• Title/Summary/Keyword: Pre-hospital care

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Effect of Breast-feeding Education and Follow-up care on the Breast-feeding Rate and the Breast-feeding Method - Focused on Home Visit and Phone Counselling - (모유수유교육과 추후간호방법이 산모의 모유수유실천율과 모유수유방법에 미치는 효과 - 가정방문과 전화상담을 중심으로 -)

  • Park, Sook-Hee;Koh, Hyo-Jung
    • Women's Health Nursing
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    • v.7 no.1
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    • pp.30-43
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    • 2001
  • This was a pre-experimental study to confirm the breast-feeding ability and effect of follow up care on the breast-feeding rate and the breast-feeding method by the mother-infant breast-feeding assessment tool for the mothers who got the breast-feeding education. The subjects were 46 mothers who experienced normal delivery of infants at a college hospital in K-city, Kyungsangbuk-do, from July 1 to October 21, 2000. The instrument for data obtainment were The Mother-Infant Breast-Feeding Assessment Tool of Johnson et al. (1999), and The Breast- Feeding Method Measurement Tool of Jeong, Geum-hee(1997). This instrument was reliable, showing Cronbach $\alpha$.751. This study classified them into 3 groups: at high risk for breast-feeding failure, at risk for breast-feeding problems, and at low risk for breast-feeding failure by the mother-infant breast-feeding assessment tool on the day of discharge from the hospital after delivering individual breast-feeding education to the subjects. This study investigated the breast-feeding rate and the breast-feeding method through mail questionnaire at the four week after childbirth, and through the phone counselling and the home visit for follow up care at the first week and the second week after childbirth. The sixth week after childbirth, this study investigated the breast-feeding rate by phone. The data analyzed the hypothesizes by $x^2$-test, paired t-test, ANOVA, Wilcoxon signed rank test, Wilcoxon rank sum test and trend analysis using SPSS/PC+ WIN 10.0 program. The results were as follows : 1) Hypothesis 1-1, "there won't be any difference the breast-feeding rate of a group at risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t= -1.501, p=.270). Hypothesis 1-2, "there won't be any difference the breast-feeding rate of group at low risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t=-1.732, p=.225). 2) Hypothesis 2-1, "there won't be any difference between the breast-feeding method of group at risk for breast-feeding failure for four weeks after childbirth and just after childbirth” was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-7.267, p=.000). Hypothesis 2-2, "there won't be any difference between the breast-feeding method of the group at low risk for breast-feeding failure for four weeks after childbirth and just after childbirth" was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-2.501, p=.012). 3)The 3rd hypothesis, "there won't be any difference between breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure at the 4th week after childbirth and just after childbirth" didn't show any difference between the breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure in the advance test(t=-1.521, p=.130) but there was difference between them in post test (t=-2.012, p=.044). As a result, the 3rd hypothesis was supported by pre test, but it was rejected by post test. In conclusion, this study confirmed breast- feeding education and follow up care just after childbirth were effective for the breast-feeding rate and method. Accordingly, it is proposed that successful nursing intervention of breast-feeding to be necessary by continuously providing follow up care through the mother-infant breast-feeding assessment tool as well as to execute individual breast-feeding education to mothers just after childbirth.

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Effectiveness of the Self-care Education for the Medication and Symptoms Management on the Psychiatric Patients' Quality of life (약물 및 증상관리에 대한 자가간호교육이 정신질환자의 삶의 질에 미치는 효과)

  • Son Kyung-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.300-314
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    • 1999
  • This study is an attempt to evaluate the effect of the medication and symptoms self-care education on the psychiatric patients' quality of life. This exploratory study was designed to a quasi-experiment of pretest-postest with a non equivalent control group. Subjects of 40 patients who were discharged from a mental hospital in Pusan were selected to be experiment and control group, with each group consisting of 20. The research period was from March, 6 to May, 29, 1999 and the pre-post test was given before and after implementing MSSE to the both experiment and control group. The results finding were summarized as follows ; 1. subjects who attended self-care education scored significantly higher than control group in quality of life.(Z=-2.06, P=0.034) 2. Those who were in the experiment group reported more significant higher scores than control group in item of quality of life, living situation(A=-2.62 P=0.012), relations with spouse (Z=-2.31 P=0.038) and children (Z=3.37, P=0.008), fear (Z=-1 95, P=0.049) and anger(Z=-2.07 P=0.041), work functioning (Z=-2.34, P=0.021), environmental adjustment. (Z=-2.05, P=0.039)

