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Actual Physical Symptom and Stress in Caregivers of Patients with Cerebrovascular Disease (뇌혈관질환 환자를 돌보는 가족원의 신체증상과 스트레스)

  • 김희승;박현애;오미정
    • Journal of Korean Academy of Nursing
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    • v.28 no.3
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    • pp.695-704
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    • 1998
  • This study aims for examines the actual physical symptom and stress in caregivers of patients with cerebrovascular disease. The data were collected by a survey conducted from August to September, 1997 which included 65 caregivers of cerebrovascular disease patients in 4 hospitals located in Seoul. The caregiver's stress was measured by Choi (1992)'s instrument and the actual physical symptoms were investigated. The data were analyzed using ANOVA, Scheffe test, Pearson correlation coefficient and stepwise multiple regression. The results were as follows : 1. The mean number of caregiver's physical symptom was 3.5. There were significantly higher number of physical symptom in women, those of who have a religious affiliation, those of who perceive their own health status perceived as bad, and those of who perceived their patients disease condition as serious than in their counterparts. Also, the number of caregiver's physical symptom was significantly higher in caregivers whose patients have a paralysis sypmtom and the disease onset as accident than in caregivers whose patients have no paralysis symptom and the disease onset as spontaneous. 2. The average of caregiver's stress was 57.9. The caregiver's stress was the highest in between the ages of 50 and 59. There were also significantly higher level of stress in women, those of who perceived the disease condition of their patients as serious than in their counterparts. 3. The most common caregiver's physical symptom was fatigue(87.7%). This was followed by insomnia(58.5%) and muscle pain(47.7%). 4. Caregiver's physical sypmtom was positively correlated with caregiver's stress and negatively correlated with patient's activity of daily life. 5. The most important vairable affecting the caregiver's physical symtom was patient's activity of daily life which accounted for 12.7% of the total variance in stepwise multiple regression analysis. The most important vairable affecting the caregiver's stress was the patient disease condition perceived by the caregiver that accounted for 12.1% of the total variance.

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In Vitro Fertilization in Infertile Patients with Previous History of Pelvic Tuberculosis (골반결핵 기왕력이 있는 불임환자의 체외수정시술에 관한 연구)

  • Kim, Seok-Hyun;Chang, Yoon-Seok
    • Clinical and Experimental Reproductive Medicine
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    • v.16 no.1
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    • pp.81-91
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    • 1989
  • It has been suggested that the prognosis for fertility of the infertile patients with healed pelvic tuberculosis is very poor. Total 60 patients(77 cycles) with previous history of pelvic tuberculosis who underwent IVF-ET from January 1988 to March 1989 at SNUH were classified into three groups according to the principal histopathological lesions : tuberculous endometritis group(N=20, 28 cycles), tuberculous salpingitis group(N=32, 37 cycles) and pelvic peritoneal tuberculosis group(N=8, 12 cycles). To evaluate the effects of previous pelvic tuberculous lesions on ovarian follicular growth and development in controlled ovarian hyperstimulation for IVF-ET and its final outcome, serum E2 levels on the day of hCG administration(Day 0) and the day after hCG administration(Day +1), the number of ovarian follicles with mean diamete ${\geqq}$ 12 mm on Day 0, the number of oocytes retrieved by transvaginal aspiration, and pregnancy rate per cycle were measured and compared with control group(N=123, 161 cycles). There were no significant differences in cancellation rate during controlled ovarian hyperstimulation, total dosage of FSH and hMG administrated, menstrual cycle date(MCD) of hCG injection, serum E2 levels, the number of ovarian follicles with mean diameter ${\geqq}$ 15 mm, and the number of oocytes retrieved between pelvic tuberculosis group and control group. But in pelvic tuberculosis group, the number of ovarian follicles with mean diameter 12-14 mm, total number of ovarian follicles(${\geqq}$ 12 mm), and pregnancy rate per cycle were significantly decreased. These data suggest that previous pelvic tuberculous lesions have no significant adverse effects on the ovarian response to gonadotropin stimulation. IVF-ET proved to be an useful treatment modality for infertile patients with previous history of pelvic tuberculosis in spite of its relatively lowered pregnancy rate.

