• Title/Summary/Keyword: Patient Comfort

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Treatment of Venous Stasis Ulcer with $3M^{TM}$ $Coban^{TM}$ 2 Layer Compression System: A Case Report (두겹 압박방식 $3M^{TM}$ $Coban^{TM}$을 이용한 울혈성 정맥궤양의 치료: 증례보고)

  • Chu, Ho-Jun;Son, Dae-Gu;Kim, Jun-Hyung;Han, Ki-Hwan;Kim, Hyung-Tae
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.699-702
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    • 2011
  • Purpose: Venous stasis ulcer is the most severe form of chronic venous insufficiency and this commonly appears in the lower limb. Pharmacological therapy, reconstruction of the venous system, surgical management, cellular therapy and compression therapy are known as the treatments of venous stasis ulcer, but relapses are common, which make it a typical chronic wound. We report here on a case of recurrent venous stasis ulcer that healed with compression therapy without any other treatment. Methods: A 35-year-old man with a 13 years history of venous stasis had developed an ulcer on the distal third portion of the lower left limb which was developed 12-year before enrollment in this study. He had been treated with vacuum assist closure, 2 times of cell therapy and 3 times of skin graft for 8 years, but the lesion recurred. From November, 2008 compression therapy was done with the 3M $Coban^{TM}$ 2 Layer Compression System (3M, St. Paul, USA). The ulcer at that time was oval shaped and $3{\times}4$ cm in size. A comfort layer bandage was applied from the proximal phalanx of the great toe to the knee. A compression layer bandage was applied on the previous layer with it being overlapped one half the width of the comfort layer bandage. The dressing was changed every 4 days and the change was recorded with photography. Results: A total of 12 $Coban^{TM}$ 2 Layer Compression Systems were used. The size of the ulcer decreased to $2.5{\times}2.5$ cm in one month, to $2{\times}2$ cm in 2 months, it was $1{\times}1.8$ cm in size at 3 months and it completely healed in 4 months. Conclusion: The venous stasis ulcer was completely healed using the 3M $Coban^{TM}$ 2 Layer Compression System. This method was easy to apply, made the patient comfortable and it provided an excellent compression effect. As in the previous studies, this compression therapy has been proven to play an important role for the treatment and prevention of venous stasis ulcer.

The Analysis of Trends and Contents of Nursing Intervention Research for Stroke Patients in Korea (국내 뇌졸중 환자를 대상으로 한 간호중재 연구현황 및 분석)

  • Hong, Myung-Sun;Jo, Hyun-Sook;Yom, Young-Hee;Kim, Geun-Myun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.1
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    • pp.109-121
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    • 2012
  • Purpose: This study was conducted to provide background information on nursing interventions to further enhance the quality of nursing practice and related professions, based on those performed for stroke patients. Methods: The analysis was performed in light of 84 researches papers on nursing intervention published between 1990 and 2010, and based on NIC(Nursing Interventions Classification) and NOC(Nursing Outcomes Classification). Results: 1. The quasi-experimental design was used as the most primary form of research design across 69 papers that constitute 82% of the total. 2. The number of nursing intervention methods identified throughout 84 research papers was 144. Based on the NIC that 90(62.5%) of those interventions fell into the physiological basic domain while 53(36.8%) belonged to the behavioral domain. 2) Interventions on activity and exercise management, physical comfort promotion, patient education conducted by class level of NIC were 40(27.78%), 34(23.61%), and 31(21.53%) respectively. 3) Outcomes of mobility, psychological well-being, energy maintenance, health & life quality measured by class of NOC among 317 dependent variables 79(24.92%), 64(20.19%), and 63(19.87%) respectively. Conclusion: Most interventions were classified as belonging to few particular domain types, which triggers needs for the development and application of multidisciplinary intervention methods through a more collective approach.

A Study of Perceived Discomfort of The Patients Under Local Anesthesia - Centering Around the Development of Measures - (국소마취 수술환자의 불편감에 관한 연구 - 도구개발을 중심으로 -)

  • Lee, Gyeong Sug;Kim, Mi Ja;Park, Sun Mi;Paek, Sun Young;Lee, Yang Sug;Bae, Sang Do;Choi, Jung Hoon
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.6-17
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    • 2000
  • Background : This study was attempted to provide a basic information necessary for the development of measures evaluating perceived discomfort of the patients under local anesthesia and the developments of nursing intervention and nursing standard. Method : The study subjects were a convenience sample of 100 surgical patients under local anesthesia. The researcher visited the patients directly and explained the purpose of the study to them. Then they were asked to fill out questionnaires which were developed and structured by the researcher, under their prior permission. Out patient's data were collected at recovery room after operation. Results : Factor analysis on measures evaluating the patients under local anesthesia showed that the measures consisted of eight factors including "explanation", "humane treatment", "motion limitation", "pain", "no togetherness", "waiting", "the environment of operating room", and "unkindness". When analyzing each of the factors regarding their degree of contribution to perceived discomfort, it was found that "waiting" was highest in terms of the degree. According to general chara-cteristics of the sampled patients, the factor of "explanation" contributed to perceived discomfort more in male patients than female ones. Regarding parts of medical examination, the patients of otorhinolaryngology felt perceived discomfort most because of the factor of "pain". Conclusion : To relieve perceived discomfort the patients under local anesthesia require providing individually systematized nursing services which can reduce perceived discomfort according to each of the factors. In doing so, an unlimited attention and much effort should be given to realize CQI reaching the dimension of increase in comfort as well as decrease perceived discomfort.

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Development of a 2-DOF Ankle Mechanism for Gait Rehabilitation Robots (보행 재활 로봇을 위한 2자유도 족관절 기구 개발)

  • Heo, Geun Sub;Kang, Oh Hyun;Lee, Sang Ryong;Lee, Choon-Young
    • Journal of Institute of Control, Robotics and Systems
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    • v.21 no.6
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    • pp.503-509
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    • 2015
  • In this paper, we designed and tested an ankle joint mechanism for a gait rehabilitation robot. Gait rehabilitation programs are designed to improve the natural leg motion of patients who have lost their walking capabilities by accident or disease. Strengthening the muscles of the lower-limbs and stimulation of the nervous system corresponding to walking helps patients to walk again using gait assistive devices. It is an obvious requirement that the rehabilitation system's motion should be similar to and as natural as the normal gait. However, the system being used for gait rehabilitation does not pay much attention to ankle joints, which play an important role in correct walking as the motion of the ankle should reflect the movement of the center of gravity (COG) of the body. Consequently, we have designed an ankle mechanism that ensures the safety of the patient as well as efficient gait training. Also, even patients with low leg muscle strength are able to operate the ankle joint due to the direct-drive mechanism without a reducer. This safety feature prevents any possible adverse load on the human ankle. The additional degree of freedom for the roll motion achieves a gait pattern which is similar to the normal gait and with a greater degree of comfort.

Clinical Study on Effect of Auricular acupuncture theraphy and Auricular acupuncture theratphy with common acupuncture theraphy(Shinmum HT7) on Insomnia in stroke patients (뇌혈관장애환자의 불면증에 대한 이침요법과 신문혈자침 병행시술의 치료효과에 대한 비교연구)

  • So, Woong-ryong;Park, Won-tae;Lee, Sun-ho;Sin, Kyung-ho;Roh, Jeong-du;Choi, Seok-woo;Kim, Jae-gwan
    • Journal of Acupuncture Research
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    • v.20 no.5
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    • pp.38-49
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    • 2003
  • Objective: This study is aimed to compare the change of clinical comfort and improvement after auricular acupuncture theraphy and auricular acupuncture theraphy with common acupuncture theraphy(Shinmun HT7) on insomnia in stroke patients. Methods : Clinical study was carried out on 40 stroke patients who was traeted insomnia by auricular acupuncture theraphy and auricular acupuncture theraphy with common acupuncture theraphy(Shinmun HT7) at Kwang-Dong Oriental Medical Hospital. Results: 1. Total sleeping time was increased in auricular acupuncture theraphy and auricular acupuncture theraphy with common acupuncture theraphy(Shinmun HT7). 2. Average delaying time before sleep and Average Awake Times was decreased in auricular acupuncture theraphy and auricular acupuncture theraphy with common acupuncture theraphy(Shinmun HT7). 3. Quality of sleep was improved in auricular acupuncture theraphy and auricular acupuncture theraphy with common acupuncture theraphy(Shinmun HT7). 4. Insomnia Score was increased in auricular acupuncture theraphy and auricular acupuncture theraphy with common acupuncture theraphy(Shinmun HT7). Conclusions : According to the results, both auricular acupuncture theraphy and auricular acupuncture theraphy with common acupuncture theraphy(Shinmun HT7) were effective on insomnia in stroke patient. but, auricular acupuncture theraphy was more effective than auricular acupuncture theraphy with common acupuncture theraphy(Shinmun HT7) in total sleeping time and insomnia score.

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Congenital Polydactyly of the Foot (선천성 족부 다지증)

  • Hwang, Kuhn-Sung;Kim, Tae-Seung;Sung, Il-Hoon;Park, Jun-Sic
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.2
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    • pp.120-128
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    • 2001
  • Purpose: This study was undertaken to review the precise morphological patter'ns of polydactyly of the foot and to evaluate outcomes of surgical interventions. Materials and Methods: The records of patients who had polydactyly of foot from 1983 to 2000 were reviewed retrospectively. 29 duplicated toes(24 patients) were analyzed. All cases were evaluated and classified with Temtamy and McKusick's axial pattern, Watanabe's morphologic pattern and level of duplication. Clinical evaluation was performed according to Phelps and Grogan's. Mean age at surgery was 5.7 years(range: 10 months$\sim21$ years). All the patients were subsequently evaluated during mean 17 months(range: 13 months-$\sim5$ years). Results: Preaxial polydactyly was seen in 3 cases, central polydactyly in 3 cases, postaxial polydactyly in 22 cases and remaining 1 case was multiple my involvement. Only 2 patients have familial history and the most common associated anomaly was hand deformity(20.8%). Clinical results were excellent in 14 cases, good in 5 cases, poor in one. 17 patients(70%) were operated before 6 years olds and they had better results than those of who were operated after 6 years olds. Conclusion: The Method of surgical correction for the polydactyly should be individualized by its morphological pattern because the purpose of operation was to give comfort in wearing shoes and patient's psychological relief. This study showed that polydactyly of the foot could be corrected surgically with good results in most cases, and the better results would be achieved if the operation is performed before preschool age according to its individualized pattern of duplication.

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XPS® Microresector for Treatment of Axillary Osmidrosis (XPS® Microresector(Shaver)를 이용한 액취증 수술)

  • Han, Byung Ki;Park, Sung Wook;Song, Jea Yong;Kim, Chung Hun
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.569-573
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    • 2008
  • Purpose: Surgical excision of the subcutaneous tissues, with or without skin excision in the axillary hair-bearing area, has been the treatment of choice in treating osmidrosis for several decades. However, long periods of postoperative immobilization of a shoulder joint, partial necrosis of skin flaps or the possibility of hematoma and scars have occurred frequently. So we used $XPS^{(R)}$ microresector(Shaver) in procedure which requires removal of soft tissue for comparing results between surgical excision and the laters. Methods: From January 2007 to February 2008, a total of 20 patients(8 male and 12 female) underwent $XPS^{(R)}$ microresector(Shaver) assisted aspiration for treating osmidrosis. The mean age of the subjects was 21.9, and we tried to analyze some advantages of $XPS^{(R)}$ microresector(Shaver). Results: The average operation time was 61.6 minutes. This results can show that the patients who received $XPS^{(R)}$ microresector(Shaver) assisted aspiration can accomplish better outcomes than any other procedures in terms of operation time at least. Moreover, no significant postoperative complications occurred in our studies. Subjects have been followed up from 2 months to 1 year and among these patients, no one suffered from critical complications. Conclusion: In brief, $XPS^{(R)}$ microresector(Shaver) is able to shorten the time of operation and simplify the procedures relatively and this device has more superiorities in wound healing by maintaining of vascularized dermal skin flaps. It means that $XPS^{(R)}$ microresector (Shaver) can prevent flap necrosis, axillary hair loss and minimalize scarring and bleeding. Thus, we expect that these advantages can lead to better patient's comfort and self-confidence than several previous procedures.

The Effects of viscosity and Osmolality of Enteral Solution on Flow Rates Through Nasogastric Tubes in Vitro (경관급식 유동액의 점도와 삼투압이 체외에서 비장관 튜브를 통한 흐름속도에 미치는 영향)

  • 한경희
    • Journal of Nutrition and Health
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    • v.26 no.6
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    • pp.793-803
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    • 1993
  • This study was designed to measure viscosity, osmolality and in vitro flow rates via nasogastric tubes for 6 types of commercially available and 9 hospital-blenderized enteral solutions and to examine the effect of viscosity and osmolaility of enteral formula on the flow rates in gravity drip administration. Each solution was infused through 18, 16, 14, 12 French sizes of silicone rubber tube. Flow rates were measured six times at $25^{\circ}C$ using formula bags and drip sets hung at a uniform height on a intravenous drip stand with tube uniformly positioned in collecting container. Viscosity ranged widely from 16.0 to 195.5 cps with mean, 64.61$\pm$64.42 for hospital-blenderized formula while mean viscosity of commercial formula was 7.60$\pm$4.84 cps. Mean osmolality of commercial formula and hospital-blenderized formula were 370$\pm$100.80, 540.33$\pm$89.37 mOsm/kg respectively. There was negative relationship between viscosity of formula and flow rates through tubes but no significant relationship between flow rates and osmolalty. Some of hospital-blenderized formula was too viscous to be infused througth tube with gravity drip administration and the recipe of formula requires to be modiifed. On the other hand, commercial formula with the low viscosity flows too rapidly with large bore size tubes. Smaller size of tube must be selected for hyperosmolar solution to decrease possible side effects associated with tube feeding. Two kinds of regression equations for flow rates obtained according to viscosity and tube sizes were also presented for the purpose of practical uses. In conclusion, this study emphasizes that viscosity of fomula, osmolality, patient's tolerance and comfort, caloric density should be considered in the selection of tubes for gravify drip administration.

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Development and Validation of a Measurement to Assess Person-centered Critical Care Nursing (중환자실 간호사의 인간중심 간호 측정도구 개발)

  • Kang, Jiyeon;Cho, Young Shin;Jeong, Yeon Jin;Kim, Soo Gyeong;Yun, Seonyoung;Shim, Miyoung
    • Journal of Korean Academy of Nursing
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    • v.48 no.3
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    • pp.323-334
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    • 2018
  • Purpose: The purpose of this study was to develop a scale to measure person-centered critical care nursing and verify its reliability and validity. Methods: A total of 38 preliminary items on person-centered critical care nursing were selected using content validity analysis of and expert opinion on 72 candidate items derived through literature review and qualitative interviews. We conducted a questionnaire survey with 477 nurses who worked in intensive care units. The collected data were analyzed using exploratory factor analysis (EFA) and confirmative factor analysis (CFA) with SPSS and AMOS 24.0 program. Results: EFA was performed with principal axis factor analysis and Varimax rotation. The 15 items in 4 factors that accounted for 50.8% of the total variance were identified by deleting the items that were not meet the condition that the commonality should be .30 or more and the factor loading over .40. We named the factors as compassion, individuality, respect, and comfort, respectively. The correlation coefficient between this scale and the Caring Perception Scale was r=.57 (p<.001), which determined concurrent validity. The item-total correlation values ranged from .39 to .63, and the internal consistency for the scale was Cronbach's ${\alpha}=.84$. Conclusion: The reliability and validity of the 15 item person-centered critical care nursing scale were verified. It is expected that the use of this scale would expand person-centered care in critical care nursing.

A Study on Self-care Behavior Types of Hypertensives : Q-methodological Approach (고혈압환자의 자가간호행위 유형에 관한 연구 : Q 방법론 적용)

  • Park Young-Im
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.39-57
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    • 1999
  • Essential hypertension is a typical chronic disease requiring adequate and continuous management. And many studies supported that self-care was the essential factor to promote the wellbeing. The purpose of this study is to identify and understand the behavior patterns of self-care in hypertensives. As a research method, 35 Q-statements were collected through Individual interviews and review of the related literatures. 21 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. There were 6 different self-care types classified as follows 1) Type 1 was the self-oriented control type, monitoring the blood pressure and taking the low salt diet. But they didn't take the anti -hypertensive drug and visit the health agency regularly. 2) Type 2 was the stress-control type. Their main activities were meditation to relieve the stress and communication with family. 3) Type 3 was called daily-life control type. This type tried to make their mind comfort and think positively. They also preferred walking and exercise regularly. 4) Type 4 was the medical-oriented control type, taking the anti-hypertensive drug, visiting the medical personnel and following the medical regimens. 5) Type 5 was the medication-oriented type. They only took the anti -hypertensive drug regularly and didn't any other self-care like as monitoring the blood pressure, taking the low salt diet and exercise. 6) Type 6 was called non-medication control type. This type had no medication, but tried to visit the health agency and health personnel. From the above results, it can be concluded that the self-care types were very various and self-care education have to provide individually according to the characteristics of self-care type. Another repeated study can be recommended to improve the nursing intervention the self-care behavior in chronic patient like as diabetics or rheumatoid arthritis.

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