Park, Jeong Hee;Yun, Sun Ok;Kim, Sun Hwa;Yu, Mi Gyeong;Ham, Eun Jin
Korean Journal of Adult Nursing
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v.28
no.6
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pp.637-645
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2016
Purpose: The purpose of this study was to identify the occurrences and the factors contributing to constipation in the post surgical period following major orthopedic surgery. Methods: The sample included 133 patients who had surgery of the hip, knee, or spine. Patients were excluded from the study if there was a history of bowel surgery or constipation from chart review. Data were collected using questionnaires such as Korean version of Modified Barthel index (K-MBI), Hospital Anxiety and Depression Scale, and Constipation Assessment Scale (CAS) before surgery and on the third postoperative day. Results: Reports of constipation occurred in 77 instances (57.9%). The first reported defecation was within $4.0{\pm}2.2days$ following surgery. Mean days of first defecation of constipation group vs. non-constipation group was $5.5{\pm}1.7days$ vs. $2.1{\pm}1.0days$. There were statistically significant differences between patients who reported than those who did not in terms of age, length of NPO period, postoperative ADL, and the reported incidents of preoperative and postoperative depressive symptoms. Postoperative ADL, age, and NPO period were significant influencing factors of constipation and explained 52.4% of the variance. Conclusion: Constipation is a very common symptom for patients undergoing orthopedic surgery. These results indicate a need for improving patient's ADL after surgery to prevent constipation.
Purpose: A purpose of this study was to identify the effects of cold water gargling on thirst, oral cavity condition and sore throat in orthopedics surgery patients who underwent general anesthesia. Methods: Pretest-posttest non-synchronized design with a nonequivalent control group was used. A total of 52 participants were conveniently selected and assigned to each group. The experimental group gargled hourly with cold water for 8 hours after operation. The control group received wet gauze as needed. We compared the thirst, oral cavity condition and sore throat at 0, 2, 4 and 8 hours after operation. Results: The score of thirst and oral cavity condition was lower in the experimental group than in the control group. However, there was no significant differences in the levels of sore throat between the experimental and control group. Conclusion: These findings suggest that cold water gargling can be a useful nursing intervention for alleviating thirst and improving oral condition for patients with orthopedic surgery after general anesthesia.
Background: The present study investigated the radiation dose distribution of balloon kyphoplasty (BKP) among surgeons and medical staff, and this is the first research to observe such exposure in Japan. Materials and Methods: The study subjects were an orthopedic surgeon (n = 1) and surgical staff (n = 9) who intervened in BKP surgery performed at the National Hospital Organization Disaster Medical Center (Tokyo, Japan) between March 2019 and October 2019. Only disposable protective gloves (0.022 mmPb equivalent thickness or less) and trunk protectors were used, and no protective glasses or thyroid drapes were used. Results and Discussion: The surgery time per vertebral body was 36.2 minutes, and the fluoroscopic time was 6.8 minutes. The average exposure dose per vertebral body was 1.46 mSv for the finger (70 ㎛ dose equivalent), 0.24 mSv for the lens of the eye (3 mm dose equivalent), 0.11 mSv for the neck (10 mm dose equivalent), and 0.03 mSv for the chest (10 mm dose equivalent) under the protective suit.The estimated cumulative radiation exposure dose of 23 cases of BKP was calculated to be 50.37 mSv for the fingers, 8.27 mSv for the lens, 3.91 mSv for the neck, and 1.15 mSv for the chest. Conclusion: It is important to know the exposure dose of orthopedic surgeons, implement measures for exposure reduction, and verify the safety of daily use of radiation during surgery and examination.
Purpose: This study attempted to test whether there are differences in the level and hemodynamic side effects (blood pressure, heart rate, $O_2$ saturation), and nausea & vomiting of spinal anesthesia using hyperbaric bupivacaine according to position (supine, lateral, and prone positions) in orthopedic surgery patients who received podiatric surgery under spinal anesthesia. Methods: This study was conducted with 53 patients who had received orthopedic surgery under spinal anesthesia at I General Hospital. Data were analyzed using SPSS 20.0 through repeated-measures ANOVA, post-hoc test, Chi-test, and Fisher's exact test. Results: The change of position after spinal anesthesia with hyperbaric bupivacaine caused a change in the level of spinal anesthesia (F=12.768, p<.001). However, no difference of blood pressure, heart rate, $O_2$ saturation and nausea and vomiting caused by the change in anesthesia level was observed, and in prone position, drug was administered for the correction of side effects. Conclusion: As expected, recognizing that there can be a change in the level of spinal anesthesia after the change of position in surgical patients, nurse anesthetists should monitor their conditions carefully and continuously.
