• Title/Summary/Keyword: Non-emergency

Search Result 632, Processing Time 0.024 seconds

Physical and Psychological Factors Affecting Fall in Elderly Patients with Parkinson's disease (파킨슨병 노인의 낙상에 영향을 미치는 신체적, 심리적 요인)

  • Kim, Ji-Yoen;Byun, Mi-Kyong
    • Journal of Convergence for Information Technology
    • /
    • v.12 no.3
    • /
    • pp.55-65
    • /
    • 2022
  • Elderly people with Parkinson's disease have higher rates of physical and mental risk factors for falls than non-Parkinson's disease elderly. The purpose of this study is to investigate this by using national data that includes the entire population of the elderly in Korea. As a secondary analysis study using data survey on the elderly by the Ministry of Health and Welfare in 2017, there were a total of 103 elderly people with Parkinson's disease, and a total of 96 subjects were analyzed excluding missing values. In the elderly with Parkinson's disease, the factor most influencing the fall was IADL, and IADL is related to motor control function. Decreased motor control limits physical movements essential for daily life, and even affects self-protective behavior in emergency situations, affecting falls. Based on the research results that IADL can affect falls, various exercise therapies for fall prevention interventions in the elderly with Parkinson's disease can be suggested.

The Effects of a Shift Improvement Pilot Project on Nurses' Shift Adjustment, Work-Life Balance, and Turnover Intention: A Mixed-Methods Study (교대제 개선 시범사업이 간호사의 교대근무 적응, 일과 삶의 균형 및 이직의도에 미치는 효과: 혼합연구방법)

  • Choi, Su Jung;Kim, Mi Soon;Jeon, Mi-Kyeong;Choi, Jin Ju;Son, Sook Yeon;Kim, Eun Hye
    • Journal of Korean Clinical Nursing Research
    • /
    • v.29 no.3
    • /
    • pp.223-237
    • /
    • 2023
  • Purpose: This study aimed to investigate the impact of a nurse shift improvement pilot project on nurses' shift adjustment, work-life balance, and turnover intention, as well as nurses' experiences of participating in the pilot project. Methods: An explanatory sequential mixed-methods study was performed. Survey data was collected from a total of 1,051 nurses both in participant and non-participant groups. For the qualitative study, focus group interviews were conducted with 22 nurses who participated in the shift improvement pilot, including 12 staff nurses, 7 nurse managers, and 3 substitute nurses. Results: There were significant positive effects on the key variables of nurses' shift adjustment, work-life balance, and turnover intention in the group that participated in the nurse shift improvement pilot project. Based on the qualitative study, participants in the shift improvement pilot project indicated that it enabled nurses to recover their circadian rhythm, and achieve a better work-life balance, and they wanted to continue working as a nurse, and hoped expanded application of the pilot project. Conclusion: In order for expanded implementation of the pilot project and continued improvement in the shift system, we recommend establishing compensation standard, systematizing the use of substitute nurses, developing guidelines for shift schedules, and expanding the shift improvement pilot project to other departments such as the emergency room.

Effects of a virtual reality simulation integrated with problem-based learning on nursing students' critical thinking ability, problem solving ability, and self-efficacy: a non-randomized trial (문제중심학습 기반 가상현실 시뮬레이션 교육이 간호대학생의 비판적 사고능력, 문제해결능력 및 자기효능감에 미치는 효과: 유사실험 연구)

  • Young A Song;Minkyeong Kim
    • Women's Health Nursing
    • /
    • v.29 no.3
    • /
    • pp.229-238
    • /
    • 2023
  • Purpose: This study analyzed the effects of virtual reality simulation-based problem-based learning on nursing students' critical thinking ability, problem-solving ability, and self-efficacy in the nursing care of women undergoing induction of labor. Methods: A nonequivalent control group pretest and posttest design was employed. The study participants included 52 nursing students (24 in the experimental group and 28 in the control group). The experimental group took a problem-based learning (PBL) class in the first week, and then engaged in self-directed learning using virtual reality simulation. In the second week, lectures about emergency nursing care for induction of labor and drug administration were given. The control group participated in PBL in the first week and lectures in the second week. The study was conducted from April 17 to May 19, 2023. Data were analyzed using the chi-square test, Fisher exact test, analysis of variance, and the independent t-test. Results: Before-and-after differences between the two groups were statistically significant in problem solving ability (t=-5.47, p<.001) and self-efficacy (t=-5.87, p<.001). Critical thinking ability did not show a statistically significant difference between the two groups. The score for satisfaction with the virtual reality simulation program was 3.64±5.88 out of 5 in the experimental group. Conclusion: PBL education using a virtual reality simulation was found to be an effective way of teaching. Although convenience sampling was used, PBL education using virtual reality can be used as an educational strategy to enhance nursing students' problem-solving ability and self-efficacy.

