Purpose: This study is aimed to analyze the trend of research on pulmonary rehabilitation of patients with COPD (Chronic Obstructive Pulmonary Disease), and to suggest a direction for future research of pulmonary rehabilitation of COPD. Method: A total of 39 studies published from 1991 to 2002 were examined according to the year of publication, type of journal, characteristics of patients, rehabilitation program, research design, and instruments and research findings. Results: 1) The number of studies related to pulmonary rehabilitation of COPD patients has rapidly increased since 1996's (87.18%) 2) There were 10 studies published in the chest. There were 6 studies published in domestic journals and 33 studies published in international journals. 3) The samples in the studies were mostly outpatients whose lung function was moderate. 4) The total period of the pulmonary rehabilitation program shown in the literature was 5 to 12 weeks. The programs included exercise interventions, educational interventions and psychosocial interventions. 5) The outcomes of the pulmonary rehabilitation were measured with lung function, 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire. Research findings were found to be effective on 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire but not on lung function. Conclusion: Based on these findings, pulmonary rehabilitation should be further emphasized, and standardized protocols and community based pulmonary rehabilitation programs need to be provided. More qualitative research should also be conducted in the future to describe the experiences of the pulmonary rehabilitation of patients with COPD.
The purposes of this study were 1) to identify patterns and trends of studies of anxiety and stress and 2) to provide direction on which to base further research. Research studies of anxiety and stress were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, Monthly Nurse, and from theses and dissertations, which had been conducted for the 20 years from 1970 to 1990. The total population of the studies numbered 463. Seven studies were excluded from the analysis because of duplication, so that 252 studies of anxiety and 204 of stress were analyzed. These studies were analyzed for 1) time of publication or presentation, 2) research design, 3) characteristics of subjects used in each study, 4) types of correlated variables, and 5) types of nursing interventions. Findings obtained in the study were as follows : 1. The number of studies related to anxiety and stress has increased rapidly since the early 1980's. 2. The studies were primarily descriptive throughout the 20 years. However, correlational studies, comparative studies and experimental studies slowly increased. 3. Anxiety studies tend to be conducted more on patients and stress studies with normal subjects in non - experimental research. However, experimental studies were conducted more with patients than with normal subjects. 4. In correlational studies, the trend was to study physical conditions in relation to anxiety, and coping and adaptation in relation to stress. 5. In experimental studies, teaching and information therapy and relaxation were the most popular interventions for anxiety, and supportive care for stress. On the bases of these findings, the following recommendations were made : 1. These patterns of studies related to anxiety and stress in Korea need to be compared with studies conducted in other countries. 2. More attention is needed in terms of research design, reliability and validity of tools, and results of statistical analysis. 3. Meta -analysis should be done to analyze and integrate the results of various studies. 4. For theory testing and identification of useful intervention methods, experimintal studies with the same protocols must be conducted rather than more descriptive studies.
Cancer is a leading cause of death, and the number of cancer patients is increasing in Korea. The needs for the home care of cancer patients are increasing recently, but the standardized home care protocols are not developed yet. This study was designed to develop nursing assessment -intervention algorithms for the cancer chemotherapy patients at home. These algorithms suggest guidelines when we assess the patient's condition, and find appropriate nursing interventions, so that standardization and quality control of home care can be attained. The algorithms were processed by yes-no tree. Eleven common problems of cancer chemotherapy patients were identified by the literature review and oncology nurses' experience. These were digestive dysfunction, pain, fatigue, infection, respiratory difficulties, activity intolerance, hemorrhage, sensory disorder, edema, skin problem, and mucosal problem. The algorithm needs to be validated and modified by using for the cancer chemotherapy patients at home.
