• Journal of Hospice and Palliative Care
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• 제9권1호
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• pp.35-39
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• 2006

진행된 암에서 발생하는 범복막염은 치료하지 않으면 탈수와 패혈증으로 사망할 것이 예측되고 수술적 치료 또한 높은 사망률과 합병증을 가져오며, 적극적인 수액요법과 비위관삽입, 항생제 치료 등도 아직까지 효과가 불분명하고 오히려 증상의 악화도 가져오는 것으로 알려져 있다. 이에 대한가정의학과 완화의학 연구회 세미나에서는 77세 여자 환자로 진행된 위암과 암종증으로 완화의료를 받던 중 발생한 범복막염을 수술적 치료 대신 통증조절 및 증상 완화 위중의 치료를 하여 범복막염 발생 4일 후 평화롭게 임종을 맞이하였던 증례를 보고하였고, 이 증례를 계기로 암환자에서 발생한 복막염의 치료 및 관리에 대한 문헌 고찰과 토론을 통해 다음과 같은 결론을 제시하고자 한다. 먼저 환자의 여명, 환자의 임상적 상태, 수술적 위험성 등을 고려 한 후 비수술적 완화요법을 선택할 수 있다. 통증조절을 위해서는 비경구용 진통제를 사용할 수 있고, 필요한 경우 일시적인 비위 영양관을 삽입할 수 있고 분비물이 적어지면 제거한다. 초기에 충분한 양의 비경구 수액요법이 시도될 수 있으나, 환자의 상태가 호전되지 않으면, 오히려 이로 인한 부종과 호흡곤란 등의 부작용을 최소화하기 위해 최소한의 용량을 사용하는 것을 권장한다. 항생제 사용 및 중단 여부는 환자의 자기의사결정 및 보호자와의 논의 후 임상 상태와 여명을 고려하여 결정할 수 있다.

• 한국실내디자인학회논문집
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• 제23권2호
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• pp.182-192
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• 2014

Demands for geriatric hospital have increased in an era of rapidly aging population. Most of aged patients tend to stay in institutions for long terms. This means that the patient rooms of geriatric hospital should be given different considerations from those of normal hospital in designing interior features. They should be a homelike places for the aged patients and designed to take care of specific needs of the aged. However, most of geriatric hospitals are designed with little attention to such point. They appear almost same to normal ones. This study attempts to examine how users evaluate patients' rooms. The users are nurses, care-givers and family members of aged patients in six geriatric hospitals in Busan. They rated 12 features of patient rooms from 0 point to 100 points and described reasons why they rated in that way. Also, the walk-through was done for these six hospitals. 12 features are sizes of patient rooms, sizes and fixtures of bathrooms, sizes and locations of windows, bed layout, numbers and types of chairs, sizes and types of closet, lighting, color scheme, finishes of floor and wall, and interior design tone. Followings are findings : The users evaluated patients' rooms relatively positive. However, extra chairs for visitors, closet in patients rooms and storage in bathroom, and sizes of patients rooms and bathrooms were evaluated relatively negative.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.343-346
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• 1999

Objectives : In Korea, pharmacists can dispense medicines without doctor's prescription. This causes the high proportion of pharmaceutical expenditures. The study shows the prescribing behaviors of practicing pharmacists with the simulated patient of arthritis. We select the arthritis as a subject of simulation, because the arthritis is one of the major health problems and the abuse of cortico-steroids is usual in treatment of arthritis patients. Methods : Twenty drug stores among the 320 drug stores in a district, Seoul, Korea were randomly selected. One of the researchers visited the drug stores and received the medicines from the pharmacists after explaining standardized scenario of arthritis. The simulated patient recorded the practice behaviors of pharmacists. Results: The mean number of prescribed drugs are four and half. Among the twenty pharmacists, the nineteen prescribed non-steroidal anti-inflammatory drugs and the seven(35%) prescribed the cortico-steroids. The antacids were prescribed by the fourteen(70%) pharmacists. The five(25%) pharmacists only recommended the simulated patients to visit the medical doctors, and the three(15%) performed physical examination to the simulated patients. The three pharmacists(15%) asked the past history of the drug adverse effects and no pharmacist explained the adverse effects of prescribed medicines. Conclusions : The research shows that the cortico-steroids are frequently prescribed and the pharmacists commonly do not give the explanations of the prescribed medicines to the arthritis patients.

