• 제목/요약/키워드: Patient family

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The art of diabetes care: guidelines for a holistic approach to human and social factors

  • Muhammad Jawad Hashim
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.218-222
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    • 2023
  • A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

아동의 발달지연과 가족환경과의 관련성 (Relation of Developmental Delay and Family Environment of Children in Community)

  • 이성아;박수현
    • 한국콘텐츠학회논문지
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    • 제10권11호
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    • pp.275-284
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    • 2010
  • 본 연구는 3-5세 아동을 대상으로 발달선별검사인 K-DDSTII, K-ASQ을 실시하여 발달지연 결과를 가진 하부검사와 가정환경 간의 관련성을 알아보았다. 연구결과, K-DDST에서는 가족환경 중 아버지의 나이와 개인사회성, 어머니의 나이와 교육력이 대동작과 통계적으로 차이가 있었다. 또한 K-ASQ에서는 의사소통과 성별, 출생순서와 부모의 교육력에서 통계적으로 유의한 차이가 있었으며, 문제해결과 출생순서, 그리고 하부검사 중 하나이상의 발달지연이 있는 경우는 성별과 출생순서와 유의미한 통계적 차이가 있었다. 본 연구결과 발달선별 검사 시에 가족환경에 관한 조사가 병행된다면 아동 발달에 대한 선별검사의 효율성을 높이는 방안의 하나일 수 있음을 제시 할 수 있을 것이다.

뇌졸중 환자 가족의 부담감과 병원서비스 만족도 (The Family Burden and Hospital Satisfaction of Family Caregivers f Cerebral Ischemia Patients)

  • 김은정;김순례
    • 가정∙방문간호학회지
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    • 제7권1호
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    • pp.83-93
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    • 2000
  • This study was conducted to provide the data for the improvement of cerebral ischemia patient nursing services through the investigation of burden and hospital service satisfaction by family caregivers who were nursing the cerebral ischemia inpatients. The study subjects consisted of 125 family caregivers who were enrolled in four university hospitals with over 300 beds and one Chinese medicine hospital with over 100 beds. The Data were collected from all of the personal subjects using standardized questionnaires by interview from March 1 to March 30 in 2000. Data were analyzed by using t-test, ANOVA. Scheffe's multiple comparison, and Pearson's Correlation Coefficients. The results were as follows: 1. The mean score of burden felt by family caregivers who were nursing the stroke patient was 2.18. In relation to the characteristics of patients, higher scores were shown in male patients who were over 80 years old, and patients who had from 4 to 12 days care giving, over three month duration of admission, from one month to three month duration of illness. The burden felt by family caregivers revealed higher score of dependency in the Activities of Daily Living. 2. The mean score of hospital service satisfaction perceived by family caregivers was 3.35. The highest hospital service satisfaction score was shown in female caregivers, and caregivers whose patients graduated from element school, and treatment method was Chinese medicine, the duration of admission was under 1 month. As a result. the family caregivers' burden was seemed to be high when the patients who were old, male and as care giving time, duration of admission, duration of illness were getting longer. In conclution, hospital service satisfaction was good, but the satisfaction was tend to decrease that family caregivers who were male, higher education background and duration of patients' admission getting longer.

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말기암 환자 가족에 대한 호스피스 팀의 정보적 지지 제공 효과 (Effect of Informational Support by Hospice Team on Family Caregivers of Terminally III Cancer Patient)

  • 이혜원;김정남;박명화
    • 지역사회간호학회지
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    • 제12권1호
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    • pp.175-186
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    • 2001
  • To evaluate the effect of informational support by hospice team on family caregivers of terminally ill cancer patients. 22 family caregivers of D University Hospital in Daegu city were participated. The research was conducted from Aug. 16th to Oct. 28th 2000 by using self-reported questionnaires. The instruments used in this study were the Weinert's scale of perceived social support. Spielberger's state anxiety inventory. CES-D. and Ellison and Paloutzian's spiritual well-being scale. The intervention was designed to give educational and counselling program up to 7 times within 4 weeks. Educational and counselling booklets which made by the researcher were used step by step by hospice team, he data were analysed frequency. percentage. Wilcoxon Singed Ranks Test with SPSS Win l0.0/PC. The results obtained from this study were as follows; 1. The perceived social support of family caregivers was significantly increased after ready planned informational support was applied by hospice team(z=-3.045. p=0.002). 2. The anxiety of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z =-3:348. p=0.001). 3. The depression of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z=-3.641. p=0.000). 4. The spiritual well-being score of family caregivers was not significantly improved after ready planned informational support was applied by hospice team(z=-0.422. p=0.673). In conclusion. the results of this study clearly suggests that the informational support provided by hospice team not only increased the family caregivers' who are caring for terminally ill cancer patients. Therefor the informational support program designed by researcher for family caregivers who are caring for terminally ill cancer patients should be utilized and expended.