Purpose : This study aimed to assess the effectiveness of an advanced practice nurse (APN)-driven ventilator weaning protocol for patients undergoing cardiac surgeries. Methods : A retrospective analysis was conducted on 226 patients admitted to the intensive care unit (ICU) of a tertiary hospital between January and June 2020, following a cardiac surgery. Patients were divided into an APN protocol-applied group (experimental group, n=152) and a control group managed based on doctors' judgment (n=74). Ventilator weaning criteria and clinical outcomes, including duration of ventilation, length of ICU stay, and rate of reintubation, were compared between the two groups. Results : Patients in the control group were older and had a higher incidence of massive bleeding from chest tube drainage (>100 cc/hr) at baseline. The average duration of ventilation was significantly shorter in the experimental group compared to the control group (7.44 vs. 21.61 hours, p <.001). Furthermore, the mean length of ICU stay was shorter in the experimental group compared to the control group (47.96 vs. 77.97 hours, p <.001). There was no difference in the rate of reintubation between the two groups. Conclusion : These findings suggest that an APN-driven ventilator weaning protocol can improve clinical outcomes without significant complications. These results support the adoption of APN-driven mechanical ventilator weaning protocols in clinical practice.
Purpose: The study sought to determine the state of blood glucose control, and the consequent clinical effects and variation in blood glucose level, of adult patients admitted to intensive care units following cardiothoracic surgery by comparing the blood glucose levels before and after the application of a blood glucose control protocol. Methods: The protocol was developed by modifying and supplementing the Yale protocol, and was first used in 2012. The resulting blood glucose data of an experimental group (n = 314), to which the blood glucose control protocol had been applied, and a control group (n = 347), whose blood glucose levels had been controlled according to physicians'prescriptions without the protocol, were collected through the medical records. Results: The target blood glucose ratio increased significantly in the experimental group, and the low blood glucose ratio decreased significantly in the experimental group. The two groups exhibited a significant difference (p < .001) in the degree of variation in the blood glucose levels. The duration of the use of a ventilator was significantly reduced in the experimental group (p < .001). Conclusion: It is expected that the protocol can be used for the safe and effective control of critically ill cardiothoracic surgery patients' blood glucose levels.
Purpose: This study was to evaluate and compare the effectiveness of a progressive functional training program on ADL performance in stroke patients at home after selecting subjects through Resident Assessment Instrument for Home Care (RAI-HC). Method: Ninety stroke patients had a structured training which was 50 min in duration, six times per week for a period of 6 weeks. The subjects were divided into three groups as measured using the RAI-HC progressive functional training program group; the resident rehabilitation exercise group and the control group. Result: The study observed that the functional training program for stroke patients increased the level of activities of daily living (ADL), performance of functional fitness and balance. It also reduced blood lipid and the score of client assessment protocols (CAPs). The functional training program is expected to improve the quality of life in the stroke patients at home. Conclusion: The authors, with the results of this study concluded that, the functional training program is necessary for the stroke patients to improve their quality of life. Hence, the program should be employed immediately.
Purpose: This study aims to investigate the degree of burnout of 119 rescuers, to determine factors influencing their burnout, and to provide basic data for development of intervention programs to prevent the burnout. Methods: Subjects of this study were all 119 rescuers working at fire stations located in Busan and Gyeongnam. The data were collected from May 1, 2010 to June 30, 2010. The collected data were analyzed with SPSS/WIN 17.0. Results: When the difference in the degree of burnout by general characteristics was investigated, the means of burnout were significantly different depending on age, period of service, position, license, annual salary, desire to work continuously and types of working hours. Job stress, job satisfaction, social support, self efficacy and self esteem showed a statistically significant correlation with burnout. The degree of burnout became higher with more job stress and lower job satisfaction, social support, self efficacy and self esteem. As a significant factor affecting the degree of burnout of 119 rescuers, job stress showed 47.3% of explanatory power. The explanatory power of all of job stress, job satisfaction, self efficacy, types of working hours, annual salary and license was 62% and the power of job stress was the highest. Conclusion: From these results, job stress, job satisfaction and self-efficacy were found to be factors affecting the burnout of 119 rescuers. Therefore, intervention programs to reduce job stress and to improve job satisfaction, social support, self efficacy and self esteem should be developed to lower the degree of burnout of 119 rescuers. In addition, further researches to analyze works of 119 rescuers and legal and institutional strategies to improve their treatment are necessary and supplementary training in various practices by different circumstances based on standardized protocols should be conducted.