Concurrent Torsion of the Caudate Liver Lobe and Spleen in a German Shepherd Dog

  • Seong-won An;Seung-Min Hwang;Il-Gwon Jung;Sang-Kwon Lee;Young-Sam Kwon
    • Journal of Veterinary Clinics
    • /
    • v.41 no.1
    • /
    • pp.30-36
    • /
    • 2024
  • A 3-year-old, 20.6 kg, neutered male German Shepherd dog was referred to Kyungpook National University Veterinary Medicine Teaching Hospital. Clinical examination revealed chronic diarrhea for 6 weeks and a non-tender, distended abdomen without lethargy, anorexia, and vomiting. Diarrhea was watery and had a waxing and waning course despite symptomatic treatment. A complete blood count identified mild leukocytosis and mild anemia. Serum biochemistry analysis showed elevated alanine aminotransferase and aspartate aminotransferase levels, and mild hypoalbuminemia. Abdominal ultrasound examination revealed mixed echogenicity with absent blood flow at the caudate process of the caudate liver lobe and a small amount of ascites. Computed tomography revealed torsion of the caudate process of the caudate liver lobe and spleen and gas dilatation of the intestine. After establishing a diagnosis of organ torsion on imaging, we deemed the condition an emergency and immediately performed surgery. Given that laparotomy confirmed organ torsion, liver lobectomy, total splenectomy, and prophylactic gastropexy were conducted. The patient was discharged 11 days after surgery without complications. In general, liver lobe torsion and splenic torsion are uncommon in dogs and present with nonspecific clinical signs, such as abdominal pain, lethargy, anorexia, and vomiting. In the current case, torsion of the caudate liver lobe and spleen occurred without other clinical signs except for a distended abdomen. Moreover, no reports in dogs have demonstrated the simultaneous occurrence of both diseases.

Evaluation of Zone 2 Thoracic Endovascular Aortic Repair Performed with and without Prophylactic Embolization of the Left Subclavian Artery in Patients with Traumatic Aortic Injury

  • Miju Bae;Chang Ho Jeon;Hoon Kwon;Jin Hyeok Kim;Seon Uoo Choi;Seunghwan Song
    • Korean Journal of Radiology
    • /
    • v.22 no.4
    • /
    • pp.577-583
    • /
    • 2021
  • Objective: To report the authors' experience in performing thoracic endovascular aortic repair (TEVAR) for zone 2 lesions after traumatic aortic injury (TAI). Materials and Methods: This retrospective review included 10 patients who underwent zone 2 TEVAR after identification of aortic isthmus injury by CT angiography (CTA) upon arrival at the emergency room of a regional trauma center from 2016 to 2019. Patients were classified into two groups: those who underwent left subclavian artery (LSA) embolization concurrently with the main TEVAR procedure, and those in whom LSA embolization was not performed during the main procedure, but was planned as a bailout treatment if type II endoleak was noted on follow-up CTA images. Pre-procedural and procedure-related factors and post-procedure prognosis were compared between the groups. Results: There were no differences in pre-procedural factors, occurrence of endoleaks, and post-procedure prognosis (including mortality) between patients in the two groups. The duration of the procedure was shorter in the non-LSA embolization group (61 minutes vs. 27 minutes, p = 0.012). During follow-up, type II endoleak did not occur in either group. Conclusion: Delaying preventative LSA embolization until stabilization of the patient would be desirable when performing zone 2 TEVAR for TAI, in the absence of endoleak on the completion aortography image taken after complete deployment of the stent graft.