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헬스 케어를 위한 RDMS 설계 (Design of Rough Set Theory Based Disease Monitoring System for Healthcare)

  • 이병관;정은희
    • 한국통신학회논문지
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    • 제38C권12호
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    • pp.1095-1105
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    • 2013
  • 본 논문에서는 헬스 케어 시스템에서 효율적으로 질병을 관리할 수 있는 RDMS(Rough Set Theory based Disease Monitoring System)을 제안한다. RDMS는 DCM(Data Collection Module), RDRGM(RST based Disease Rule Generation Module), HMM(Healthcare Monitoring Module)로 구성된다. DCM은 바이오센서로부터 환자의 생체 정보를 수집하고, 데이터 처리 절차에 따라 RDMS DB에 저장한다. RDRGM은 RST의 코어와 속성의 지지율을 이용하여 질병 규칙을 생성한다. HMM은 DCM에 의해 수집된 환자 정보를 이용하여 환자의 질병에 대한 위험지수뿐만 아니라 질병에 대한 합병증에 관한 위험지수까지 분석함으로써 환자의 질병을 예측하고, 환자의 위험지수에 따라 환자, 주치의 등에 시각화된 환자의 정보를 전달한다. 또한, RDRGM에 의해 생성된 규칙들에 따라 환자의 의료정보, 현재의 환자건강상태, 환자 가족력 등을 비교분석하여 환자의 질병을 예측하고, 예측결과에 따라 환자 맞춤형 의료 서비스와 의료 정보를 신속하고 신뢰성 있게 제공할 수 있다.

서울 S지역에서 발생한 영아 메트헤모글로빈혈증 1례의 원인구명을 위한 역학조사 (Epidemiologic Investigation to Identify the Cause of an Infant Methemoglobinemia)

  • 김영열;최보율;박항배;김민영;여인학
    • Journal of Preventive Medicine and Public Health
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    • 제26권2호
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    • pp.192-201
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    • 1993
  • Epidemiologic investigation was conducted on January, 1993 in Seoul to identify the cause of an infant methemoglobinemia. Field investigation of the area of outbreak, survey of household and family members, analysis of ground water, and blood tests of involved family members were performed. Following results were obtained On analyzing the quality of the ground water on patient's household high levels of nitrate was found indicating contamination of water as the cause of a methemoglobinemia outbreak. On analysing the quality of the ground waters on seven other places within the neighborhood five were contaminated by nitrate in concentration that exceeded the permissible limit implying presence nearby source of contamination. Sources of contamination were thought to be originating from human waste in conventional bathroom facilities, chicken manure used in nearby orchards and plant fields or fertilizers. But the results of water analysis with presence of bacteria or E.coli, concentration of potassium, phosphate and the past history of diarrhea among family members, chicken manure suggested the most possible source of contamination. To evaluate the health status of members in the neighborhood past history was reviewed revealing no prior existence of patient with cyanosis and 65 people in the neighborhood had normal levels of methemoglobin concentration in their blood. Conclusively, the ground water on patient's household was contaminated with nitrate and despite provision of adequate water supply, family members of the patient along with their distrust in the water supply system had used ground water as their source of drinking water resulting of methemoglobinemia. Many suburban area of Seoul and country side thought to be having similar problems concerning contaminated ground water supply and dormant outbreak of patients as a result of the drinking of the contaminated water. Epidemiologic investigation and water analysis of ground waters are advised.

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동영상 기반 간호정보제공이 중환자실 입원 환자 가족의 환경적 스트레스, 불안과 간호요구 만족도에 미치는 효과 (The Effects of Video-based Admission Education on Environmental Stress, Anxiety and Nursing Needs Satisfaction among Family members with Patient in ICU)

  • 이문경;이윤미
    • 중환자간호학회지
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    • 제5권1호
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    • pp.1-11
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    • 2012
  • Purpose:The purpose of this study was to examine the effects of video-centered information among family members intensive care unit (ICU). Methods: A quasi-experimental, nonequivalent control group, pretest-posttest design was used. Participants (n=86) were family members who were the main caregivers for the patient in ICU. An experimental group (n=43) watched a video while the control group (n=43) was provided a leaflet. Levels of environmental stress, anxiety and nursing need satisfaction were measured by questionnaires before and after the interventions. Data were analyzed with ${\chi}^2$ test, paired t-test, independent t-test, Fisher's exact test and ANCOVA. Results: There were no differences in environmental stress (F=1.88, $p$=.065), and anxiety (t=0.37, $p$=.711) between 2 groups, but there was a significant difference in nursing need satisfaction (t=3.01, $p$=.004). Conclusion: Providing video-centered information would be an effective nursing intervention by improving nursing need satisfaction among family, the main caregivers members of patients in ICU.