Lee, Eun Jung;Kim, Eun Sook;Lee, You Na;Park, So Hyun;Lee, Gum Moon;Yi, Young Hee
Journal of Korean Clinical Nursing Research
/
v.20
no.3
/
pp.313-325
/
2014
Purpose: This study aimed to develop the protocol of kangaroo care for premature infants and to evaluate its effects including physiologic responses of premature infants, their parents'anxiety, and neonatal nurses'perception regarding the kangaroo care. Methods: Kangaroo care protocol was developed through a literature review and validation of an expert group. The developed kangaroo care protocol was tested with 27 preterm infants, 24 parents, and 60 nurses in one neonatal intensive care unit in S hospital. Data were collected from December 2012 to February 2013 and analyzed by descriptive statistics and t-test using the SPSS/Win statistical program. Results: Physiologic responses including heart rate, respiration rate, oxygen saturation, body temperature among premature infants received the kangaroo care were maintained within normal limit. The anxiety levels of the parents who provided kangaroo care for their infants were significantly decreased as it was compared before and after care (t=3.43, p=.002). There were no significant differences in nurses'perceptions about kangaroo care before and after the application of the protocol. Conclusion: The developed kangaroo care protocol is proved to be effective and can be used safely in nursing practice.
The control of the chronic degenerative diseases becomes a challenge in Korea as the aging of the population progresses. Accordingly, the importance of the control of the hypertension, one of the major chronic degenerative diseases, in the primary health care settings increases. However, such control activities are still minimal. This study gives brief description of how the rural residents who are currently registered for the control of the hypertension feel about the activities of the health centers, subcenters and the CHP posts, in relation to the control of the hypertension. We also describe the knowledge and practice of the registered hypertensive. In general, the knowledge, the acceptance and the satisfaction of the respondents about the hypertension control activities were not very high. Respondents being managed by the health center showed the highest knowledge, acceptance and satisfaction, and those being managed by the subcenters ranked lowest. The knowledge about the hypertension was not satisfactory. There were great variations among the items in terms of the proportion answered correctly. As many as 60% of the respondents take medication regularly but only 4.5% were practicing weight control regularly. Despite some limitations of the study, the results can be very useful for those planning hypertension control programs. The educational materials and the dietary protocols need to be developed in accordance with the regional social and food pattern, so that they can be utilized with minimal modification for each beneficiary. We also suggest to minimize the area a health personnel covers. In other word, running several small health posts at village level would be more effective than running a subcenter at the township level, in terms of the hypertension control.
Journal of Korean Academy of Nursing Administration
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v.14
no.4
/
pp.421-431
/
2008
Purpose: Using comprehensive and valid instrument, MDS-HC 2.0, this study aimed to analyze the functional status and to evaluate the care needs of the community-dwelling disabled with cerebral impairment. Method: With a convenient sample of 88 disabled with cerebral impairment, the data were collected at a community health center located in rural area in Choongchung providence in August 2005. Subject's functional status and care needs were evaluated using Minimum Data Set-Home Care version 2.0. Result: Significant proportion of subjects were totally dependent for locomotion-outdoor (26.1%), personal hygiene (24.1%), bathing (24.1%). For IADLs, over 40% of subjects were totally dependent for ordinary house work, managing finances, or shopping. Top five ranked care needs were preventive health care measures (100%), communication disorders (71.6%), visual function (55.7%), health promotion (52.3%), and pressure ulcers (48.9%). The proportion of triggered clinical assessment protocols were significantly higher in disability level I group for the risk of institutionalization (p=<.001), communication disorders (p=.004), cognitive problems (p=.001), pressure ulcers (p=<.001), skin and foot conditions (p=.010), and urinary incontinence and indwelling catheters (p=<.001). Conclusions: It is necessary to provide community based rehabilitation services that are individualized for their service needs thus enhance optimal level of functioning.
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