• Title/Summary/Keyword: Outpatient clinic

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DENTAL TREATMENT OF PATIENTS WITH DOWN SYNDROME UNDER GENERAL ANESTHESIA (다운증후군 환자의 전신마취 하 치과치료)

  • Lee, Sung-Ju;Yi, Young-Eun;Kim, Hye-Jung;Seo, Kwang-Suk;Kim, Hyun-Jeong;Yum, Kwang-Won;Kim, Dong-Wuk
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.2
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    • pp.75-79
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    • 2007
  • Background: Down's syndrome, or trisomy 21, is the commonest congenital chromosome anomaly. With improvement in medical care, these patients increasingly reach adulthood in spite of their physical maldevelopment and mental retardation. And, the number of those who required general anesthesia for dental treatment is increasing. Methods: We reviewed the 26 cases of 22 patients with Down's syndrome who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 22 years. They all had severe mental retardation and some had congenital heart anomaly, epilepsy, hypothyroidism, acute leukemia, autism, cleft palate, and chronic renal failure. For anesthesia induction, 4 cases was needed physical restriction, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (17 cases) and sevoflurane (9 cases). All patients received nasotracheal intubation and 3 cases needed difficult airway management. Mean total anesthetic time was $166{\pm}60$ min and staying time at PACU was $92{\pm}48$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

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Factors Influencing Health Behavior of Patients with Chronic Hepatitis B (만성 B형 간염환자의 건강행위 수준 및 영향요인)

  • Lee, Jung-Eun;Kim, So-Sun;Kim, Sun-Ah;Han, Kwang-Hyub;Kim, Soo-Hyun;Ji, Eun-Joo;Oh, Eui-Geum
    • Korean Journal of Adult Nursing
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    • v.23 no.1
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    • pp.20-30
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    • 2011
  • Purpose: The aim of this study was to examine patients with Chronic Hepatitis B (CHB) and their level of knowledge of their disease, uncertainty, stress and health behaviors and to identify factors influencing their health behavior. Methods: A cross-sectional, descriptive design was used. The sample included 136 patients in a gastroenterology outpatient department at one hospital located in Seoul. The mean age of the subjects was 41 and 77.2% were male. Data were collected using a structured questionnaire from April to June 2009. The collected data were analyzed using SPSS/WIN 15.0. Results: The reported scores for knowledge of the disease, uncertainty, stress, and health behaviors were 14.43, 81.50, 26.50, 52.11, respectively. There were statistically difference between health behaviors and gender, age, marital status and antivirus treatment. A positive correlation existed between knowledge of disease and health behaviors (r=.199, p=.020). In contrast, there was a negative correlation between uncertainty and health behaviors (r=-.250, p=.003). The factors influencing health behaviors were knowledge of disease, gender, age, uncertainty, antivirus treatment, and marital status ($R^2$=.267, p<.001). Conclusion: These findings support that strategies for enhancing knowledge of disease and reducing uncertainty are needed to promote health behavior in patients with CHB.

Perspectives of Women during Reproductive Years for Cervical Cancer Scans and Influencing Factors

  • Acar, Gokce Banu;Pinar, Gul
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7171-7178
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    • 2015
  • Background: This descriptive study was performed in order to assess health perspectives of women, who applied to Yildirim Beyazit University Ataturk Education and Research Hospital, Outpatient Clinic of Obstetrics and Gynecology for cervical cancer scans and were in the reproductive years. Factors influencing their perspectives were also assessed. Materials and Methods: In this study, a simple random sampling formula was adopted to calculate the volume (300) of the targeted sample. Results of the research were obtained through individual diagnosis form and cervical cancer and the Pap smear test health belief model scale (HBMS). Results: It was found that 75.0% of the women heard of the Pap smear test before, and 48.7% had undertaken one. Some 51.4% of the women who had Pap smear test expressed that they had the test at irregular periods. Most of the women stated that they heard about the smear test from the health staff (51.7%). Lack of any health complaints (28.3%) and not having adequate information about the test (21.0%) were among the reasons for not undergoing a Pap smear test. It was found that lower dimension average scores of the women obtained from the cervical cancer and Pap smear test HBMS varied from $7.7{\pm}2.3$ to $33.5{\pm}9.3$. When the lower dimension average scores of women from the HBMS were examined, the perception of usefulness was high but the susceptibility and health motivations were low. Conclusions: In this study, it was determined that the awareness of women about cervical cancer and the Pap smear test was insufficient, and susceptibility and motivation perception towards having a Pap smear test were low.

Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries

  • Kim, Un-Na;Kim, Yeon-Yong;Lee, Jin-Seok
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.1
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    • pp.53-60
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    • 2016
  • Objectives: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. Methods: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. Results: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. Conclusions: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients.