Lower Serum Cholesterol Level is Associated with More Serious Injury in Psychiatric Patients with Suicide Attempt (자살을 시도한 정신과 환자에서 낮은 혈청 콜레스테롤 농도와 심각한 자살 수행과의 연관성)

  • Kim, Yong Ku;Lee, Heon Jeong;Kim, Ji Yeon;Choi, So Hyun;Lee, Min Soo
    • Korean Journal of Biological Psychiatry
    • /
    • v.6 no.2
    • /
    • pp.227-234
    • /
    • 1999
  • An association of low total cholesterol in blood with psychiatric diseases and suicidal behavior has been suggested. As part of an attempt to further explore this relationship, we examine first, whether serum cholesterol levels in psychiatric patients with suicidal attempt would be lower than in non-suicidal psychiatric inpatients or normal controls, second, whether such significant difference of cholesterol levels would be present when the diagnostic groups are analyzed separately, third, whether low cholesterol level would be associated with a history of serious suicidal attempts, and finally, whether low cholesterol level in suicide attempters is a state or a trait marker. We determined the serum cholesterol levels in 231 patients admitted to an emergency room following an suicidal attempt, in the same numbers of age-, sex- and diagnosis- matched non-suicidal psychiatric controls, and in the same numbers of age-, sex matched normal controls. The seriousness of an attempt was divided into 5 grades according to the degree of the resulting medical injury. Total cholesterol levels in suicide attempters were significantly lower compared with both psychiatric and normal controls, when sex, age, and nutritional status (i.e., body mass index) were controlled for. This significant relationship was observed in major depressive disorders and personality disorders, but not in schizophrenia and bipolar type I disorders. The severity of suicide by a lowering of blood cholesterol was related to the magnitude of the cholesterol reduction. After treatment of their psychiatric ailments, the cholesterol levels in suicide attempters were significantly increased. This result suggests that low cholesterol level in psychiatric patients might be a potential biological marker of suicide risk. It is hypothesized that low cholesterol levels is associated with the suicide by modifying the serotonin metabolism, the production of interleukin-2 and melatonin metabolism in psychiatric patients.

  • PDF

Decreased Concentration of Plasma Brain-Derived Neurotrophic Factor in Suicide Attempters (자살 시도자에서 혈장 Brain-Derived Neurotrophic Factor 농도 저하)

  • Won, Seong-Doo;Shim, Se-Hoon;Yang, Jong-Chul;Lee, Heon-Jeong;Lee, Bun-Hee;Han, Chang-Su;Kim, Kye-Hyun;Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
    • /
    • v.12 no.2
    • /
    • pp.189-195
    • /
    • 2005
  • Objects:Some studies have suggested that brain-derived neurotrophic factor(BDNF), one of the most important neurotrophins, is involved in pathophysiology of depression and suicide. This study was performed to determine whether there is an abnormality in plasma BDNF concentration in suicidal attempters. Methods:The subjects were 71 suicidal attempters who visited emergency rooms in multi-medical centers. All subjects had been interviewed by using Structured Clinical Interview for DSM-IV(SCID), Hamilton Depression Rating Scale(HDRS), Young Mania Rating Scale(YMRS), and Positive And Negative Syndrome Scale(PANSS). The severity of the suicidal behavior was measured by Lethality of Suicide Attempt Rating Scale(LSARS) and Risk-Rescue Rating(RRR) system. Seventy-one age, sex, and diagnosis matched non-suicidal psychiatric patients who were consecutively admitted to a psychiatric ward during the same period recruited as psychiatric controls. They were drug-naive or drug-free at least more than 2 months. In addition, 80 healthy controls were randomly selected as normal controls. Plasma BDNF level was measured by the enzyme linked immunosorbent assay(ELISA) methods. Results:In overall F-test, differences of the plasma BDNF levels among the groups were statistically significant(F=20.226, p<0.001). In the multiple comparisons(Scheffe), while mean levels of plasma BDNF between normal controls and non-suicidal psychiatric patients were similar(p=0.984), the BDNF levels of suicidal attempters were lower than those of other two groups(p<0.001). LSARS and RRR did not reveal any significant correlations with BDNF levels in suicidal attempters. Conclusion:These results suggest that reduction of plasma BDNF level is related to suicidal behavior and BDNF level may be a biological marker of suicidal behavior.

