• 가정∙방문간호학회지
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• 제28권2호
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• pp.178-185
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• 2021

Purpose: In this study, we aimed to explore the risk factors for catheter-associated urinary tract infections (CAUTI) in patients receiving home care nursing. Methods: A total of 117 participants registered for home care nursing provided by the University of C hospital in Seoul were included in the study. Data were based on a survey and urine examination results from June to July 2018. Results: Asymptomatic bacteriuria was identified in 96 (82%) patients. Age, sex, activity, diabetes mellitus, mental status, presence of other diseases, catheter material type, catheter size and fixation, hand washing (care giver), gloving (care giver), perineal care, and bladder irrigation were not recognized as risk factors for CAUTI. Age and catheterization duration were associated with CAUTI. Conclusions: Old age was found to be a risk factor for CAUTI (p=0.048). CAUTI incidence decreased as catheter use exceeded 70 months (p=0.028).

• Annals of Surgical Treatment and Research
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• 제95권6호
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• pp.324-332
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• 2018

Purpose: We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes. Methods: The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. The severity index and score were calculated. Multivariate regression analysis was used to determine the association between potential predictors and clinical outcomes. Results: A total of 41 patients (male:female = 33:8) were studied. The mean age was 54.4 years (range, 24-79 years). The most common predisposing factor was diabetes mellitus (n = 19, 46.3%). Sixteen patients (39.0%) were current smokers. Seven patients had chronic kidney disease. The most frequent etiology was urogenital lesion (41.5%). The mortality rate was 22.0% (n = 9). Multivariate regression analyses showed that extension of necrosis beyond perineal/inguinal area and pre-existing chronic kidney disease were significant and independent predictors of mortality. Extension of necrosis beyond perineal/inguinal area was a significant predictor of increased duration in the intensive care unit and hospital stay. In addition, pre-existing chronic kidney disease was a significant predictor of flap reconstruction in the wound. Conclusion: Fournier gangrene with extensive soft tissue necrosis and pre-existing chronic kidney disease was associated with poor prognosis and complexity of patient management. Early recognition of dissemination and premorbid renal function is essential to reduce mortality and establish a management plan for this disease.

• 한국보건간호학회지
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• 제15권1호
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• pp.27-41
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• 2001

The purpose of this study was to discern the level of satisfaction of postpartum care in hospitals. the level of importance of traditional postpartum care and the need for home health care for postpartum women. The study's design was to obtain data needed to develop a community-based postpartum care program and to improve the quality of nursing for postpartum care recipients. Data for the study was collected from 1 March to 31 June 2000 from 116 postpartum care recipients treated in Chung-Buk, Korea. Data analysis consisted of frequency, percentage, t-test, and ANOVA. using SPSS win program. The results the of analysis were as follows: 1) The level of satisfaction of postpartum care in the hospital (mean 1.31) was very low. The most laudable items of nursing care by category were: moderate satisfaction with 'perineal wound care' (2.04) and 'afterpain observation'(2.09). The overall level of satisfaction of postpartum care in the hospital. however, was very low. 2) Among other items of postpartum care in the hospital, 'postpartum exercise' $(25.9\%)$. 'assessment and support for postpartum depression' $(25.9\%)$, 'operation wound care for women who underwent Caesarean sections' $(24.5\%)$. and 'contraception and family planning' $(20.4\%)$ showed a need for home health care for postpartum care recipients above $20\%$. 3) The level of importance of traditional postpartum care (Sanhujori) was relatively high (mean 2.72). The importance of Sanhujori by category was as followed: 'the fourth principle: protecting the body from harmful strains' was the highest (2.88), 'the third principle: eating well', 'the first principle: invigorating the body by augmenting heat and avoiding cold', 'the second principle: resting without working', 'the fifth principle: keeping clean' and 'the sixth principle: handling with the whole heart' showed 2.85, 2.80, 2.70, 2.51 and 2.46 respectively. 4) The need for home health care with Sanhujori was very low. 5) The relationship between demographic factors and the level of satisfaction with postpartum care in the hospital was as follows: the satisfaction levels were significantly different among' delivery frequency' and 'health status' alteration after delivery'. 6) The relationship between demographic factors and the importance of the Sanhujori category was as follows: There were no significant differences in the level of importance of the first and the forth principle of Sanhujori. The level of importance of the second principle of Sanhujori was significantly different among 'income' and 'family type'. The level of importance of the third principle of Sanhujori was significantly different among 'having a boy'. The level of importance of the fifth principle of Sanhujori was significantly different among 'income' and 'feeding type'. The level of importance of the sixth principle of Sanhujori was significantly different among 'education background' and 'feeding type'. In conclusion. the findings of this study illustrate the nursing needs of postpartum care recipients. It provides a challenge to caregivers in the healthcare industry to develop a continuous postpartum care program and integrative postpartum care system that embodies the oriental and western paradigm for the promotion of women's health.

