• Title/Summary/Keyword: Pre-hospital care

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항암화학요법에 관한 개별교육이 자가 간호 지식과 자가 간호 수행에 미치는 효과 (The Effects on Self-care Knowledge and Performance in the Individualized Education for Chemotherapy)

  • 정혜윤;권명순
    • 종양간호연구
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    • 제8권1호
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    • pp.8-16
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    • 2008
  • This study was conducted to investigate whether an individualized cancer patient education would increase self-care knowledge and performance. Eventually, it was to reduce side effect and promote self-care for chemotherapy. Method: This study utilized a nonequivalent control group pre-post test design. The subjects included 50 patients with cancer 25 in the experimental group, and 25 in the control group. The study was performed from January 2006 to June 2006 for the patients who were first treated by chemotherapy in a university hospital. Results: Individualized education was significantly increased in self-care knowledge and performance. