• 제목/요약/키워드: Post care

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외상 센터에서의 외상 진료 시스템 도입에 따른 변화: 단일 외상 센터에서의 초기 경험 (The Influence of How the Trauma Care System Is Applied at the Trauma Center: The Initial Experience at Single Trauma Center)

  • 김형원;홍태화;이승환;정명재;이재길
    • Journal of Trauma and Injury
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    • 제28권4호
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    • pp.241-247
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    • 2015
  • Purpose: To evaluate the influence of how the trauma care system is applied on the management of trauma patients. Methods: We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups. Results: The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the post-trauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group. Conclusion: Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

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신생아집중치료실에 입원 경험이 있는 미숙아 어머니의 외상 후 성장에 영향을 미치는 요인 (Factors Influencing Post-traumatic Growth in Mothers with Premature Infants Admitted to the Neonatal Intensive Care Unit)

  • 이현수;강숙정
    • Child Health Nursing Research
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    • 제26권2호
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    • pp.267-276
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    • 2020
  • Purpose: Caring for a vulnerable premature baby is a challenging task, but some mothers experience growth through that process. The purpose of this study was to investigate the factors influencing post-traumatic growth in mothers with premature infants admitted to the neonatal intensive care unit. Methods: A correlational research design was used and 105 mothers of premature infants were recruited from an online community. Data were collected from January 15 to January 25, 2019. Post-traumatic growth was measured using the Korean version of the Posttraumatic Growth Inventory. Data were analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical multiple regression. Results: The final model developed in this study explained 45.5% of post-traumatic growth (F=13.66, p<.001). Resilience (β=.54, p<.001) was the strongest predictor of post-traumatic growth, followed by the age of the mother when giving birth (β=.17, p=.028) and current employment status (β=.17, p=.049). Conclusion: For mother with premature infants to grow psychologically after their experience, it may be needed to support them to develop and strengthen their resilience through either education or their own support network.

집중치료 후 증후군 경험에 관한 질적 통합 연구 (Post-Intensive Care Syndrome Experience among Critical Care Survivors: A Meta-synthesis of Qualitative Research)

  • 강지연;정연진;윤선영;이민주;백민정;신소영;홍희진;김수경;조영신
    • 중환자간호학회지
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    • 제10권1호
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    • pp.13-30
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    • 2017
  • Purpose: The purpose of this study was to integrate the results of qualitative studies to understand critical care survivors' experience of the post-intensive care syndrome (PICS). Methods: This was a meta-synthesis of primary studies that used qualitative methods. We reviewed 26 qualitative studies on PICS selected from 8 international and Korean databases and from a manual search. Thomas and Harden's 3 stages (free coding, development of descriptive themes, generation of analytical themes) for thematic synthesis were utilized to analyze the collected qualitative data. Results: Four descriptive themes emerged from the thematic synthesis: weak physical conditions, psycho-emotional changes, the painful-memory of intensive care units, and social vulnerability. The analytical theme for the current study was "unfamiliarity with the vulnerable self." Critical care survivors had to confront entirely different "selves" after discharge from intensive care units. They had become physically weak, psychologically unstable, and the critical memories continued to create distress. These changes increased their social vulnerability by making them dependent on others, causing family conflicts, and changing interpersonal relationships. Conclusions: Finding from this qualitative synthesis and other related literature highlight the severity of PICS and the importance of rehabilitative intervention for critical care survivors.

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집중치료 후 증후군의 신체적 장애 측정도구에 관한 체계적 고찰 (Instruments to Assess Physical Impairments in Post-Intensive Care Syndrome: A Systematic Review)

  • 강지연;이민주;정연진;김수경;조영신;박정훈;이순영;홍지원
    • 중환자간호학회지
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    • 제11권1호
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    • pp.46-66
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    • 2018
  • Purpose : The purpose of this study was to systematically review the instruments utilized to assess physical impairment in post-intensive care syndrome (PICS) of intensive care unit (ICU) survivors. Method : Online databases searched were MEDLINE, Cochrane, CINAHL, and Embase. Studies that met the following criteria were included: 1) the study population exclusively had experience with ICU admission; 2) the study assessed pulmonary, neuromuscular, and physical functions; and 3) the study was published in English language journals after 2007. Results : A total of 56 instruments (2 pulmonary, 25 neuromuscular, 29 physical function) from 94 studies were reviewed. They were classified into self-report, observation, and measurement according to the type of assessment. No instrument measured all 3 areas of physical impairment. Five instruments were originally developed for the ICU patients. The most frequently applied instruments were the Medical Research Council and the 36-item Short Form Survey (physical component summary), which were used in 23 studies each. Only 13.8% of reviewed studies reported the reliability or validity of the instruments. Conclusion : Our results suggest that the appropriateness of instruments assessing physical impairment in PICS cannot be guaranteed. Despite the multidimensional concept of physical disabilities, most studies measured only one area, and studies that reported psychometric properties were limited. Accordingly, we propose to develop a unique and multifaceted instrument for ICU survivors.