• 여성건강간호학회지
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• 제10권3호
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• pp.226-234
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• 2004

Purpose: This study was to examine health status, reproductive health problems and the degree of prenatal management in working women. Method: The subjects were 902 married working women among 2,000 women selected by cluster sampling. The work area was classified to product factory, school, office, etc. After an Informed consent was obtained, participants were asked to fill out a self-administered questionnaire. The instruments included a questionnaire, parity check list, menstrual problems and gynecologic problem check list. Result: Many women have experienced menstrual cycle change during the past year. There was a significant difference in general health, menstrual regularity, reproductive health and prenatal management by occupation type. 40.6 percent of the subjects have gynecological problems such as menstrual cycle change, perineal inflammation, irregular vaginal bleeding, amenorrhea, ovarian/uterine disease, infertility, or abortion. Prenatal care was received in only 28.5% of the total subjects. In addition, 16.3% answered they had experienced low birth weight babies. Conclusion: We can conclude that working woman have changes in menstruation cycle and in reproductive health status. Therefore, we suggest that some occupational characteristics may affect subject's reproductive health, these should be clear and avoided as much as possible.

• The Korean Journal of Pain
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• 제10권1호
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• pp.134-137
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• 1997

We report a case of cauda equine syndrome following caudal anesthesia possibly caused by metastatic spine tumor. Male, 80-year-old, who had prostatic carcinoma with $L_3$ and $L_4$ spine metastasis was scheduled for bilateral orchiectomy. Twenty two-gauge needle was introduced at sacral hiatus and 15 ml of 2% lidocaine administered. The next morning, patient complained of perineal numbness and urination difficulty. During the next several day patient had episodes of fecal incontinence and motor weakness on both lower extremities. This case reminded us that neuroaxial blocks such as spinal, epidural and caudal anesthesia, should be used with extreme care in patients having neoplasm with high incidence of spine metastasis.

• 대한한방부인과학회지
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• 제28권2호
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• pp.156-164
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• 2015

Objectives : This study aims to report the effect of Korean medicine treatment on Sequela of Bladder Cancer. Methods : The patient was treated with korean medicine of Paljeongsan-gamibang, acupuncture at Qihai (CV6), Guanyuan (CV4), Qugu (CV2), Hyeolhae (SP10), Sameumgyo (SP6) and we evaluated treatment effects by visual analogue scale (VAS) and urine analysis (UA) finding. Results : After treatments, the symptoms such as perineal pain, painful urination, dysuria, anorexia were improved and taking number of narcotic analgesic was reduced. Conclusions : This clinical study suggests that korean medicine treatment shows possibility to care for sequela of bladder cancer patient.