  • PDF

The Effects of Semi-Fowler's position on Post-Operative Recovery and Pain for Patients with Laparoscopic Abdominal Surgery (복강경 수술 후 반좌위가 수술회복성과 통증에 미치는 영향)

  • Choi, Un Jong;Ha, Tae Uk;Kang, Ji Sook
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.18 no.5
    • /
    • pp.412-419
    • /
    • 2017
  • Purpose:This study was conducted to identify the effects of theSemi-Fowler's position on post-operative recovery and pain for patients with laparoscopic abdominal surgery Methods: This study utilized a non-equivalent control group non-synchronized design to validate the effects of theSemi-Fowler's position. After IRB approval, 56 patients took part in this study, 29 in the experimental group and 27 in the control group. Consent was obtained from the participants. The Semi-Folwer's position was applied to experimental group and the supine position was applied to the control group for 24 hours after surgery. All data were reviewed retrospectively from April to June 2016. Collected data, frequency, percentage, average, standard deviation, chi-squared test, independent t-test and repeated measures ANOVA were conducted using SPSS 20.0. Results: There was no significant difference between the experimental and control group with regard to recovery outcomes; however, there was a significance differencebetween groups and among check times with regard to post operational pain. Conclusion:The results of this study provide information that will be usefulto the development of strategies for improving recovery outcomes and pain for laparoscopic operation patients.

Analysis of Medical Expenses Structure for Patients on Percutaneous Coronary Intervention by Medical Security Type (의료보장형태에 따른 관상동맥중재술 환자의 진료비 구조분석)

  • Son, Mi-Kyung;Lee, Sok-Goo
    • Journal of agricultural medicine and community health
    • /
    • v.44 no.4
    • /
    • pp.195-208
    • /
    • 2019
  • Objectives: The purpose of this study was to analyze whether there are differences in medical expenses according to medical security type in the use of medical services with high disease burden such as coronary intervention. Methods: Chi-square test and covariance analysis(ANCOVA) were conducted to identify the differences in the characteristics and costs according to medical security type of 1,904 patients who underwent coronary intervention in a university hospital from 2011 to 2012. Hierarchical regression analysis was conducted to determine whether the cost affects medical expenses. Results: In the medical aid group, the proportion of women, those without a job, those without a spouse, and those who received hemodialysis was high, length of stay was high, patients using the emergency room and those who died was high. The medical aid patients were significantly higher in the non-benefit medical expenses, optional medical expenses, physician and admission, meals, medications and injections. National health insurance patients were significantly higher in procedure. The medical security type was found to be significant as a variable affecting the medical expenses. Conclusions: Provision of medical expenses should be managed in advance by providing prevention and education services for the vulnerable, and care services in the region should be provided to suppress the occurrence of medical expenses due to the increase in the number of days spent. In addition, it is necessary to support medical expenses to prevent unsatisfactory medical services from occurring for non-benefit and optional care.

DENTAL TREATMENT OF THE PATIENT WITH AUTISM AND HEMOPHILIA A UNDER GENERAL ANESTHESIA A CASE REPORT (자폐증상이 있는 혈우병 A 환아의 전신 마취를 통한 치과적 치험례)

  • Park, Kyeong-Sun;Lee, Keung-Ho
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.23 no.3
    • /
    • pp.593-600
    • /
    • 1996
  • This case report is a treatment of patient with hemophilia A and autism. The patient's chief complaint was treatment of dental caries on entire dentition and he has an impacted mesiodens located on the apex of the upper right primary central incisor. The patient was consulted with pediatrician and anesthetist about the detailed discussion of the complexities of hemorrhagic disorder. Because he had some problems of behavior management and bleeding, the treatment was done under the gerneral anesthesia. The following results were obtained. 1. Consult with the patient's physician and hematologist about the replacement therapy and bleeding tendency. 2. For the severe hemophiliac child who requires extensive or surgical treatment, general anesthesia may be indicated for the comprehensive care. 3. For the hemophiliac child who has a behavior management problem due to autism and other defects, general anesthesia may be considerable. 4. Care must be taken during dental procedures not to causing a bleeding. 5. Local hemostatic methods must be acquired for the emergency state. 6. Neve prescribe aspirin or non-steroidal anti-inflammatory drugs such as ibuprofen, indomethacin, and phenylbutazone. These drugs affect platelet aggregation and exaggerate the bleeding defect. 7. Do not be afraid of hemophiliac patient, and never compromise quality of dental care.

  • PDF