• Title/Summary/Keyword: Patterns of care

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A Literary Review of Human Being by Nursing Aspects - As the Theory Development in Nursing - (인간에 대한 간호학적인 해석에 관한 고찰 -간호이론발달을 통해서 -)

  • 이광자
    • Journal of Korean Academy of Nursing
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    • v.9 no.2
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    • pp.49-61
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    • 1979
  • A review of this literature and discussions reveal a development of ideas concerning the elements of nursing models. The elements of a nursing model are the nurses view of the human being, nursing's goal, and nursing activities. It has long been recognized that human beings, at one time or another, require nursing care. Varieties of literature were reviewed in regard to the human being as recipient of nursing care through the theory development in nursing. Florence Nightingale initiated the modern era of nursing and described more clearly man as the recipient of nursing care. She looked at man as responding to the laws of nature whether the person was healthy or sick. Henderson added to Nightingale's concept of man , the recipient of nursing care by emphasizing that man is a whole, complete, and independent being. Her view is further specified by her enumeration of the activities the human being must perform. Johnson has developed a very comprehensive view of man as the recipient of nursing care. Man is a behavioral system which has a tendency to achieve and maintain stability in patterns of functioning. Like Nightingale, Johnson sees that similar patterns occur in both health and illness. Johnson postulates that the whole behavioral system of the human is composed of eight sub-systems: affiliative, achievement, aggressive, dependency, eliminative, ingestive, restorative, sexual. Roger's main contribution to the development of nursing models was her emphasis upon unitary man. She pointed out that man is a unified whole, possessing his own integrity and manifesting characteristics that“are more than and different from the sum of his parts.”Rogers focuses on the life processes of the human and points out that these processes have the following characteristics. Wholeness, openness, unidirectionality, pattern and organization, sentence, and thought. According to Roy, man is a biopsychosocial being in constant interaction with a changing environment. To cope with this changing environment, man has certain innate and acquired mechanisms. Man's ability to respond positively or to adapt, depends upon the degree of the change taking place and the state of the person coping with the change. When she analyzes man as an adaptive organism she further describes man as being composed of four adaptive modes: physiological needs, self-concept, role function, and interdependence. Based on the literary review through the theory development in nursing, general approach by a unified nursing model to a view of the recipient of nursing care may be stated as follows: Man is a unified whole composed of subsystems with a flexible and normal line of defense; his internal regulating mechanisms help him to cope with a changing environment; he functions by the principles of homeodynamics.

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Patterns of care for patients with nasopharyngeal carcinoma (KROG 11-06) in South Korea

  • Sung, Soo Yoon;Kang, Min Kyu;Kay, Chul Seung;Keum, Ki Chang;Kim, Sung Hwan;Kim, Yeon-Sil;Kim, Won Taek;Kim, Ji-Yoon;Kim, Jin-Hee;Moon, Sung Ho;Ahn, Yong Chan;Oh, Young Taek;Wu, Hong-Gyun;Lee, Chang-Geol;Chung, Woong-Ki;Cho, Kwan Ho;Cho, Moon-June;Choi, Jin Hwa
    • Radiation Oncology Journal
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    • v.33 no.3
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    • pp.188-197
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    • 2015
  • Purpose: To investigate the patterns of care for patients with nasopharyngeal carcinoma (NPC) in South Korea. Materials and Methods: A multi-institutional retrospective study was performed (Korean Radiation Oncology Group [KROG] 11-06) on a total of 1,445 patients from 15 institutions. Results: Of the 1,445 patients, more than half were stages III (39.9%) and IV (35.8%). In addition to patterns of care, we also investigated trends over time with the periods 1988-1993, 1994-2002, and 2003-2011. The frequencies of magnetic resonance imaging and positron emission tomography-computed tomography were markedly increased in the third period compared to previous 2 periods. Concurrent chemoradiation (CCRT) was performed on 894 patients (61.9%), neoadjuvant chemotherapy on 468 patients (32.4%), and adjuvant chemotherapy on 366 patients (25.3%). Of stage II-IV patients, CCRT performed on 78.8% in 2003-2011 compared to 15.0% in 1988-1993. For patients treated with CCRT, cisplatin was the most commonly used agent in 81.3% of patients. Over the periods of time, commonly used radiotherapy (RT) techniques were changed from 2-dimensional RT (1988-1993, 92.5%) to 3-dimensional RT (2003-2011, 35.5%) or intensity-modulated RT (IMRT; 2003-2011, 56.5%). Median RT doses given to primary tumors, high-risk lymphatics, and low-risk lymphatics were 70.0 Gy, 58.1 Gy, and 48.0 Gy, respectively. Adoption of IMRT increased the dose per fraction and escalated total radiation dose. Conclusion: Assessment of the patterns of care for NPC patients in South Korea demonstrated that management for NPC including diagnostic imaging, treatment regimen, RT techniques and dose schedule, advanced in accordance with the international guidelines.