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Incidence of Malignancy and Its Predictive Factors in Intrapulmonary Nodules Associated with cT1-2N0M0 Non Small Cell Lung Cancer (임상적 병기 T1-2N0M0인 비소세포폐암에 동반된 폐결절의 악성여부 및 그 예측인자)

  • Yoon, Ho Il;Yim, Jae-Jun;Lee, Choon-Taek;Kim, Young Whan;Han, Sung Koo;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.2
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    • pp.151-158
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    • 2004
  • Background : When a non small cell lung caner patient at the $_cT_{1-2}N_0M_0$ stage is diagnosed with intrapulmonary nodule(s), the treatment plan and prognosis of the patient largely depend on whether the nodule is benign or malignant. In most cases, however, it is hard to conduct a biopsy on such a nodule, due to its small size. Furthermore, the predictive factors that may imply benignancy or malignancy of the nodules remain unknown. As such, the purpose of our study was to validate the incidence of malignant nodules in such cases, and find if there are any predictive factors. Methods : Chest computed tomography(CT) scans and the medical records of 444 patients, who had undergone non small cell lung cancer surgery, between July, 2001 and September, 2003, at Seoul National University Hospital, were retrospectively reviewed. Among $_cT_{1-2}N_0M_0$ non small cell lung cancer patients, with intrapulmonary nodule(s), only those cases where a CT scan or a biopsy of the nodules had been conducted, and had been followed up at intervals of more than 6 months were included. However, patients who had received chemotherapy or radiation therapy, pre- or post-operatively, or with calcified nodules, were excluded. Results : Our study group consisted of 39 patients, divided into two groups. The first group, 33 patients, had benign nodules, and the second group, 6 patients, had malignant nodules. The two groups were compared with regard to gender, age, cell type, pathologic stage, shape, size, location and number of nodules and presence of calcification around the nodules. There was no statistically significant difference between the two groups. Conclusion : The intrapulmonary nodules in non small cell lung cancer patients at the $_cT_{1-2}N_0M_0$ stage were mostly benign. Therefore, surgical treatment for such patients can be considered. Moreover, without predictive factors, pathological confirmation of the diagnosed nodules should be sought in all patients.

Influence of Simulation-Based Practice on Emergency Care for Patients with Dyspnea on Learning Outcomes in Nursing Students (시뮬레이션을 활용한 호흡곤란 응급관리 실습이 간호학생의 학습 성과에 미치는 영향)

  • Hur, Hea-Kung;Choi, Hyang-Ok;Jung, Ji-Soo;Kang, Hye-Won;Kim, Gi-Yon
    • Journal of Korean Critical Care Nursing
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    • v.5 no.1
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    • pp.12-22
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    • 2012
  • Purpose: This study was conducted to evaluate the learning outcomes of simulation-based practice on emergency care for patients with dyspnea in nursing students. Methods: One group pre-post experimental design with 28 nursing students was used. Simulation-based practice on the basis of SimMan Human Patient Simulator including academic lectures, simulation lab exercises and debriefing was applied for four and half hours. The learning outcomes were assessed by measuring knowledge, critical thinking, problem solving process of cognitive skills, self-confidence and learning attitudes of affective domain. Furthermore, self reported clinical performance ability of psychomotor skills was examined. Results: After the completion of simulation-based practice, there was a significant increase in the mean of following measured variables: knowledge, critical thinking, problem solving process of cognitive skills, self-confidence, learning attitudes of affective domain and clinical performance ability of psychomotor skills. Significant positive relationships were found among learning outcome measurement variables. Conclusion: Simulation-based practice is an effective method to improve cognitive skills, affective domain and psychomotor skills of nursing students. Hence, Simulation-based practice should be applied for improving current limited emergency care training for nursing students and enhancing students' competency in clinical situations.