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The Effectiveness on Prevention of Rehospitalization with Long-Term Psychosocial Interventions for Patients with Major Psychiatric Disorders (주요정신질환 환자에 대한 장기 정신사회적 중재의 재입원 예방에 대한 효과)

  • Jeong, Jae Hoon;Kang, Min Jeong;Kwon, Min Young;Lee, Sang Min;Lee, Kyu Young
    • Korean Journal of Schizophrenia Research
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    • v.22 no.2
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    • pp.66-73
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    • 2019
  • Objectives: This study aimed to elucidate the effectiveness of long-term psychosocial intervention in reducing the disabling period of patients with major psychiatric disorders by their rehospitalization rate. Methods: Of the 210 patients with major psychiatric disorders received psychosocial interventions in a Mental Health and Welfare Center, 192 patients (147 with schizophrenia spectrum disorders, 45 with mood disorders) who received interventions more than 6 months were selected. Review of case management records was conducted to obtain information. Results: The number and length of hospitalization and the hospital days per year significantly decreased after psychosocial intervention. Additional analysis of 102 patients followed up for more than 5 years suggested that the effectiveness of the intervention persisted for a sufficient period. However, no significant difference was observed in the number of rehospitalization in 45 patients with mood disorders, though the length of hospitalization significantly decreased. In addition, the hospital days per year of 21 patients with mood disorder followed up for more than 5 years also showed no significant decrease. Conclusion: Long-term psychosocial intervention had a significant effect on reducing the number and length of hospitalization for patients with major psychiatric disorder and the effectiveness maintained for more than 5 years.

Analysis of Hospital-based Home Care Service Utilization Using National Health Insurance Claim Data from 2008 to 2017 (건강보험 자료를 이용한 전국 의료기관 가정간호 실시 및 이용 현황 분석: 2008년-2017년)

  • Ko, Jeong Yeon;Yoon, Ju Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.26 no.1
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    • pp.36-50
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    • 2019
  • Purpose: The purpose of this study is to analyze the status quo of hospital-based home care utilization in Korea from 2008 to 2017. Methods: Data from a total of 1,396 medical institutions, 350,390 patients, and 3,563 home care nurses were analyzed using claim data from the Health Insurance Review & Assessment Service. Results: The number of hospital-based home care agencies decreased from 177 in 2008 to 115 in 2014. This number started to increase in 2015 and reached 179 in 2017. The number of hospital-based home care patients declined from 35,056 in 2008 to a low of 26,848 in 2013. This number started to increase in 2014 and reached 67,863 in 2017. Essential hypertension was the most common disease among hospital-based home care patients from 2008 to 2015. The number of hospital-based home care visits declined from about 500,000 in 2008 to a low of 362,000 in 2013. This number started to increase in 2014 and reached 658,000 in 2017. Conclusion: It is necessary to vigilantly monitor hospital-based home care agencies, patients, and the utilization of services. This may help establish platforms for providing community and home-based nursing services for the super-aged society in Korea.

Symptom Distress and Spiritual Well-Being in Patients with Cancer according to Illness and Treatment (암 환자의 질병.치료관련 요인에 따른 불편감과 영적안녕에 관한 연구)