The Attitude to a Good Death of Nurses in Long-term Care Hospitals (요양병원 간호사의 좋은 죽음에 대한 태도)

  • Kim, Sang-Hee;Kim, Ick-Jee
    • The Korean Journal of Health Service Management
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    • v.8 no.3
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    • pp.103-112
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    • 2014
  • The purpose of this study is to explore and classify the types of the attitude on a good death of nurses in long-term care hospitals. Q-methodology, which is effective in scientifically measuring individual subjectivity, was used. 151 Q-population were selected through the processes of review of research articles, newspaper articles and interviews. 34 Q-sample were selected from the 151 Q-population and 27 nurses in long-term care hospitals were invited as the P sample. The result of the Q-sort was analyzed using PC QUANL Program. The types of attitude on a good death of nurses in long-term care hospitals was categorized into three. 1) Death in supportive environment 2) a comfortable death in real life 3) Dignity guaranteed death By identifying 3 attitude patterns toward a good death of long-term hospital nurses, this study provides an opportunity for their reflection and recognition toward a good death based on this result and suggests to think about ways to improve the quality of nursing in the current increasing long-term hospitals.

Evaluation of Menu Pattern and Nutritional Contents of Snack Menus Provided by Child Care Information Centers in Seoul (서울시 소재 육아종합지원센터에서 제공하는 어린이집 간식 식단의 유형 및 영양소 평가)

  • Yeoh, Yoonjae;Kwon, Sooyoun;Lee, Youngmi
    • Journal of the East Asian Society of Dietary Life
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    • v.24 no.5
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    • pp.614-620
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    • 2014
  • This study was conducted to evaluate menu pattern and nutritional contents of snack menus provided by child care information centers in Seoul. Snack menus during March 2013 (morning snack : 125 cases, afternoon snack : 100 cases), including information on portion size, were collected from five child care information centers, after which the number of menu items, menu patterns, and nutritional contents were analyzed. About two-thirds of total snack menus included two menu items. There were significant differences in service time (morning & afternoon snacks). 'Beverage+Food' pattern (66.7%) was the most commonly used; 'Beverage' pattern was significantly higher in morning snacks (10.4%) than in afternoon snacks (1.0%). Morning and afternoon snacks provided 124.5 and 170.6 kcal of energy and 116.4 and 90.9 mg of calcium, respectively, which are 8.9% and 12.2% as well as 19.4%, and 15.2% of children's daily energy and calcium requirements. To improve the quality of food and nutrition offered to children through snacks at child carre centers, a more detailed snack menu plan as well as nutritional guidelines for institutions should be developed.

Classification of emergency room usage patterns according to the type of insurance in patients visiting an emergency medical center in Seoul, Korea (서울지역 일개 지역응급의료센터에 내원한 환자의 보험급종별 응급실 이용행태 분류)

  • Kim, Moo-Hyun;An, Hyoung-Gin
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.1
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    • pp.25-36
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    • 2020
  • Purpose: We analyzed the characteristics and differences in patients' medical benefits and health insurance based on disease severity classification. Methods: We examined 29,139 patients who visited the emergency medical center of K Hospital from January 1,2016 to December 31, 2016. Survey items included the Korean Triage and Acuity Scale (KTAS) classification of emergency and non-emergency situations ratio and type of insurance. Results: According to KTAS classification, 76.2% of patients exhibited an emergency condition and 23.8% exhibited a non-emergency condition. Emergency patients exhibited more trauma than non-emergency patients. According to the type of insurance coverage, the duration of stay in the emergency room was longer for patients with medical care than for patients with health insurance. Additionally, 119 ambulances use was significantly higher among patients with medical care. Conclusion: Policy discussions should address alternative ways to replace the 119 ambulances used by patients in this study. Additionally, health care administrators should identify alternative care agencies as potential alternatives to emergency room visits.