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A Systematic Review on the Vocational Pharmacy Education and Pharmacists' Role in the Singapore's Healthcare System (싱가포르 보건의료체계의 약사 양성교육과 약사 직능에 대한 체계적 고찰)

  • Kwon, Nu Ri;Cho, Eun
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.187-199
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    • 2015
  • Background: Singapore has the stable healthcare system with utilizing pharmacist manpower in proper positions by demand of populations' health among Asian countries. Objective: This study aims to systematically review (1) the pharmacists' role and (2) the pharmacy education system of Singapore in comparison with Korea. Method: We searched for information about academic, medical and governmental institutions related to professional pharmacists' practice in Singapore by primarily using database such as DBpia, KISS, Google Scholar and ProQuest and the official website of the Singapore Ministry of Health. We contacted and arranged the visit schedules with National University of Singapore, National Health Group's polyclinics, Agency for Integrated Care, National University Hospital, and community chain pharmacies. During onsite visits, we interviewed pharmacists working in each institution and obtained additional documents and materials relevant to this manuscript work. Results: To become a registered pharmacist in Singapore, the pharmacy curriculum requires four full-time academic years and six additional months allotted for pre-registration training. Pharm.D. course is offered for pharmacy graduate students with additional two full-time years of study. Team teaching and inter professional education program seem the most significant method in pharmacy education. Pharmacists working at hospitals, polyclinics, and community pharmacies in Singapore take broader roles and offer more cognitive services such as smoking cessation program and medication reconciliation. Especially, pharmacists in Agency for Integrated Care fill the role of primary care providers for the continuing care of the community through the governmental support toward the patients-centered integrated care. Conclusion: Singaporean pharmacists take significant and active roles in collaboration with other healthcare providers. Efforts such as interprofessional pharmacy education and governmental endorsement of the systematic and interactive care between pharmacists and other medical providers in Singapore are needed to be urgently applied to Korea healthcare system for the promotion of population health.

Effects of Holistic Hospice Nursing Intervention Program on Self Esteem and Spiritual Well-being for Inpatients of Hospice Palliative Care Unit (전인적 호스피스 간호중재 프로그램이 호스피스완화의료병동 입원 환자의 자아존중감과 영적안녕에 미치는 효과)

  • Choi, Sung-Eun;Kang, Eun-Sil
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.209-219
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    • 2009
  • Purpose: This study was to testify the effects on self esteem and spiritual well-being of holistic hospice nursing intervention program ("Rainbow program") for inpatients of hospice palliative care unit. This was designed as a preliminary experimental study with one-group pre-post test. Methods: A total of 27 patients who were over 18 years old, and admitted in hospice palliative care unit of S hospital in P city, submitted informed consent for this study, participated in holistic hospice nursing intervention program(total 10 sessions and 1,200 minutes for 2 weeks) from April 6, 2004 to April 20, 2005. To test the effects of this intervention, Self Esteem Questionnaire (SEQ) and Spiritual Well-being Questionnaire were used. The collected data were analyzed by Paired t-test with SPSS/WIN 12.0 program. Results: (1) Hypothesis No. 1 "The experimental group which received Rainbow program will have a higher degree of self esteem than before" was supported (t=11.554, P<0.001). (2) Hypothesis No. 2 "The experimental group which received Rainbow program will have a higher degree of spiritual well-being than before" was also supported (t=6.387, P<0.001). Conclusion: This Holistic Hospice Nursing Intervention Program was effective in increasing self-esteem and spiritual well-being of patients in hospice palliative care unit. Therefore, it can actively be used and also applied to hospice palliative care practice, research, and education as a useful model of interdisciplinary team approach by hospice professionals.

