• Title/Summary/Keyword: Patients' Evaluation

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Analysis of Nursing Records for Pain Management in Intensive Care Unit Patients (내·외과계 중환자의 통증간호기록 분석)

  • Im, Young-Sk;Yi, Yeo-Jin
    • Journal of muscle and joint health
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    • v.19 no.2
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    • pp.173-183
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    • 2012
  • Purpose: The purpose of this study was to analyze nursing records for pain management in intensive care unit (ICU) patients. Methods: Nursing process for pain management were analyzed retrospectively by 180 ICU patients' nursing records. Instruments consisted of 3 questionnaires (pain assessment, intervention, and evaluation). Results: For assessment, there was different pain intensity between cancer patients (7.95) and non-cancer patients (7.20). Also pain intensity was lower in PCA group (5.08) than in PCA with PRN group (8.27). Common pain site was surgical areas, along with 17 kinds of words expressed for pain, and mean of pain intensity was 7.47 by numeric rating scales (NRS). For intervention, the patients received pharmacologic interventions (99.4%) such as narcotic analgesics (38.3%) intermittently (70.5%) without side effects (94.4%). For evaluation, mean of pain intensity was decreased to 3.14, but a few patients (12.8%) experienced pain over 5 points despite the intervention. Nurses evaluated the degree of pain relief after the intervention in 87.2% of patients. Conclusion: Nurses do assess patients' pain by using objective tool, intervene, and evaluate for effective pain management. Nurses should make an individual approach and record all nursing activities for pain management.

Psychologic Evaluation with SCL-90-R in patients induced seven-emotion (간역정신진단검사(簡易精神診斷檢査)를 이용한 칠정상(七情傷) 환자(患者)27례(例)의 심리상태평가)

  • Lee, Ji-In;Lee, Seung-Hee;Kwen, Soon-Ju;Chung, Dae-Kyoo;Kim, Bo-Young
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.2
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    • pp.117-125
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    • 2003
  • Objective : This investigation was carried out to see psychologic evaluation with SCL-90-R in patients induced seven-emotion. Methods : 27 patients induced seven-emotion were administered SCL-90-R. Results : 1. All subscale scores by sex and age were significantly recognized in patients. 2. Dimension depression were significantly recognized in male patients. 3. All subscale scores by sex weren't significantly recognized in patients. 4. Dimension obsesive-compulsive, anxiety were significantly recognized in patients entered through ER. 5. Dimension phobic anxiety were significantly recognized in patients with psychologic history. Conclusion : we have significant differences on comparisons of Scores by sex, admission route and psychologic history of the Patients.

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Diagnostic Usefulness of CISS Image in Preoperative Evaluation of Trigeminal Neuralgia and Hemifacial Spasm (삼차신경통과 반측안면경련에서 CISS 영상의 진단적 유용성)

  • Lee, Dong Hoon;Lee, Sang Weon;Choi, Chang Hwa
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.186-193
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    • 2001
  • Objectives : Trigeminal neuralgia and hemifacial spasm are caused by vascular compression of the REZ(root entry or exit zone) of the 5th and the 7th cranial nerve. Preoperative detection of neurovascular compression is essential for accurate diagnosis, appropriate treatment, and the good operative results. Three dimensional Fourier Transformation-Constructive Interference in Steady State(3DFT-CISS) images are known to give good contrast between CSF, nerve, and vessels. We applied a 3DFT-CISS imaging technique for the preoperative evaluation of patients with these diseases and estimated the diagnostic accuracy and usefulness of this study. Methods : A series of 71 patients with trigeminal neuralgia and hemifacial spasm were treated by microvascular decompression. Among them 34 patients with trigeminal neuralgia and 24 patients with hemifacial spasm had preoperative CISS images. We compared the radiologic finding with the operative finding, and analysed the diagnostic usefulness of 3DFT-CISS imaging. Results : The sensitivity of CISS images of detecting the neurovascular compression was 90.3% in trigeminal neuralgia and 100% in hemifacial spasm. There were one false-positive and three false-negative cases in trigeminal neuralgia, and one false-positive case in hemifacial spasm. The accuracy in diagnosing the causative vessel was 73.5% in trigeminal neuralgia and 83.3% in hemifacial spasm. Conclusion : CISS image is very useful diagnostic tool for preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia and hemifacial spasm. No additional neuroradiologic examination other than CISS image and MRA is needed for preoperative evaluation of patients with trigeminal neuralgia and hemifacial spasm.