  • Bae, Su-Hyun;Park, Jeong-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.4
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    • pp.457-465
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    • 2007
  • Purpose: This study was done to analyze symptom distress and spiritual well-being in patients with cancer according cancer diagnosis, metastasis, treatment stage, number of hospitalizations and treatment modality. Method: The participants, 285 patients being treated in one of ten general hospitals either as in- or out-patients, completed the McCorkle and Young(1978) Symptom Distress Scale translated and adapted by Uhm(1986) and the Spiritual Well-Being Scale by Paloutzian and Ellison(1982) translated by Choi(1990). Data collection was done from June 19 to September 30, 2006. Results: For symptom distress, there were significant differences for cancer diagnosis(p=.018), metastasis(p=.000), treatment stage(p=.000), number of hospitalizations(p=.000), and treatment modality(p=.002). For spiritual well-being, the only significant difference was for cancer diagnosis(p=.002). Patients with ovarian/uterine cancer had the lowest spiritual well-being. Conclusion: For patients with cancer, symptom distress was significantly different for illness and treatment factors, in particular, stage of illness, while for spiritual well-being, patients with uterine ovarian cancer had the lowest spiritual level. These results indicate a need to develop nursing interventions to decrease symptom distress in patients according to treatment stage and to promote spiritual well-being, particularly in women with ovarian/uterine cancer.

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The Clinical Analysis of 104 Sanhupung Patients that visited at an Oriental Medicine Hospital. (일개 한의대 부속 한방병원에 산후풍으로 내원한 환자 104례에 대한 실태 분석)

  • Jang, Se-Ran;Park, Young-Sun;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.3
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    • pp.192-204
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    • 2010
  • Purpose: Sanhupung's pathological conditions is different from non-postpartum's disease. So it is important to analyze Sanhupung's construction, onset factors and Oriental theraphy. Methods: We studied 104 Sanhupung women visiting $\bigcirc\bigcirc$ hospital form January 2008 to December 2009. We analyzed the general characteristics, kinds of symptoms and Oriental theraphy's present condition. Also We compared patients' age, the number of live births and delivery month to the National Statistical Office's results. Results: 1. Patients over the age of 30, who have one child and who gave birth in September(14.42%) and in Summer(43.26%) occupied the highest percentage. But delivery method was not correlated with Sanhupung. 2. Musculo-skeletal symptoms(42.13%) were the most common symptoms. Wrist, waist, knees(59.59%) were the most common pain areas and the other pain symptoms (40.21%) appeared a significant portion of cases respectively. 3. In the 21~30days after delivery, the most patients visited. The number of patients admitted within 30 days after delivery or within 90 days was small comparing with Sanhupung onset. Patients treated within 10 days(47.12%) and treated only herb medicine(54.90%) were the most common. And the patients responded satisfacion or over were 88.46%. Conclusion: Patients' age, the number of born babies, delivery time were correlated with Sanhupung symptoms, but the method of delivery was not associated. And musculo-skeletal symptoms were the most common symptoms. Sanhupung patient's treatment period and methods were limited.

A Survey of Drug Intoxication Patients Transferred by 119 Ambulance Service - Seocho area in Seoul - (일 지역 119구급대를 통한 약물중독 사례 고찰 - 서울시 서초지역 중심 -)

  • Cho Wonsun
    • Journal of Korean Public Health Nursing
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    • v.10 no.1
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    • pp.106-117
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    • 1996
  • This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.

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Comparing the "pre-COVID-19 period" and the "COVID-19 early-stage period" for emergency medical services (COVID-19 발현 초기 119 구급대를 경유해 응급실로 내원하는 환자들의 이송 시간과 호소하는 증상의 변화 : 부산지역 일개 응급의료센터로 이송된 환자의 구급활동일지를 중심으로)

  • Kang, Ji-Hun;Ji, Jae-Gu;Jang, Yun-Deok;Lee, Si-Won;Kim, Seong-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.161-169
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    • 2020
  • Purpose: This study aims to identify changes in patients' transport time and chief complaints visiting the emergency room via emergency medical services from the "pre-COVID-19 period" compared to the "COVID-19 early-stage period". Methods: This retrospective observational study analyzed the emergency medical services reports at two time periods defined by the COVID-19 virus outbreak in Korea. The study was conducted in Busan, the Republic of Korea, from January 19 through May 6, 2019. Results: The transfer time of patients transported during the "COVID-19 early-stage period" was significantly delayed compared to the "pre-COVID-19 period" (p<.05). We found a significant increase in transport time for patients complaining of respiratory infections compared to patients without symptoms (p<.05). During the "COVID-19 early-stage period", there was a significant increase in the number of patients with respiratory infections and patients complaining of general symptoms compared to the "COVID-19early-stage period" (p<.05). Conclusion: The spread of the COVID-19 virus infection delayed patient transport and increased the number of patients reporting respiratory infection symptoms. Emergency medical services will need administrative and economic support to transport the increased number of patients requiring services.

