• 제23권3호
• /
• pp.350-360
• /
• 2017

Purpose: The purpose of this study was to investigate the present status of falls among inpatients in general hospitals and to identify the fall risk factors that reflect the characteristics of domestic hospitals. Methods: Data were collected between December 15, 2016 and January 15, 2017 from 32 Korean hospitals having 500 or more beds. First, 42 risk factors were extracted based on literature review and expert opinions. Then the importance of each factor was evaluated by 223 nurses from medical and surgical adult ward and intensive care units in 40 hospitals. Results: The incidence rate of falls in 18 hospitals was 3.87 per 1,000 total discharged patients and 0.55 per 1,000 patient-days, and the rate of injury-related falls was 40.5%. Major risk factors for falling were identified as the following: being over 65 years of age, history of falls during admission, physical mobility disorders requiring assistance, physical factors (dizziness or vertigo, unstable gait, general weakness, walking aids, visual problems), cognitive factors (delirium, lack of understanding on limitations), neurological disease, CNS medications Conclusion: The findings provide information that can be in the development of a fall risk assessment tool for inpatients in general hospitals in Korea.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제15권1호
• /
• pp.31-34
• /
• 2015

Vascular injury caused by a central venous catheter (CVC) has been reported to be a rare complication, especially delayed vascular injury due to CVC has a few cases and it can be fatal because of delayed recognition and more serious complications. A 59-year-old woman with no available medical history was admitted for treatment of ovarian cancer. For the surgery, a triple-lumen CVC was placed through the left subclavian vein. Parenteral nutrition through the CVC was used for postoperative nutritional management in the first postoperative day. On the sixth postoperative day (POD), the patient suddenly complained of dyspnea. The CT revealed bilateral pleural effusion and irregular soft tissue density and air bubble in anterior mediastinum suggesting migration of the distal portion of the CVC into the anterior mediastium. In the intensive care unit (ICU) bilateral thoracentesis and percutaneous drainage were performed. She was discharged from the ICU in 3 days later and transferred to the general ward. This case emphasizes the possibility of the delayed vascular injury related to CVC and some strategies for prevention of vascular injury.

• 정신신체의학
• /
• 제16권1호
• /
• pp.17-24
• /
• 2008

소아청소년에서의 정신신체의학은 자문조정 정신의학이라고도 불리며 신체적 질환이 있는 소아청소년에서의 정신건강 서비스를 제공하는 것으로, 정신과에서는 정신사회학적 질병모델에 익숙한 반면 타과 의료진의 경우 생의학적 질병모델에 입각하여 접근하기 때문에 원활한 의사소통을 통한 타과 의료진과의 협업 체계 구축이 중요하다. 신체질환이 있는 소아청소년의 정신과적 문제에 대해서는 개별 질환에 초점을 맞추고 의학적 심리적 정신과적 인자들의 상호작용과 그 영향을 밝히는 범주적 접근법과 질병에 걸렸다는 사실로 인하여 스트레스를 경험하는 아동 자체에 대한 접근에 주안점을 두는 비범주적 접근법으로 나눌 수 있다. 이러한 신체질환이 있는 소아청소년의 치료에 그들의 발달단계에 맞는 고유한 치료기법의 적용이 필요하다. 비약물학적인 치료의 경우 경험적으로 입증된 치료(empirically supportive therapy)들을 구분하려는 시도도 이루어지고 있다.