Journal of Korean Academy of Nursing Administration
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v.9
no.1
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pp.89-101
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2003
Purpose : this study was to examine the effect of using a nursing standards for the quality of nursing care in musculo-skeletal patients. Method : The approach to nursing quality assurance evaluation was selected process-outcome framework. The subjects ware 100 case of musculo-skeletal patients in orthopedic surgery nursing care unit of E. university hospital in seoul. The data of a control group were collected from 23 December 2001 to 20 March 2002 and an experimental group were collected from 1 June to 25 August 2002. The instruments used for this study were a nursing care standards in musculo-skeletal disorder patients developed by the investigator and an evaluation tool for the quality of nursing care in orthopedic surgery patients developed by soon-ook Choi in 1995. It's reliability is Cronbach alpha=.8628. The data were analyzed by means of $x^1$-test, t-test, ANOVA with SPSS program. Results : This study are as fellows : 1. Scores of the quality of nursing care in standard 1 in the experimental group were higher than those of the control group with no significant difference(t=-8.793, p=.000), scores of the quality of nursing care in standard 2 in the experimental group were higher than those of the control group with significant difference(t=-8.793, p=.000) and standard 3 in the experimental group were higher than those of the control group with significant difference(t=-10.550, p=.000). scores of the quality of nursing care in standard 4 in the experimental group were higher than those of the control group with significant difference(t=-8.793, p=.000). scores of the quality of nursing care in standard 4 in the experimental group were higher than those of the control group with no significant difference(t=-1.833, p=.070). 2. Scores of the quality of nursing care in criteria 28 of 33 criteria in the experimental group were higher than those of the control group with significant difference in 12 criteria(p<.05 ). 3. Scores of the quality of nursing care in standard 1 to standard 4(process evaluation); the experimental group were higher than those of the control group with significant difference(t=-10.704, p=.000). scores of the quality of nursing care in standard 5(outcome evaluation); the experimental group were higher than those of the control group. but no significant difference(t=-1.833, p=.070). 4. Scores of the quality of nursing care in experimental group were higher than those of the control group with significant difference(t=-10.794, p=.000). Conclusion : Through this study, I'm sure that using a nursing care standards in musculo-skeletal disorder patients improve quality of nursing care and nursing care standards are effective nursing care.
Purpose: This study aimed to investigate the degree of discomfort and to identify factors related with discomfort in patients wearing thigh-length compression stockings after orthopedic surgery. Methods: The participants were 105 patients wearing thigh-length compression stockings after orthopedic surgery at two hospitals in B city. Data were collected by the scale of discomfort in wearing compression stockings from July 5 to October 20, 2011. Results: Mean score of discomfort on wearing compression stockings was significantly higher at post-op. day 3 than day 1 (t=-2.30, p=.004). Discomfort scores for 'itching skin' and 'tightened leg' items were higher than others. There was significant difference in discomfort at post-op. day 1 according to surgical regions. The total score of discomfort at post-op. day 3 was positively related with the body mass index (r=.20, p=.041). Conclusion: Wearing thigh-length compression stockings to prevent deep vein thrombosis may cause physical and psychological discomfort for orthopedic surgical patients. To reduce discomfort in wearing compression stockings, nurses need to intervene discomfort and problems related to the stockings post-operatively.
Purpose: This study was conducted to investigate the correlation among nurses' knowledge, performance, and stress about care for delirium. Methods: The data were collected using the instruments for knowledge about nursing care (50 items), performance (23 items), and stress (20 items). Descriptive statistics and Pearson's correlation coefficient were used to analyze the data of 222 participants. Results: Nursing knowledge were different by clinical experience (F=3.12, p=.016), position at work (t=-2.54, p=.012), experience in caring patients with delirium (t=3.90, p<.001), and conflicts with other disciplines on matters related to delirium (t=4.00, p=.001). The difference in performance were associated with age (F=4.19, p=.001), clinical experience (F=2.67, p=.003), and whether there was a guideline for managing the patients with delirium (t=2.30, p=.022). Stress of nurses was different by whether they had a religion or not (t=-2.41, p=.017). The knowledge of care for delirium had the positive relationship with performance (r=.21, p=.001) and negative relationship with stress (r=-.29, p=.001). Conclusion: It is necessary to develop educational program and guideline for improving the knowledge and performance in care for delirium among nurses working at orthopedic hospitals.