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Analysis of patient transfer status of private emergency ambulance services in Busan (부산 지역 민간 응급 이송업체의 환자 이송 현황 분석)

  • Han, Sung-Min;Park, Joung-Je;Lee, Jeong-Hyeok;Kook, Jong Won
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.147-158
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    • 2021
  • Purpose: This study was conducted as a direct investigation of the data in the dispatch logbooks and status of patient transportation provided by private emergency transport companies in Busan. Methods: This study was conducted using SPSS 23.0 version for a total of 1,000 processed records of private emergency ambulance services in Busan from September 23, 2017 to November 5, 2019. Results: First, 100% of the emergency patient transfers by private emergency ambulances were carried out between medical institutions; 76.4% of all transfer patients had emergency conditions, and 86.0% had serious diseases. Second, 59.3% of the emergency patients were located at distances less than 10 km and 43.2%, at more than 10 km from the medical institutions. Third, 63.5% of the passengers were accompanied by first-class emergency rescuers according to the severity of the condition. Fourth, 92.7% of the reasons for the selection of medical institutions were transferred to places where professional care was available, accounting for most of the reasons for the selection. Finally, the medical institutions were selected according to the severity of the patient's condition; 76.5% patients were transported to institutions with a large number of doctors, and 42.9% of those were transported to specialized care institutions. Conclusion: This study collected data from 1,000 dispatch records of private emergency transport companies in Busan; these records reflect the government's policies to improve the emergency patient transfer system. The current status of emergency patient transfer offered by private transport companies was analyzed. All of the emergency patient transfers were carried out between medical institutions, and 76% of the transferred patients had emergency conditions.

Dementia Incidence Rate Before and After Implementing the National Responsibility Policy for Dementia Care in Patients With Vascular Risk Factors in Korea

  • Gihwan Byeon;Sung Ok Kwon;JinHyeong Jhoo;Jae-Won Jang;Yeshin Kim
    • Dementia and Neurocognitive Disorders
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    • v.22 no.2
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    • pp.49-60
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    • 2023
  • Background and Purpose: The National Responsibility Policy for Dementia Care was implemented in September 2017 in Korea. This study aimed to compare dementia incidence in Seoul and Gangwon-do before and after the implementation of this policy. Methods: We extracted insurance claim data from the Korean Health Insurance Review and Assessment Service for people diagnosed with diabetes, hypertension, or dyslipidemia for the first time in Seoul and Gangwon-do, Korea. We defined two enrollment groups based on the policy implementation date: 1) January 1, 2015 to December 31, 2016 (Index 1, pre-implementation), and 2) January 1, 2017 to December 31, 2018 (Index 2, post-implementation). Each group was followed up for 1 year from the time of enrollment. Then, we calculated hazard ratios to compare the incidence of dementia between the two groups, and between Seoul and Gangwon-do. Results: In Seoul, the incidence of dementia was significantly lower in Index 2 than in Index 1 (hazard ratio [HR], 0.926; 95% confidence interval [CI], 0.875-0.979). However, the incidence rate did not differ between the 2 groups (HR, 1.113; 95% CI, 0.966-1.281) in Gangwon-do. In Index 1, the incidence of dementia did not differ between Seoul and Gangwon-do (HR, 1.043; 95% CI, 0.941-1.156), but in Index 2, was significantly higher in Gangwon-do than in Seoul (HR, 1.240; 95% CI, 1.109-1.386). Conclusions: After implementing the National Responsibility Policy for Dementia Care, the dementia incidence rate decreased significantly in Seoul, consistent with other studies, but not in Gangwon-do.