• 보건교육건강증진학회지
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• 제24권4호
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• pp.231-240
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• 2007

The hospital setting provides many opportunities for health promotion. There are many health professionals including physicians, nurses, medical technicians who have close contact with patients and their family. Health professionals are very influential to arouse the awareness about health and illness, and to motivate to change lifestyle among patients. Thus health professionals are most effective and important human resources for health education for patients to improve recovery rates and to promote health. In spite of the importance of health professionals' role in health promotion, the Korean government has provided little support for their health education for patients. Most of the health professionals have not learned about health education theories and skills, and have little attention to educate patients to change their lifestyle. Also the health professionals themselves have relatively poor lifestyle compared with advanced western countries. To improve health education for patients and their family, following strategies and policies should be considered: reinforcing curriculum for health education in college and training course, providing practical incentives for patient education, capacity building for health education and developing guideline for patient education, training health educators, networking and collaborating between community health center and hospitals, promoting the importance of health education among patients, researching and developing health education theory and practice including cost-benefit of health education.

• 성인간호학회지
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• 제17권5호
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• pp.709-718
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• 2005

Purpose: The research aims to understand the lived experience of the caregivers of chronic renal failure(CRF) patients and its essential meaning. The results of the study can be used as basic materials for developing comprehensive intervention methods of care givers of CRF patients. Method: The research used van Manen's hermeneutic and phenomenological research methods in order to describe the lived experience and to understand its meaning. It concentrates on the understanding the essence of experience and consists of existential survey, hermeneutic and phenomenological reflection and hermeneutic writings. Participants in this research were five women care givers of CRF patients who had hemolysis at C university hospital in a metropolitan city, the period of data collection was from July 27 to Sep. 4, 2004 and major data of results in the following 5 essential themes. "sole responsibility for the patient enduring everything", "creating their own field", "heavy and painful life without hope of their private life", "wishing not to be inherited and consoling each other". Conclusion: The above findings point out that the experience of care givers of CRF patient affected and changed all parts of an individual life and his or her family life. Therefore, it suggests that total family nursing care must be considered in order to provide the holistic caring for CRF patients and their care givers.

• PNF and Movement
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• 제8권2호
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• pp.37-46
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• 2010

Purpose : The purpose of this study was to investigate the performance level of functional independence of the stroke patient. Methods : In order to find out the functional independence of stroke patient, 160 peoples, 80 peoples in a large city and 80 peoples in small-to-medium sized city, were questioned. Result : The results of this study were as follows: 1. Functional independence level due to social factor; The comparison of functional independence level between two groups showed significant difference in educational level, religion, family member, vocation, and medical fees(P<.05). However, the two groups did not show significant difference in spouse. 2. Functional independence level due to environment factor; The comparison of functional independence level between two groups showed significant difference in place of residence and residental environment(P<.05). However, each group did not show significant difference. Conclusion : These results suggest that realization of stable housing, educational level, various physical activities, and diversified family members is essential. Also, stable environment and social satisfaction are needed to maintain and improve the health of patient.

• Journal of Genetic Medicine
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• 제9권1호
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• pp.38-41
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• 2012

A 32-year-old female patient and her sister show high levels of high density lipoprotein (HDL) cholesterol in regular health checkups, since female patient was 11 years old. The patient's serum total cholesterol was 285 mg/dL and HDL cholesterol was 113 mg/dL. Her sister's total cholesterol was 240 mg/dL and the HDL cholesterol measured to be 90 mg/dL. Lipoprotein pattern and cholesteryl ester transfer activity gene analysis were examined in these patients. We found c.1321+1G>A (IVS14+1G/A) hetero mutation in cholesteryl ester transfer protein (CETP) genes. Generally, CETP mediates transfer and exchange of triglycerides and cholesteryl ester between plasma lipoproteins. Also we investigated a key role of HDL-CE and Apo A-1 metabolism. Patients with low levels of CETP have increased serum HDL levels. We hereby report two Korean cases of CETP deficiency in a family. Brief literature review ensues with the cases.