DENTAL TREATMENT UNDER GENERAL ANESTHESIA OF A CHILD WITH MULTIPLE DISABILITIES : A CASE REPORT (중복 장애 환아의 전신마취 하 치과치료 : 증례보고)

  • Lee, Eungyung;Kim, Jiyeon;Kim, Shin;Jeong, Taesung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.114-118
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    • 2017
  • Sedation or general anesthesia is often required to offer dental treatment to patients with special needs. However, patients with ASA classification of III or higher are not indicated for moderate sedation and might be exposed to danger when treated at outpatient dental clinic. For this reason, it is recommended to treat those patients under general anesthesia. The dental team can supervise and monitor the whole procedures during treatment with an appropriately equipped facility. This case report describes the dental treatment of a 7-year-old girl with multiple disabilities. Preoperative evaluation including medical consultation was carried out thoroughly and dental treatment was performed under general anesthesia safely.

Management of Idiopathic Interstitial Pneumonia Treated only with Traditional Korean Medicine: a Case Report

  • Kang, Ji-Young;Han, Jong-Min;Kim, Jun-Young;Jung, In-Chul;Kang, Wee-Chang;Oh, Young-Seon;Lee, Jin-Woo;Park, Yang-Chun
    • The Journal of Korean Medicine
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    • v.35 no.4
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    • pp.104-109
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    • 2014
  • Objectives: To present the case of a 76-year-old man diagnosed with idiopathic interstitial pneumonias (IIPs) treated exclusively with traditional Korean medicine (TKM). Methods: The patient was treated with the revised Sasammaekmundong-tang (rSMT), acupuncture, and pharmacopuncture from September 2013 to May 2014 in our outpatient clinic. We prescribed rSMT three times a day for 4 months. Acupuncture and pharmacopuncture were performed twice a week for 9 months. To evaluate therapeutic efficacy, we recorded the patient's chief complaints at each visit, and pulmonary function test was performed at intervals of three months. Chest radiography and chest computed tomography were performed before and after treatment, respectively. Results: During the course of the treatment, dyspnea, cough, sputum, and overall pulmonary function improved. Conclusions: We suggest that traditional Korean medicine (TKM) for IIPs patients might be effective in the control of the main symptoms of IIPs and in the recovery of respiratory function.

Psychosocial Analysis of Cancer Survivors in Rural Australia: Focus on Demographics, Quality of Life and Financial Domains

  • Mandaliya, Hiren;Ansari, Zia;Evans, Tiffany;Oldmeadow, Christopher;George, Mathew
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2459-2464
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    • 2016
  • Background: Cancer treatments can have long-term physical, psychological, financial, sexual and cognitive effects that may influence the quality of life. These can vary from urban to rural areas, survival period and according to the type of cancer. We here aimed to describe demographics and psychosocial analysis of cancer survivors three to five years post-treatment in rural Australia and also assess relationships with financial stress and quality of life domains. Materials and Methods: In this cross-sectional study, 65 participants visiting the outpatient oncology clinic were given a self-administered questionnaire. The inclusion criteria included three to five years post-treatment. Three domains were investigated using standardised and validated tools such as the Standard Quality of Life in Adult Cancer Survivors Scale (QLACS) and the Personal and Household Finances (HILDA) survey. Included were demographic parameters, quality of life, treatment information and well-being. Results: There was no evidence of associations between any demographic variable and either financial stress or cancer-specific quality of life domains. Financial stress was however significantly associated with the cancer-specific quality of life domains of appearance-related concerns, family related distress, and distress related to recurrence. Conclusions: This unique study effectively points to psychosocial aspects of cancer survivors in rural regions of Australia. Although the majority of demographic characteristics were not been found to be associated with financial stress, this latter itself is significantly associated with distress related to family and cancer recurrence. This finding may be of assistance in future studies and also considering plans to fulfil unmet needs.

The practical study of contralateral therapeutic theory in acupuncture approach -about the change in the blind spot mapping pre and post acupuncture- (針의 巨刺法에 對한 實證的 硏究 -眼球의 Blind spot 變化에 對하여-)