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가족 지지와 삶의 질이 남자 관상동맥질환자의 금연에 미치는 영향 (Effects of Family Support and Quality of Life in Relation to Smoking Cessation in Male Patient with Coronary Artery Disease)

  • 손행미;이은남
    • 기본간호학회지
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    • 제15권1호
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    • pp.71-79
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    • 2008
  • Purpose: The purpose of this study was to identify effects of family support and quality of life on smoking cessation in patients with coronary artery disease. Method: Data were collected using a self-reported questionnaire included smoking history, family support and quality of life (QOL). The participants were 159 male patient with coronary artery disease who were current smokers or ex-smokers. A logistic model was developed to estimate the likelihood of current smoker or ex-smoker. Results: Of the participants, 28.3% were current smokers and 71.7% were ex-smokers. The mean score for family support was 27.41 for positive support and 23.11 for negative support. The mean score for QOL was 50.48. There were significant differences in QOL according to smoking status. The predictors of smoking cessation were social interaction QOL and self-control QOL, and duration of smoking. The model correctly classified 89.5% of ex-smokers and 44.4% of current smokers and the correct classification for the total was 76.8%. Conclusion: Social interaction QOL, self-control QOL and duration of smoking were significant variables in prediction of smoking cessation. QOL should be considered in developing smoking cessation interventions. It is advisable to also examine the mediating effect of family support on quality of life.

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혈액투석 환자의 가족지지, 자기효능감 및 피로가 삶의 질에 미치는 영향 (The Effect of Family Support, Self-efficacy, and Fatigue on the Quality of Life in Hemodialysis Patients)

  • 이영희;김혜숙
    • 동서간호학연구지
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    • 제21권1호
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    • pp.1-9
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    • 2015
  • Purpose: This study was attempted to provide the foundations for the nursing intervention program that could improve hemodialysis patient's quality of life by examining influences of family support, self-efficacy and fatigue on quality of life among hemodialysis patients. Methods: We have surveyed 200 patients that aged 18 or older being diagnosed with end-stage renal disease (ESRD) and are receiving hemodialysis treatment in three general hospitals equipped more than 400 beds, one specialized dialysis clinics located in city M. Using the SPSS 17.0 windows program, gathered data were analyzed by number, percentage, mean, standard deviation, t-test, ANOVA, Duncan, Pearson's correlation coefficients and multiple regression analysis. Results: We found the factors that had great influences on patient's quality of life were family support (${\beta}=.155$, t=2.18, p=.031), fatigue (${\beta}=-.487$, t=-7.73, p<.001), and monthly income (${\beta}=.147$, t=2.36, p=.019). Explanatory power of this model was 49.6%. Conclusion: The quality of life of the hemodialysis patients on hemodialysis is affected by family support, fatigue, and monthly income. The higher monthly income, family support and the less fatigue, the more likely they can improve their quality of life.

류마티스 관절염 환자의 심리사회적 요인과 증상과의 관계 (The Relationship between Psychosocial Factors and Symptoms of Patient with Rhematoid Arthritis)

  • 강현숙;한상숙
    • 근관절건강학회지
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    • 제6권2호
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    • pp.295-309
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    • 1999
  • This study was done to Identify the relations between psychosocial factors and symptoms of patient with rheumatoid arthritis. Its subjects were 150 outpatients selected at H. Rheumatism clinic from July to August in 1998. Data were collected by means of questionnaires using interview. Those data were analyzed by Frequency, t-test, ANOVA, pearson's correlation using SPSS window 8.0. The results were as follows : 1) The level of family support was relatively high and the level of self-efficacy and performance of daily living activities were average. Among their symptoms, fatigue and pain were frequent problems. 2) Family support was different by educational level, self-efficacy and physical, psychological symptoms were different by performance of regular exercise. 3) The family support was inversely related to physical symptoms especially ADL, while it was not related to psychological symptoms except a reverse correlation between depression and anxiety, and family support. Self-efficacy held a reverse correlation with both physical and psychological symptoms. And there was a close relationship between symptoms. In conclusion it was found that the promotion of family support, self-efficacy and exercise-performance holds a key post in reducing symptoms of rheumatoid arthritis.

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