보건진료전담공무원의 업무분석과 직무만족도 (Working Patterns and Job Satisfaction in Primary Health Practitioners)

  • 김진학;송민선
    • 가정간호학회지
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    • 제24권1호
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    • pp.69-78
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    • 2017
  • Purpose: The purpose of this study was to identify the frequency and duration of primary health practitioners' work, and their job satisfaction, and to confirm differences in work and job satisfaction by type of primary health care post. Methods: Work frequency, duration of work, and job satisfaction were estimated by 371 primary health practitioners. Chi-square test and t-test were used to identify the differences in working patterns and job satisfaction by type of primary health care post. Results: Primary health practitioners were found to spend more time working with the elderly population than with students, pregnant women, children, people with disabilities, and multicultural families. Those in costal areas were more concerned with students than those working inland. In the latter group of practitioners, more time was spent working with patients with chronic diseases, pregnant women, women, children, multicultural families, and mental health clients. Also, the job satisfaction of inland primary health practitioners was significantly higher than that of costal practitioners. Conclusion: It is necessary to identify the characteristics of primary health practitioners' work, focusing on changes in the medical service environment. Furthermore, it is necessary to provide job training according to type of primary health care post, as practitioners' approaches should differ between posts.

COVID-19 환자를 간호한 간호사의 외상 후 스트레스에 영향을 미치는 요인 (Factors Affecting Post-Traumatic Stress of Nurses in Direct Care for COVID-19 Patients)

  • 김옥녕;최소영
    • 임상간호연구
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    • 제27권2호
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    • pp.121-129
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    • 2021
  • Purpose: The purpose of this study was to investigate post-traumatic stress, job stress, fatigue, and social support of nurses in direct care for COVID-19 patients and to identify the factors affecting post-traumatic stress among the nurses. Methods: The participants were 150 nurses from three hospitals. Data were collected from September 11, 2020 to September 21, 2020. The data were analyzed with SPSS/WIN/25.0 program. Results: The mean score of post-traumatic stress was 22.27±15.49 (range 0~88). The percentage of high risk group of post-traumatic stress was 35.3%, risk group was 20.0%, normal group was 44.7%. Post-traumatic stress showed statistically significant differences according to quarantined experience (t=2.15, p=.033), and provision of COVID-19 manual (t=-2.40, p=.026). Post-traumatic stress was positively correlated with job stress (r=.48, p<.001), and fatigue (r=.58, p<.001), and it was negatively correlated with social support (r=-.22, p=.005). Job stress was positively correlated with fatigue (r=.74, p<.001), and it was negatively correlated with social support (r=-.17, p=.030). Fatigue and social support (r=-.17, p=.029) had a negative correlation. The results of regression analysis showed that the factors affecting post-traumatic stress included fatigue (β=.56, p<.001), provision of COVID-19 manual (β=-.24, p<.001), and quarantined experience (β=.18, p=.006) and that the total explanatory power was 42.0%. Conclusion: In this study, fatigue, provision of COVID-19 manual, and quarantined experience were found as influential factors of post-traumatic stress among nurses in direct care for COVID-19 patients. Therefore, development of the intervention for reducing the fatigue should consider to prevent post-traumatic stress in nurses. Also, provision of COVID-19 manual for nurses and psychological intervention program for nurses experienced quarantine are necessary.

