• Title/Summary/Keyword: Nursing records

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Phenomenological Analysis of the Task-Based Field Experience for Medical Students: Focusing on the Medical Care Support Department in the Hospital (의대생들의 과제해결기반 병원 내 진료지원부서 현장체험에 관한 현상학적 분석)

  • Park, Kwi Hwa
    • The Journal of the Korea Contents Association
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    • v.20 no.8
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    • pp.152-161
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    • 2020
  • The purpose of this study was to conduct a task-based field experience program for medical care support departments in hospitals for 1st medical students, and then to analyze the their experiences and its meanings phenomenologically. We selected the following department in hospital; nursing, medical records, pharmacy, diagnosis laboratory, radiology, administration, customer consulting center, organ transplant center, palliative medical ward, and international medical center. The students visited the department and used various methods such as interviewing, observation, and experience to solve the given task. As a result, in the program satisfaction, students rated the highest as having many department in the hospital and understanding their role. The essential structure of the experience of medical care support department in the reflection journal written by the students was the recognition of reality, respect and collaboration, and self-reflection from experience recognition.

호스피스 환자의 임종증상

  • Choe, Hwa-Suk;Kim, Su-Ji
    • Korean Journal of Hospice Care
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    • v.2 no.1
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    • pp.75-86
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    • 2002
  • Prupose: The purpose of this study was to identify signs and symptoms of hospice patients during their dying processes. Method: The subjects of this study were 76 patients who received hospice care services in 2 different hospice care programs in Seoul area. Data was obtained from January, 1999 to June, 2001 by hospice nurse's observation, interviews with patient's primary caregiver and hospice volunteers, patient's self report, nursing records and questionnaires which had been developed by selecting from various references and refining them based on the result of preliminay studies. The collected data were analyzed with the SPSS PC+ program and content analysis. Results: Mean lengths of hospice patient's dying process were 3.6 days. Physical signs and symptoms of hospice patients during their dying processes were 'increased sleep'(89.5%), 'decreased oral intake of food'(88.2%) and 'liquids'(86.8%), 'change of respiration'(82.9%), 'decreased urine output'(80.3%), 'cold extremities'(69.7%), 'death rattle'(67.1%), 'cyanosis'(57.9%), 'restlessness'(55.3%), etc. And psychological, spiritual and social signs and symptoms were 'decreased interpersonal relationships'(61.8%), 'panorama of memories from childhood'(60.5%), 'experiences as like hallucination'(56.5%), 'saying bye with family'(69.7%), 'forgiveness', 'make a will', etc. Experiences as like hallucination were seemed not as dream but reality were shown by 43 dying patients. They had experienced to see and to talk with their deceased mother(18.6%) and/or relatives(30.2%), angels(20.9%), heaven(11.6%), old house in which they had lived, someone from the world beyond with black clothes, etc. Conclusion: The above results indicate that death of hospice patients is ongoing process with dying signs and symptoms during several days contains not only in physical aspects but also among psychological, spiritual and social aspects including family dynamics.

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The Meaning of Good Dying of Chinese Terminally Ill Cancer Patients in Taiwan

  • Chao, Co-Shi Chantal
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2000.12a
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    • pp.162-174
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    • 2000
  • The purpose of this hermeneutic study was to investigate the meaning of "good dying" of Chinese terminally ill cancer patients in Taiwan; the factors related to this morning; and the strategies cancer patients used to ensure "good dying". Indepth unstructured interviews, prolonged participant observations, and review of clinical records were selected as the methods for data collection. In the four and one-half month period of data collection, the researcher was in the role of a full time clinical nurse specialist who directly took care of the subject patients in 4 hospitals and in patients' homes. The 20 subject were selected purposively according to selection criteria and various demographic backgrounds. Interview transcripts and field notes comprised the data for analysis. The results were composed by 3 constitutive patterns and 12 themes. Achieving inner peace appeared to herald the good dying state. The "good dying" for Chinese terminally ill cancer patients in Taiwan meant peace of body, peace of mind, and peace of thought. The constitutive pattern of peace of body included 4 themes: (1)minimizing the agony of physical symptoms; (2)short period of dying process without lingering death; (3) cleanliness, neatness, and integrity of the body; and (4) mobility. The constitutive pattern of peace of mind included 5 themes: (1) yielding; (2) non-attachment; (3) not to be lonely; (4) settle down all affairs; and (5) being in a preferred environment and enjoying nature. The third constitutive pattern of peace of thought included 3 themes: (1) getting through day by day without thinking; (2) meaningful life; and (3) expectation that the suffering would be ending. Through understanding of the terminally ill cancer patient' needs in their meanings of "good dying", recommendations can be made for humanistic care. The findings of this study have recommendations for care givers daily contact with dying patients and for medical and nursing education.