Analysis of Treatment Pattern in COPD Patients Using Health Insurance Claims Data: Focusing on Inhaled Medications (건강 보험 청구 자료를 이용한 COPD 환자에서 치료제 처방 변화 분석: 흡입제를 중심으로)

  • Lim, Hana;Park, Mihai
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.155-165
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    • 2022
  • Background: Chronic obstructive pulmonary disease (COPD) is not completely reversible and requires long-term management with appropriate treatment. This study aimed to analyze trends in treatment regimens and medication costs for COPD patients using a national claims database. Methods: We conducted this analysis using National Patient Sample data from the Health Insurance Review and Assessment Service covering the period from 2015 to 2018. We have constructed a dataset comprising COPD disease classification codes J43.x and J44.x (based on KCD-7 code, J43.0 was excluded) and compiled a list of drugs fitting current guidelines. To identify trends, we calculated frequency, ratio, and compound annual growth rate (CAGR) using the numbers of prescriptions and patients. Results: The number of COPD patients was 7,260 in 2018, slightly decreased from 2015. Most of these COPD patients were aged 60 or older and included a high proportion of males (72.2%; 2018). The number of patients prescribed inhaled medications increased gradually from 2015 to 2018 (9,227 (47.1%); 2015, 9,285 (51.5%); 2018), while the number of patients prescribed systemic beta-agonists and Xanthines has decreased since 2015 (CAGR -14.7; systemic beta-agonist, -5.8; Xanthines). The per capita cost of medication has increased by 0.4% (KRW 206,667; 2018, KRW 204,278; 2015) annually during the study period. Conclusion: This study showed that treatment with inhaled medications had continuously increased in accord with changing guidelines, but oral medications were still widely used. It is necessary to emphasize the importance of inhaled medications in treating COPD to reduce additional economic burden through appropriate medication use.

Polypharmacy and Potentially Inappropriate Medication Use in Elderly Patients Hospitalized after Falls (낙상으로 입원한 노인의 다약제복용과 잠재적 부적절 약물 사용)

  • Kim, Ji-Yeon;Choi, Suyoung
    • Journal of Korean Biological Nursing Science
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    • v.24 no.3
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    • pp.161-170
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    • 2022
  • Purpose: The purpose of this study was to investigate polypharmacy and potentially inappropriate medication (PIM) use in elderly patients admitted to hospitals after falls. Methods: The study surveyed 283 patients 65 or older admitted January 1-December 31, 2016. Data were collected from electronic medical records, and medications administered immediately prior to admission were examined. PIM use for patients was investigated using the Beers criteria, and data were analyzed by Chi-square test and independent ttest. Results: The average age of participants was 79.42± 8.16, and the study included 226 women (79.9%) and 57 men (20.1%). The average number of self-administered medications daily was 4.94± 3.68, and 55.1% took five or more medications. PIM use was found in 107 patients (37.8%). There was a significant difference in polypharmacy according to age, and the proportion of medical aid beneficiaries and prevalence of cardiocerebrovascular, endocrine, and other chronic diseases were higher in the polypharmacy and PIM use patients than in the non-polypharmacy and non-PIM use patients. The number of chronic diseases and medications taken were significantly high among polypharmacy and PIM use patients. Conclusion: It is necessary to minimize polypharmacy and PIM use, and establish a system for systematically evaluating and managing medication use to prevent falls in the elderly.