Clinical Significance of the Nutritional Support Team for Preterm Infants in a Neonatal Intensive Care Unit (신생아중환자실에 입원한 미숙아에서 영양지원팀 활동의 임상적 의의)

  • Yang, Hye-Ran;Choi, Chang-Won;Kim, Beyong-Il;Seo, Jeong-Kee;Choi, Su-Ahn;Kim, So-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.39-45
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    • 2009
  • Purpose: Preterm infants are very susceptible to malnutrition because of a lack of storage of nutrients, immature digestion and metabolism, and accompanying diseases associated with prematurity. The purpose of this study was to evaluate the effects of nutritional support by the pediatric nutritional support team (pNST) on the clinical course of preterm infants in the neonatal intensive care unit (NICU). Methods: Between July 2003 and July 2006, 48 preterm infants who were admitted to the NICU at Seoul National University Bundang Hospital were included. The subjects were divided into the following two subgroups according to the presence of NST activity; pre-NST group (n=23) and NST group (n=25). Hospital records were reviewed retrospectively. Results: Forty-eight preterm babies were included (M:F=27:21; gestational age, 25~33 weeks). A dietician, pharmacists, or the pNST participated in the prescription of total parenteral nutrition (TPN) more rapidly in the NST group (p=0.000). The fasting periods and TPN administration periods were significantly decreased in the NST group compared to the pre-NST group (p=0.017 & p=0.001, respectively). The doses of calories, protein, and lipids administered via TPN were significantly increased in the NST group compared to the pre-NST group (p=0.016, p=0.000, and p=0.000, respectively). The total period on antibiotic therapy was significantly decreased in the NST group compared to the pre-NST group (p=0.007). Conclusion: Because nutritional support by the pNST is of benefit to the clinical course of preterm infants in the NICU, the pNST should recommend to improve the nutritional status and clinical outcome of preterm infants.

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Nursing Time Use in a Newborn Intensive Care Unit (NICU) (신생아중환자실 간호사의 간호업무량 분석)

  • Jun, Eun-Kyoung
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.1
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    • pp.55-81
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    • 2000
  • This study examined nursing care in a Newborn Intensive Care Unit (NICU) by reviewing nursing activities for the newborns. Through direct observation, time used for nursing care according to the nursing activity, shift, day of the week, and position of the nurses was measured. This study was done on November 15, 21, 24, 1999 at a university medical center hospital and included eight nurses and 179 newborns as the study subjects. The data were collected from the medical records, and by using a nursing activity record for the NICU, and a nursing activity time record for the NICU. The first step in the data collection process was to develop a list of nursing activities which was done through a literature review, examination of medical affairs and duty records. Content validity was measured by a panel of three professors who were experienced clinicians. In the second step two pre-training sessions were held with three sophomore student nurses who then measured the time for each nursing activity using a stopwatch. The data were analyzed using frequencies for nursing activities, averages, percentages and ANOVA for differences between shift and between days of the week, and percentages and t-test for differences according to position of the nurse. The results are as follows: 1) The total number of activities was 156, direct or indirect nursing activities. Direct nursing activity classified according to physical, educational, emotional/social/economic/spiritual needs. There were 109 direct nursing activities in 16 fields. 2) The order of nursing activities, according to time required, was record keeping, nutritional care, measurement/observation, medication, hygiene care, examination and specimen collection, and checking supplies, and according to frequency, measurement/ examination, record keeping, nutrition care, hygiene care, elimination care and medication. 3) According to shift, direct care during the night shift at 313.4 minutes was the longest time and indirect nursing care during the night shift at 252.2 minutes was the highest time. 4) For days of the week, Monday had the highest time for direct care 275.8 minutes (34.6%) and Wednessday had the highest time for indirect nursing care 269.6 minutes (36.1%). 5) For nursing time according to position of nurse, general nurses had the highest for direct care (330.7 minutes), nurse managers for indirect nursing activities (239.0 minutes) and general nurses for individual private time (63.9 minutes). The results of this study show that the major nursing time consuming activities included record keeping, nutrition care and measurement/examination. For newborns, time needs to be allowed for care to be sensitive, sophisticated and specialized rather than concentrated on indirect nursing tasks such as record keeping. Therefore, it is imperative to develop computerized systems that support a systematic approach to record keeping which is more efficient. Moreover, nursing needs according to shift, day or position of nurse can be utilized in assessing nursing resources through a computerized process.

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