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Incidence and Factors Influencing Neutropenia in Patients with Chemotherapy (항암화학요법을 받은 유방암환자의 호중구 감소증 발생실태와 영향요인)

  • Ju, Eunsil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.519-525
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    • 2018
  • The purpose of this study was to identify the incidence of neutropenia in patients with breast cancer who received chemotherapy and to identify the differences in incidence according to influential factors. We analyzed the medical records of 353 breast cancer patients who received chemotherapy at university hospital in Seoul, Korea from January 2010 to March 2016. The collected data were analyzed by descriptive statistics, $X^2-test$, and logistic regression analysis using SPSS 20.0. Among the 353 subjects, 33.1% had neutropenia, and the factors that showed significant difference according to neutropenia were exercise performance, RT status, and regimen. The results of this study suggest that it is important to predict the prevalence of neutropenia in breast cancer patients receiving chemotherapy and to provide appropriate education and nursing intervention.

Evaluation of goodness of fit of semiparametric and parametric models in analysis of factors associated with length of stay in neonatal intensive care unit

  • Kheiry, Fatemeh;Kargarian-Marvasti, Sadegh;Afrashteh, Sima;Mohammadbeigi, Abolfazl;Daneshi, Nima;Naderi, Salma;Saadat, Seyed Hossein
    • Clinical and Experimental Pediatrics
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    • v.63 no.9
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    • pp.361-367
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    • 2020
  • Background: Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors. Purpose: The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018. Methods: This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05. Results: The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P<0.05). Parametric models showed better fitness than the Cox model in this study. Conclusion: Breastfeeding and availability of central venous catheter had protective effects against length of stay, whereas phototherapy, acute renal failure, and mechanical ventilation increased length of stay in NICU. Therefore, the identification of factors associated with NICU length of stay can help establish effective interventions aimed at decreasing the length of stay among infants.

Development of Case Review Form for Detecting Adverse Events (위해사건 확인을 위한 증례검토지 개발)

  • Ock, Min-su;Lee, Sang-il;Kim, Yoon;Lee, Jae-ho;Lee, Jin-yong;Jo, Min-woo;Kim, Seon-ha;Son, Woo-seung;Kim, Hyun-joo
    • Quality Improvement in Health Care
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    • v.21 no.1
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    • pp.66-76
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    • 2015
  • Objectives: The purpose of this study is to develop a case review form for detecting adverse events through a medical records review in hospitalized patients in South Korea. Methods: To develop the case review form, several literatures were reviewed, first. Through the clinical expert meeting, screening criteria were selected and case review form was developed. Result: The Korean version of case review form consisted of the review form-1 for adverse event screening and form-2 for adverse event identification. The applied methodology for the case review form is determined according to the previous studies. For example, the method used in the first stage review is nurse review. Furthermore, the National Coordinating Council for Medication Errors Reporting and Prevention index is used to categorize disability, and a scale of 1 to 6 was used in the causation scores and preventability scores, respectively. Through the clinical expert meeting, a total of 41 screening criteria were selected. Conclusion: The Korean specific case review form was developed for detecting adverse events in hospitalized patients. The results from this study can be used in a large-scale study regarding the nationwide incidence of adverse events.