COVID-19 기간 동안 보건진료소를 이용하는 마을 주민의 미충족 보건의료서비스 이용 경험: 앤더슨 행동모델을 기반으로 한 혼합연구 (Experiences of Unmet Healthcare Service Utilization in Rural Populations Using Primary Health Care Posts during the COVID-19: A Mixed Method Study Based on Andersen's Behavior Model)

  • 하영미;김영남;최현경;양승경;고영숙;정미라;이지선;최영미;신은지;김윤경;이고운;정애리;장지희;김다은;김경희;신소영;박송란;임은실
    • 한국농촌간호학회지
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    • 제18권2호
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    • pp.80-91
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    • 2023
  • Purpose: The purpose of the study quantitatively investigates the experience of unmet healthcare service utilization by rural populations in vulnerable areas during the COVID-19 pandemic based on Andersen's behavior model. At the same time, this study attempts to describe the experiences of unmet healthcare service utilization among participants in vulnerable rural areas by analyzing qualitative contents through open-ended question. Methods: Data were collected from October to November 2022 using Qualtrix, a web-based survey platform. A total of 863 participants completed an online survey. Quantitative data were analyzed using 𝑥2 test and logistic regression analysis. Qualitative data were analyzed using content analysis. Results: The factors affecting participants' unmet healthcare service utilization were type of residential area and underlying disease. The qualitative analysis identified; four categories and nine sub-categories. Conclusion: Based on these findings, it is necessary to develop a disaster nursing response model according to the type of residential areas and the number of people.

코로나바이러스 감염증(COVID-19) 전담병원 중환자실 간호사의 외상 후 스트레스 장애 영향 요인 (Factors Influencing Post-traumatic Stress Disorder in Intensive Care Unit Nurses in Dedicated Hospitals for Coronavirus 19)

  • 정현옥;박혜자
    • 동서간호학연구지
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    • 제28권2호
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    • pp.170-178
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    • 2022
  • Purpose: This study aimed to identify the factors influencing post-traumatic stress disorder in intensive care unit nurses in dedicated hospitals for coronavirus disease of 2019 (COVID-19) during the peak of the outbreak. Methods: This study used a cross-sectional correlational design. A total of 100 participants completed questionnaires comprising the Impact of Event Scale-Revised (IES-R), coping strategy indicator, social support, and post-traumatic growth. Post-traumatic stress disorder was classified as normal, mild risk, and high risk. Data were analyzed using 𝛘2 test, Fisher's exact test, Kruskal-Wallis test with multiple comparison analysis, Pearson correlation coefficient, and multinominal logistic regression analysis. Results: Fifty seven nurses (57.0%) had a high risk of post-traumatic stress. Higher levels of post traumatic stress were associated with higher levels of social support seeking, and higher levels of avoidance, and lower levels of social support from supervisors. Higher post traumatic growth was correlated with higher social support for seeking coping, and problem solving coping strategies, and social support from supervisors and colleagues. Post-traumatic stress risk was associated with social support seeking and supervisors' social support. In addition, a higher risk of post-traumatic stress was related to COVID-19 work duration and supervisors' social support. Conclusion: Supportive programs, including increasing social support and building coping skills, may be suggested to safeguard the mental health of critical care nurses during the pandemic.

자살시도 후 생존 퇴원한 환자에서 지역정신건강센터 등록 요인 분석 - 응급실 기반 자살시도자 관리시스템 자료 중심으로 - (Contributing Factors for the Registration Rates within Emergency Department Based Post-suicidal Care Program)

  • 김동기;전병조;문정미;조용수;배경열;김현정;김미진
    • 대한임상독성학회지
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    • 제14권1호
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    • pp.54-59
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    • 2016
  • Purpose: This study was conducted to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between January and September 2015 at the academic ED in the tertiary urban hospital. The variables examined included gender, age, address, type of insurance, history of previous psychiatric disease, suicide methods, number of previous attempts, CES-D (The Center for Epidemiologic Studies-Depression Scale), and disposition at ED. Univariate and multivariate logistic regression analysis were conducted to identify factors affecting the registration rate for the community-based post suicidal care program. Results: Overall, 331 suicides were investigated, 61 (18.4%) of which were registered in the post-suicide care program. Factors such as a intervention by psychiatric physician (OR: 3.287, 95%; CI: 1.207-9.624) and levels of depression by CES-D score of 16-24 (OR: 3.635; CI: 1.055-12.526) were significantly correlated with registration for the program. Conclusion: The registration rate for the community-based post suicidal care program was influenced by frequent intervention by a psychiatric physician and levels of depression by CES-D score of 16-24.

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