  • Woo, Young-Min;Nam, Young
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.13 no.2
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    • pp.200-210
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    • 2000
  • objective to ascertain whether the concept of the therapeutic side is associated with changes in the blind sport mapping that represents the brain function. design Physiological blind spot maps were used as an integer of brain activity before and after acupuncture needling on the meridian point Hapkok(合谷) and Techung(太衝) in the unilateral side decided by double-blind controlled study(20 subjects). setting outpatient clinic participants: adult volunteers intervention twenty subjects were divided into two comparative groups and underwent specific acupuncture therapy on the unilateral side. Blinded examiners obtained reproducible pre and post-acupuncture cortical maps, which were subjected to statistical analysis. main outcome measures Brain activity was demonstrated by reproducible circumferential measurements of cortical hemispheric blind spot maps before and after acupuncture on the unilateral side. in case of acupuncture needling on the ipsilateral side of an enlarged side of bilnd spot, there were reduction of blind spot in 7 cases of 10 subjects, and enlargement in 3 cases. in case of acupuncture needling on the contralateral side of the enlarged side of blind spot, there were enlargement of blind spot in 6 cases of 10 subjects, and reduction in 4 cases. results the significant changes in the blind spots before and after acupuncture were observed Acupuncture needlings on the ipsilateral or contralateral side of an enlarged cortical map were associated with the concept of the therapeutic side traditionally accepted in the oriental medical society. Acupuncture needling on the ipsilateral side of an enlarged blind spot map is associated with the reduction of map, and increaed contralateral cortical activity. Acupuncture needling on the side opposite an enlarged blind spot map is associated with the enlargement of map, and decreased cortical activity. conclusion Reproducible maps of cortical responses can be used to measure the neurological consequences of acupuncture needling. Acupuncture can affect the somatic sensory informations that reach to the contralateral thalamus, and so affect thalamic integration. we found that acupuncture therapy may be associated with an increase or a decrease in brain function depending on the side of acupuncture needling. thus, the traditional concept of the contralateral therapeutic theory in acupuncture approach has the clinical significance in the view of brain function.

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Health-related Quality of Life in Korean Patients with Rheumatoid Arthritis: Association with Pain, Disease Activity, Disability in Activities of Daily Living and Depression (류마티스 관절염 환자의 건강관련 삶의 질 영향요인 분석: 통증, 질병활성도, 일상생활 수행능력 장애 및 우울과의 관련성)

  • Uhm, Dong-Choon;Nam, Eun-Sook;Lee, Ho-Yeon;Lee, Eun-Bong;Yoon, Young-Im;Chai, Gong-Ju
    • Journal of Korean Academy of Nursing
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    • v.42 no.3
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    • pp.434-442
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    • 2012
  • Purpose: The purpose of this predictive study was to identify factors affecting health related quality of life (HRQoL) in patients with rheumatoid arthritis (RA). Methods: The participants in this study were 131 patients with RA who were recruited from the outpatient clinic of a university hospital in Seoul. Disease activity in rheumatoid arthritis was evaluated by calculating the Disease Activity Score 28. Disability in activities of daily living (ADL) was assessed with the Korean Health Assessment Questionnaire, and depression with The Center for Epidemiologic Studies Depression Scale. HRQoL was evaluated using The Short Form 36 Health Survey. Data were analyzed using descriptive statistics, correlation, and hierarchical multiple regression. Results: Pain, disability in ADL, disease activity, and depression correlated negatively with physical and mental dimensions of HRQoL. But hierachical multiple regression analysis revealed that disability in ADL and depression were the only variables negatively influencing physical and mental QoL after adjustment for influences of sociodemographic variables. Conclusion: Results of this study suggest that disability in ADL and depression, rather than disease activity and pain have profound effects on HRQoL in patients with RA. Further studies are needed to assess the predictive ability of disease activity and pain on HRQoL in this population.

A Study on Spouse Support, Self Esteem and Psychosocial Adjustment of Patients in Mastectomy (유방절제술 환자의 배우자 지지, 자아존중감 및 사회심리적 적응에 관한 연구)

  • Lee, Eun-Young;Kim, Chung-Nam
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.550-563
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    • 1998
  • This study was designed to provide the basic data of effective nursing intervention for alleviation of psychosocial adjustment of patients in mastectomy after identifying the correlation between the spouse support, self esteem and psychosocial adjustment. The study subjects were 83 postmastectomy patients who visited the outpatient clinic at 3 university hospitals in Taegu city from September 10, 1997 to October 16 1997. Data was collected by researcher and face to-face interview was conducted. Nam's spouse support scale(1987), Rosenberg's self esteem instrument (1965), Derogatis' Psychosocial Adjustment to Illness Scale were used. The data were analyzed by using descriptive statistics, Pearson correlation coefficient, t -test and ANOVA with the SAS program. The results of this study were as follows: 1. The mean score for the spouse support of the subjects was 3.73, self esteem was 3.69 and psychosocial adjustment was 3.61points. 2. According to the patient's hope of breast reconstruction(t=2.04, p=0.0445), there was significant difference of self esteem. According to the patient's family number( t = 2.31, p = 0.0237), there was significant difference of the psychosocial adjustment. 3. Perceived spouse support and self esteem had statistically significant positive correlations(r= 0.5120, p=0.0001). Perceived spouse support and psychosocial adjustment had statistically significant positive correlations(r=0.4187, p=0.0001). Perceived self esteem and psychosocial adjustment had statistically significant positive correlations(r = 0.6296, p=0.0001). Therefore, to increase the level of psychosocial adjustment of patients in mastectomy, it will be effective to supportive nursing intervention by improving spouse support and enhancing self esteem.

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