Changes in Diseases of Physical Therapy Patients and Medical Department on Two General Hospitals in Taegu (대구시내 2개 종합병원 물리치료환자의 진료과 및 질병 변화 $(1989\~1991)$)

  • Chu Min;Kim Ji-Sook;Im Bok-Hee
    • The Journal of Korean Physical Therapy
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    • v.5 no.1
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    • pp.47-60
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    • 1993
  • This study was conducted to investigate the changes diseases of physical therapy patient. Through the analysis, of total 2,902 cases in one university hospital and one general hospital in Taegu, of which 1,619 cases for 1989 and 1,283 cases for 1981. The physical records were analyzed in terms of sex, age, pattern in PT diseases, fee, and medical department of PT. The international classification of Diseases, 9th revision was used fer the study. Major results are as follows : 1. The ratio of male me female nae 1.51 to 1 in 1989, 1.53 to 1 in 1991. The proportion of the elderly over 60 was $15.6\%$ in 1989, $22.0\%$ in 1989. And the age groups of 50-59 years ranked the first an years. 2. As to the PT patients of medical department, Orthopaedics$(50.3\%)$, Neurosurgery$(28.1\%)$. Neuromedicine$(8.0\%)$. Plastic surgery$(4.4\%)$, and Dentry$(3.2\%)$ in that order in 1989. On the other hand, Orthopaedics$(51.2\%)$, Neurosurgery$(22.1\%)$, Neuromedicine$(9.6\%)$, Plastic surgery$(6.5\%)$, and Internal medicine$(6.5\%)$ in that order in 1991. 3. No significant difference was observed by season of PT patients, but winter (December, January and February) ranked the first all years. 4. No significant difference was observed changes in diseases as for the 56 international classification of diseases of PT patients, Diseases of the musculoskeletal system and connective tissue occupied the largest proportion all years. Fractures increased from $21.4\%$ in 1989, $24.5\%$ in 1991. On the other hand, Diseases of the nervous system remarkably increased from $8.9\%$ in 1989, $19.7\%$ in 1991.

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Clinical Usefulness of Critical Patient Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurological Patients in Intensive care units(ICU) (Glasgow coma scale의 임상적 유용성 평가 - 중환자 중증도 분류도구 -)

  • Kim, Hee-Jeong;Kim, Jee-Hee;Roh, Sang-Gyun
    • Proceedings of the Korea Institute of Fire Science and Engineering Conference
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    • 2012.04a
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    • pp.190-193
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    • 2012
  • The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$,.734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$,.612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

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Convergent Study of the Factors Affecting the Quality of Sleep among Elderly Insomnia Patients (노인 불면증 환자의 수면의 질에 영향을 미치는 요인에 관한 융합연구)

  • Han, Eun Kyoung
    • Journal of the Korea Convergence Society
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    • v.8 no.3
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    • pp.141-150
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    • 2017
  • The purpose of this study was to identify relationship among the depression, social support and quality of sleep in elderly insomnia patients. A total of 143 patients with insomnia diagnosed according to DSM-IV criteria. Quality of sleep, depression, and social support were measured using a self structured questionnaire and participant's medical records were reviewed for obtaining their clinical information. Quality of sleep was positively associated with depression(r=.255, p<.05), and negative correlation with social support(r=-.270, p<.001). The significant factors for quality of sleep were information support(${\beta}=-0.406$, p<.05) and affectionate support(${\beta}=-0.525$, p<.05). These factors explained 13.2% of the variance in quality of sleep. The elderly patients suffering the insomnia need the nursing interventions considering information support and affectionate support in order to improve sleep quality.

Convergence Factors of affecting Rehospitalization of Tuberculosis Patients (결핵환자의 재입원에 미치는 융복합적 영향요인)

  • Lee, Hwa-Sun;Lee, Hyun-Ju
    • Journal of Digital Convergence
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    • v.13 no.5
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    • pp.259-267
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    • 2015
  • This study is aimed at understanding the factors affecting rehospitalization of a tuberculosis patient. In a public hospital with a tuberculosis ward in Seoul, the data of 360 patients who discharged the hospital from July 1, 2012 to December 31, 2012. Data was selected from 'nursing information survey' or 'discharge analysis DB' of the department of medical records. The possibility of rehospitalization was higher in the group with those who has no job, those with medical care assistant than with health insurance, drinks about 10 times a month, personally came to the hospital, main guardian is the patient's spouse, have discharged from hospital against the doctor's advise, and principle diagnosis is not a pulmonary tuberculosis but the other respiratory disease. Therefore, it is expected that the possibility of rehospitalization would be effectively reduced if an intensive intervention is taken on the first hospitalized patients who have the features described above.