Projections and Patterns of Welfare Service Demand for Elderly Dementia Home-Based Care in Kyungpook Area (재가치매노인 복지서비스 실태 및 수요전망 - 경북지역을 중심으로 -)

  • Kim, Han-Gon
    • Journal of Families and Better Life
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    • v.21 no.3
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    • pp.39-46
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    • 2003
  • There are three main purposes in this study. First, we project the number of elderly dementia population in the future based on the projection of the elderly population in the Kyungpook area. Second, the demands of home-based care service and facility-based care for the elderly dementia are estimated. Thirdly, some policy implications for the improvement of welfare services for the elderly dementia are addressed. The findings of this study are as follows. Considering the size of the elderly dementia population, facilities for the elderly dementia are extremely insufficient and most of the elderly dementia patients rely heavily on home-based care. Although we expect that there will be a rapid increase in the number of the elderly dementia in the next two decades, the social welfare services for them in the future are very unreliable. Home nursing for the demented elderly needs to be recognized by law and financed by the government. In this context, we address some issues regarding the rapid growth of the elderly dementia population in the future and social welfare services for them as well. Finally we suggest some policy implications regarding this matter.

A Study on the Development of Standardized Nursing Care Plans for Computerized Nursing Service (간호업무 전산화를 위한 표준화된 간호계획의 개발에 관한 연구)

  • 김조자;전춘영;임영신;박지원
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.368-380
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    • 1990
  • A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to form a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of a standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalize patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows ; 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were “PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE”. 2. The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to the condition, recording pattern, desired outcomes and nursing orders (nursing interventions). 3. The plan was used with hospitalized patients on medical - surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research. The results of this study suggest that in order to increase the use of nursing diagnoses in the clinical area, it would be effective to select some wards as a pilot project, give the nurses training in the use of nursing diagnosis and develop and use the standardized nursing care plans. In addition to the ten diagnosis used in this study it is recommended that continual development of nursing diagnoses be done using diagnoses that are appropriate to Korea and testing them for validity through standardized care plans.

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Nonsteroidal Anti-inflammatory Drugs Utilization Patterns among the Elderly with Osteoarthritis at Primary Ambulatory Care Units in Busan Metropolitan City, Korea (부산지역 의원급 외래 노인 골관절염환자의 비스테로이드소염제 사용양상평가)

  • Choi, Nam-Kyong;Kim, Yoon-I;Lee, Seung-Mi;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.2
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    • pp.150-156
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    • 2004
  • Objectives : To investigate the utilization patterns of non-steroidal anti-inflammatory drugs (NSAIDs) among the elderly with osteoarthritis (OA) undergoing primary ambulatory care in Busan metropolitan city, Korea. Methods : OA patients, aged 65 years and over, were identified from the Korean National Health Insurance Review Agency drug prescription database. The subjects had at least one episode of claim for OA (ICD-10-CM: M15-M19) between August 1, 2000 and February 28, 2002. Trends in the determinations of NSAIDs utilization were identified using chi-squared tests for trend. Results : There were 47,711 osteoarthritic patients. The total number of visits by these patients was 177,443, with a total frequency for NSAID prescriptions of 214,952. Seventy-nine percent of the OA patients were female. NSAIDs were prescribed on 133,284 visits (75.1%) and the proportion of prescriptions was significantly increased with age. Only the proportion of visit when NSAIDs were prescribed decreased, from 65.1 to 43.5%, during the study period (p<0.001). However, the proportion of combined treatments with anti-ulcer drugs was increased. The use of NSAIDs injections was decreased. Of the individual NSAIDs, diclofenac (28.7% of total frequency of NSAID prescriptions), piroxicam (15.0%) and talniflumate (8.7%), were the most frequently prescribed. Among the NSAIDs prescribed OA visits, 45.7% used two or more NSAIDs. Conclusion : The total proportion of NSAIDs prescribed to the osteoarthritic patients was higher than in other studies. The decline in the use of NSAIDs during the study period, and the frequent selection of safer medications, such as combination therapy with anti-ulcer drug, may reflect the risk awareness of the use of NSAIDs.