Purpose: Postmenopausal women are a unique population with high risk for the degeneration of muscle. The aim of the present meta-analysis was to accurately evaluate the effects of vitamin D on muscular strength in postmenopausal women. Methods: A review was conducted using electronic databases, including PubMed, EMBASE, Ovid Medline, CINAHL complete, and the Cochrane Library from inception through 19 March 2019. Included studies were selected by two independent reviewers. The meta-analysis were performed using Review Manager 5.3 software. Results: A total of nine randomized controlled clinical trials were included in this review. Vitamin D interventions led to no changes in the upper limb muscle strength (mean difference -0.16, 95% CI: -1.09 to 0.77), lower body muscle strength (standard mean difference 0.08, 95% CI: -0.11 to 0.26), and back/hip muscle strength (standard mean difference 0.06, 95% CI: -0.05 to 0.17). Conclusion: Pooled results from eight studies indicated that supplementation of vitamin D did not increase muscle strength in postmenopausal women. Apparently, the present review suggests that supplementation of vitamin D alone had no didn't show any beneficial effects on muscle strength in postmenopausal women.
Purpose: The purpose of this study was to determine the effect of nurses' pain experience on the inference of their patients' suffering. Method: Study subjects were sampled from 184 nurses who worked in general wards in one S university hospital located at Seoul. Nurses' pain experience consists of personal pain experience and professional pain experience. The Standard Measure of Inference of Suffering (Davitz & Davitz, 1981) was used for suffering inference measure, and patients' suffering which consists of physical pain and psychological distress. Result: Suffering inference scores of nurses without personal pain experience revealed a higher value than that of nurses with personal pain experience. But these differences were not statistically significant. The higher intense pain was experienced, the higher were suffering inference scores. This physical pain inference score was statistically significant(p=.044). Of the nurses who had personal pain experience, suffering inference scores of nurses with unrelieved pain experience revealed a higher value than that of nurses with relieved pain experience. Physical pain and psychological distress inference scores were statistically significant(p=.010, p=.006). Suffering inference scores of nurses without professional pain experience(internal medicine, general surgery, orthopedic surgery) revealed a higher value than that of nurses with professional pain experience. Professional pain experience of internal medical illness was statistically significant in psychological distress of internal medical illness(p=.044), and professional pain experience of orthopedic surgical illness was statistically significant in physical pain of orthopedic surgical illness(p=.027). Conclusion: Nurses who have experienced low pain intensity or good pain relief are inclined n to underestimate patient' pain. Although nurses who care for the same patient over a long time deal skillfully with that patient, nurses are inclined to underestimate that patients' pain. Nurses need to be aware of possible biases related to pain assessment as a result of pain experience.
Purpose: The aim of this study was to investigate the effects of home care exercise program on knee joint function(WOMAC) and the quality of life in patient with total knee replacement arthroplasty. Method: Forty-one subjects were sampled according to research criteria, and divided into two groups : 21 out of experimental group and 20 out of control group. The patients having treatment of total knee replacement arthroplasty were out of the hospital. After surgery executed, it took 8days for them to recovere their health conditions since 10th day, the experimental group received the home care exercise program per regularly four days interval. Results: 1) After applying home care exercise program, the total score on the WOMAC Index for the control group was $3.09{\pm}.76$. The score of the experimental group was $3.55{\pm}.55$ which is statistically higher than that of the control group. (P=.007). 2) After applying home care exercise program, the score of the quality of life for the control group was $3.09{\pm}.50$. The score of the experimental group was $3.46{\pm}.35$ Which is statistically higher than that of the control group. (P=.007). Conclusion: This figures show that home care exercise program has good results. These findings also indicate that the services of home care exercise program are alternatives for the hospitalization.
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