• 여성건강간호학회지
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• 제2권1호
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• pp.125-137
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• 1996

This study was conducted to identify the educational need of pregnant women, and to evaluate the effect of the 2-hour childbirth class provided by researchers. The subjects were composed of 183 pregnant women who participated voluntarily in the 2-hour childbirth class, and the data were collected by self reporting structured questionnaire designed by researchers. The data were analyzed with descriptive statistics, paired t test, and McNemar test by SPSS pc program. The results were as follows ; 1. Mean age of th subjects was 27 and most subjects graduated from the high school and the college. 80.3% of the subjects had nuclear family. 82.5% of the subjects were full time housewives. 2. 85.8% of the subjects were ipara. Though 71.6% of the subjects might have antepartal care in the clinic, 67.2% of the subjects had no chance to participate in the childbirth class before this study. 3. Subject's health and lifestyle, especially related to eating habits, were changed in the antepartum period. We found that the pregnancy affected positively on health and lifestyle of the women. Over 75% of the subjects became to understand the progress of labor, breath methods during the labor, and perineal exercise. Most subjects changed to think that they could control their body more actively and positively during the labor after participating in the childbirth class. 93.4% answered that 'childbirth class was necessary and important'. Most subjects wanted to be taught the contents, such as postpartum care, breast feeding, and infant care in the childbirth class. In conclusion, pregnant women to attend the childbirth educational program with their husband, and the 2-hour childbirth class provided by the researchers very effective in many aspects. Therefore we anticipated that the childbirth class on basis of pregnant women's needs will contribute to improvement of pregnant women's health and well-being during the labor.

• 한국의료질향상학회지
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• 제2권2호
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• pp.156-171
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• 1996

Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.

• 지역사회간호학회지
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• 제24권3호
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• pp.368-376
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• 2013

Purpose: The purpose of this study was to identify the current urinary incontinence states in women above middle age dwelling in rural areas and their coping with the problems. Methods: The participants were 261 women above middle age. Data were collected from February to May, 2012 using a structured questionnaire. The data were analyzed with the SPSS/WIN 20 program. Results: The frequency of urinary incontinence in women above middle age was 45.4%. There were significant differences in urinary incontinence due to age, education, job status, frequency of delivery, and menstrual status. And, there were significant relations among urinary symptoms, difficulty of ADL, incontinence stress and depression. Frequently used coping-methods with urinary incontinence were washing frequently in order to avoid awful smell, paying attention to perineal cleaning, and going to restroom frequently. Conclusion: Community nurses who are in charge of primary health care ought to assess urinary incontinence and develop a urinary incontinence program that includes psychological and social factors.

• 대한간호학회지
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• 제36권7호
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• pp.1204-1214
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• 2006

Purpose: This retrospective study was done to evaluate the status of nosocomial urinary tract infections and to determine the risk factors and transmission route of causal IRPA through molecular epidemiology. Method: Two hundred ninety-nine of 423 patients admitted to the internal medicine and surgery ICU at a university hospital incity B had a positiveurine culture. Twelve of the 299 patients who had a urinary tract infection had IRPA strains. The data was collected from November 1, 2004 to January 31, 2005. The following results were obtained after the data was analyzed using percentile and UPGMA. Result: The rate of nosocomial urinary tract infections in the ICU was 10.8%. Therewere 16.8 cases of infection based on the period of hospitalization. There were 16.9 cases of infection based on the use of a foley catheter. The rate of nosocomial urinary tract infection in the ICU and urinary tract infections related to IRPA were higher in patients with the following characteristics: men, old age, admission through the emergency room, longer than seven days admission, severity of admitting causes, disturbance of consciousness, hydration less than 300cc in 24hours, a long course of antibiotics, a long period of foley catheterization and perineal care. Most of the microorganisms that caused the urinary tract infection were gram negative bacilli, among which P. aeruginosa was found in 70 patients (18.5%) and IRPA in 12 (4.0%). Among the 12 IRPA strains that were tested with PFGE, eight showed a dice coefficient higher than 80%, suggesting a genetic relationship. They were related with the period of hospitalization in the same ICU. These patients all received direct care for a urinary tract infection. Conclusion: Through these results, IRPA can be consideredas a contributing factors to urinary tract infections thus, active preventative measures are needed by the medical staff.