• Clinics in Shoulder and Elbow
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• 제26권1호
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• pp.20-24
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• 2023

Background: The Friends and Family Test (FFT) developed by the UK National Health Service evaluates whether patients are satisfied with a service provided, where improvements are needed, and how likely patients are to recommend the intervention. Calculated from the FFT, the Net Promoter Score (NPS) creates a recommendation metric for treatment. The primary aim of this prospective study is to evaluate NPS for arthroscopic subacromial decompression (ASD) and rotator cuff repair (RCR). Secondary aims are to postoperatively evaluate 1-year changes in patients' Oxford Shoulder Scores (OSSs) in terms of the proportion of patients satisfied with their surgery and correlation with FFT. Methods: During a 2-year period, all patients undergoing ASD or RCR completed questionnaires prospectively. Collected preoperatively and postoperatively at 1 year. Results: NPSs were 31 for ASD (n=32) and 52 for RCR (n=39). OSSs increased by 4.3 and 6.9 for ASD and RCR, respectively (P<0.001). Overall, 75% of ASD and 77% of RCR patients were either "satisfied" or "very satisfied," respectively, with procedure outcomes. Scores from FFT had a positive correlation with improvement in OSS and satisfaction scores among patients undergoing arthroscopic shoulder surgeries (P<0.001). Conclusions: The current study shows positive NPS outcomes in patients with ASD and RCR. Scores from FFT correlate well with both satisfaction and OSS among patients. NPS can be an adjunct to traditional patient-reported outcome measures to provide global evaluation of patient experiences to aid in determining the clinical value of common procedures in shoulder orthopaedics. Level of evidence: III.

• Journal of Hospice and Palliative Care
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• 제21권3호
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• pp.75-83
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• 2018

목적: 호스피스 완화의료에서 환자의 기대 여명 예측뿐 아니라 퇴원형태를 예측하여 적절한 치료를 제공할 필요가 있다. 이번 연구에서는 입원 초기 환자의 퇴원 형태 예측에 유의한 요소들을 알아보고 효율적인 완화의료의 방향에 대해 제시하고자 한다. 방법: 2016년 4월 1일부터 2017년 12월 31일까지 P병원 호스피스 병동에 입원한 말기암환자 568명 중 377명을 대상으로 하였으며 입원 시 사정한 환자의 수행 지수, 증상 및 징후, 사회 경제적 상태와 혈액검사 자료를 바탕으로 연구를 진행하였다. 결과: 입원 당시 높은 수행지수, 양호한 증상 및 징후, 정상에 가까운 혈액검사 수치를 보일 때 생존 퇴원할 가능성이 높았다. 결론: 환자의 퇴원형태 예측에 ECOG, KPS, Global health, Mental status와 같은 수행지수, dyspnea, anorexia, dysphagia, fatigue와 같은 증상 및 징후, CBC, LFT, BUN, CRP 혈액검사 수치가 유의한 지표임을 확인하였다.

• 한국의료질향상학회지
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• 제9권1호
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• pp.66-73
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• 2002

The current health care system demands provisions for patient care in perspectives of a cost-effectiveness and patient satisfaction. Critical pathway implementation facilitates optimal sequencing and intervention timing of patient care, and makes medical team and patients participate in a treatment actively. In this study, a critical pathway was developed and implemented to patients with osmidrosis who undertake operation. Sixty patients were included in the study. The critical pathway was implemented for care of 26 patients while the traditional care was implemented for 34 patients. In the critical pathway implemented group, time needed for charting and unessential working was reduced. Mean time amount of time for patient nursing was increased. The critical pathway implementation is an effective method to utilize time of medical team. Also it increases the satisfaction index of patients and medical team simultaneously.