A Study on the Characteristics of Application for Therapeutic Light and Color in Dementia Care Facilities - Focused on Qualitative and Quantitative Application Characteristics (치매요양시설에서의 치료를 위한 빛·색채의 시설적 적용 특성에 관한 고찰 - 정성적 및 정량적 적용 특성을 중심으로)

  • Jee, Soo In
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.4
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    • pp.69-87
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    • 2018
  • Purpose: This study has been started with the awareness that light and color are the main visual sensors of the multi-sensory stimulation environment to achieve the therapeutic environment for demented elderly. The purpose of this study therefore is for clarifying the application characteristics of therapeutic light and color for dementia care facilities. Methods: Internal and external literature reviews have been conducted for the investigation into a)disorders and visual system in demented elderly, b)therapeutic effects of light and color, c)heliotherapy, light therapy and color therapy to deduce the therapeutic characteristics of light and color for demented elderly, and finally into d)the application characteristics of it for dementia care facilities. Results: The application characteristics of the therapeutic light and color for dementia care facilities are classified into both qualitative and quantitative characteristics. Qualitative application characteristics of light represented using of daylight, using of lighting approximate to daylight, expansion of iluminance level, equality in iluminance Level, reduction of shadow, and as well as exclusion of blare. Quantitative application characteristics of it represented iluminance level, color temperature and color rendering index prescribed in international lighting standards. Qualitative application characteristics of color represented non-monochromatic color, color contrast, long wavelength of yellow-red colors, exclusion of short wavelength of blue colors and patterns, and as well as different colors for idenfication. Quantitative application characteristics of it represented kontrast(K) prescribed in DIN32975:2009 and light reflectance value(LRV) prescribed in BS8300:2009. Implications: To form dementia care facilities as therapeutic environment both qualitative and quantitative application characteristics of therapeutic light and color in dementia care facilities are needed.

Correlations among Lifestyle and Health Status -A comparative study between nurses and clients- (생활양식과 건강수준간 상관성분석 -간호사와 비간호사 비교연구-)

  • Kim, Young-Im
    • Research in Community and Public Health Nursing
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    • v.5 no.1
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    • pp.53-63
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    • 1994
  • Health could be maintained and promoted by pursuing an active healthy lifestyle. Life-style include health habits and behavior pattern such as exercise, diatry change, weight control, stress management et al. The objectives of this studies are (1) to analyze recognition and practice of lifestyle between nurses and non-nurses, (2) to analyze health status of clients which presented healthy lifestyle, (3) to analyze factors that affected healthy lifestyle. The lifestyle assessment questionnaire is divided into ten sections: competence in selfcare, nutritional practices, physical activity, sleep patterns, stress management, self-actualization, sense of purpose, relation with others, environmental control, and use of health care system. The major results are as follows : (1) The level of recognition and practice of lifestyle was not high. Nurses showed more higher score than non nurses in lifestyle area such as competence in selfcare, stress management, environmental control, and use of health care system. (2) Good health status and lifestyle presented positive relation. (3) In mutiple classifiction analysis, competence in selfcare, nutritional practices, physical activity, sleep patterns, stress management, environmental control, and use of health care system had significant relation to independent variables. (4) Change of concept for healthy lifestyle after this survey was higher in nurses group and the most concern area was stress management. To sum up, lifestyle pattern of nurses as health professional was not desirably high. Therefore nurses ownself should effort to practice healthy lifestyle prior to others, and then educate importance of lifestyle for health promotion and disease prevention. In conclusion, it will be useful to consider significant lifestyle factors that was be identified in this study to develop health promotion program.

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