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Development of an evaluation tool for the quality of nursing care in neurosurgical intensive care unit patients (신경외과 중환자 간호의 질평가 도구개발)

  • Kim, Nam-Young;Jang, Keum-Seong
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.285-300
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    • 2001
  • To meet standards for high quality of care and satisfied customers, an evaluation tool about nursing care is necessary. And, We need to evaluate our practice continuously for the improvement in quality and outcomes. This study was intended to develop an evaluation tool about nursing care in NSICU, and was progressed of 3 steps; development, content validity verification and reliability verification. Data were obtained and analysed from Feb. To April, 2000. Development process of the study was as follows A preliminary list was made item by item on the basis of clinical Experience, literature review and patients' record review. Then the standards, criteria and indicators of preliminary evaluation tool were set by 5 clinical nursing panel, and their content validity was reviewed by 27 ICU nurses. Finally, an evaluation tool was developed and verified the reliability at c-university hospital located in Kwang-Ju. The results of this was as follows 1) The evaluation tool of this study developed 8 standards, 39 criterias and 106 indicators. The standards were divided into two dimensions. One was process dimension which contained 4 standards(26 criteria), The other was outcome dimension which contained 4 standards(13 criteria). 2) the Average content validity of the tool was 3.39 at standards, 3.55 at criteria and 3.51 at indicators. 3) Interrater reliability of the tool is r=.7993(p<.001) & internal consistency reliability ${\alpha}$ is .6031 4) Scores of NSICU Patients who participated in this study were 57 at total mean score, 58 at process mean score and 56 at outcome mean score The evaluation tool developed in this study seems to be useful in evaluation nursing practice appropriately for the improvement of nursing care in NSICU. I hope that this evaluation tool can be used effectively in NSICU as an intervention for the improvement of quality control.

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User Evaluation of Characteristics of Interior Space in Outpatient Department of General Hospital - Focused on Outpatients' Evaluation of 6 Departments - (종합병원 외래 진료부의 실내공간특성에 대한 사용자 평가 - H 종합병원의 6개 진료과에 대한 환자평가를 중심으로 -)

  • Oh, Chan-Ohk;Kim, Suck-Tae
    • Korean Institute of Interior Design Journal
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    • v.22 no.6
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    • pp.20-28
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    • 2013
  • This study attempts to grasp outpatients' demands for interior space of outpatients departments through evaluating them. Six departments in H general hospital such as surgery, orthopedics, neurosurgery, plastic surgery, obstetrics, and urology, were evaluated. Evaluating items were consisted of ones related to spatial layout, furniture, interior climate, color and finishes, and dressing room of each waiting area, doctor's room and treatment room in six departments. The subjects were 210 outpatients who were using one of six departments. The results were ; 1) The outpatients evaluated very high interior space of waiting areas in six departments. 2) They evaluated doctor's rooms to be relatively high. However, visual privacy in there was not enough met. 3) The treatment room was also evaluated relatively high. However, furniture and equipment arrangement, consideration for patients and a dressing room were evaluated relatively low. 4) The outpatients' evaluation was significantly different by their gender and age. The male evaluated them higher than the female. Also, the older patients evaluated them higher than the younger. 5) The outpatients responded that ventilation, comfort interior, and space arrangement were very important elements in healthcare facility design.

Review of Programs for Improving Patient's Access to Medicines (의약품 접근성 향상을 위한 방안 고찰)

  • Kim, EuGene;Kim, Younhee
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.1
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    • pp.40-50
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    • 2018
  • Objective: This study presented the analysis period, the complexity of combined therapy and comparator choice as the key limitations in the economic evaluation of new drugs, and discussed programs for coping with these limitations. Methods: This study evaluated the post-evaluation, risk-sharing agreement, extra funding program, and flexible incremental cost-effectiveness ratio (ICER) threshold as actions or programs that would increase accessibility to costly new drugs. The study also presented the cases of other countries. The application of the post-evaluation was considered to deal with high uncertainty regarding new drugs. Results: The risk-sharing agreement was introduced in European countries as well as South Korea and has been responsible for the shift from using the financial schemes to outcome-based schemes. The drug funding program has had troubled in securing stable extra funds. The application of higher ICER in the economic evaluation of expensive and innovative oncology drugs was criticized because of the inequity between oncology patients and patients with other diseases. Conclusion: Therefore, introducing and applying actions that would increase the accessibility to costly new drugs in South Korea have been deemed necessary after careful reviews and discussions with various stakeholders (insurer, policy makers, pharmaceutical companies and patients).

Therapeutic Approaches to the Patients who were Referred for Psychiatric Consultation from Medical Departments - Internist's View about Management of Medical Patients with Psychiatric Problems - (정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 - 내과의사로서의 입장 -)

  • Lee, Sang-In
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.81-91
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    • 1993
  • The consulting internist will encounter patients with psychiatric symptoms and those who take psychotropic medications in many settings. The internist must loam to feel comfortable interacting with patients who display psychiatric symptoms. while maintaining an open and unprejudiced attitude toward their evaluation. The proper delineation of psychiatric disorders from normal emotional reactions resets on a careful history, a mental status evaluation. and a knowledge of psychiatric syndromes. Many physicians tend erroneously to view behavioral changes only in a psychological framework Abrupt changes in behavior, personality, mood. or ability to function should be evaluated for possible organic causes. Then, the internists should take their consultation to psychiatrists and freely discuss psychologic problems of the patients.

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Suggested Clinical Reasoning Strategies Using a Mnemonic Device for Patients with Neurological Disorders (연상법을 이용한 신경계 환자의 임상적 추론 전략 제안)

  • Woo, Young-Keun
    • PNF and Movement
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    • v.17 no.1
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    • pp.145-156
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    • 2019
  • Purpose: This study suggests clinical reasoning strategies for therapists with little experience in clinical reasoning for the evaluation and treatment of patients with neurological disorders. Methods: The suggested method was the mnemonic PT STRESS whose initials represent the body structure and functions that can affect the activity limits and the items that can cause problems at the functional level in patients with neurological disorders. Results: PT STRESS stands for pain (P), ability of the trunk (T), sensation (S), tone (T), range of motion (R), emotion and endurance (E), muscular strength (strength), and stability (S). It tests and measures problems in the body structure and functions. Conclusion: This study suggests easy clinical reasoning strategies that can be used by therapists who have insufficient experience in the evaluation or treatment of patients with neurological disorders. However, more factors need to be considered in the future with regard to clinical reasoning of the diverse problems of patients with neurological disorders.

Correlation between Radiographic Findings, Clinical Findings and Joint Sounds of Temporomandibular Joint Osteoarthritis Patients

  • Shin, Jung-Youn;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.42 no.2
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    • pp.35-43
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    • 2017
  • Purpose: This study aims to evaluate the correlation between joint sounds and radiographic bone change patterns along with clinical symptoms of temporomandibular joint osteoarthritis (TMJ OA) patients. Methods: The patients for this study were over 19 years of age, diagnosed tentatively with TMJ OA. The patients were examined with temporomandibular disorders analysis test and all three radiographs, including panoramic radiography, transcranial radiography, and cone beam computed tomography (CBCT). Information of the patients' age, pain status, joint sound and mouth opening range were collected. And bone change pattern was examined by reviewing panoramic radiography, transcranial radiography and CBCT images. Results: The patients with crepitus had a higher average active mouth opening (AMO) range than patients without crepitus, and the group with bilateral crepitus had a higher average AMO range than the group with unilateral crepitus (p<0.001). And the patient with pain during mastication was increased in the group with clicking than the group without clicking, and the group with bilateral clicking showed a statistically significant increase in the patient with pain during mastication than the group with unilateral clicking (p<0.05). The analytical results of the relevance of crepitus showed a high correlation with bone change observed from each of the three radiographs. And the agreement in bone change findings from 3 groups of paired radiographs showed high agreement (p<0.001). Meanwhile, 77.2% of CBCT findings showed bone change of condyle without crepitus (p<0.001). Conclusions: This study presented significant results in the evaluation of the correlation with crepitus and bone change of TMJ OA patients from panoramic radiography or transcranial projection. However, the accurate assessment is required through CBCT for the patient with complains of persistent pain, limitation of mouth opening, and occlusal change even if the crepitus does not exist.

Comparison of Impedance Parameters and Occupational Therapy Evaluation in the Paretic and Non-paretic Upper Extremity of Hemiplegic Stroke Patients

  • Yoo, Chan-Uk;Kim, Jaehyung;Hwang, Youngjun;Kim, Gunho;Shin, Yong-Il;Jeon, Gyerok
    • Journal of Korea Multimedia Society
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    • v.20 no.12
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    • pp.1980-1991
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    • 2017
  • Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body function in paretic and non-paretic regions. In this study, the impedance parameters were acquired to assess the physical status in the upper extremity of thirty six stroke patients with hemiplegia caused by cerebral hemorrhage (10 patients) and cerebral infarction (26 patients), using bioelectrical impedance. Prediction marker (PM), phase angle (PA), PM/PA, and resistance (R) versus reactance ($X_c$) were utilized to evaluate the functional status of the paretic and non-paretic regions. In addition, the hand grip strength (HGS) and the pinch strength (lateral, palmer, tip) were measured on the upper extremity of hemiplegic stroke patients. PM was distributed in inversely proportional to HGS, but PA was distributed in proportional to HGS. However, there were a number of patients with HGS of 0, regardless of the impedance parameters (PM, PA, R vs. $X_c$). Paretic and non-paretic status in upper extremity of these patients could not be analyzed using impedance parameters. At the rehabilitation therapist's instructions, they were unable to move the hand and fingers of the paretic upper extremity by cranial nerve damage, motor nerve damage, and severe cognitive decline.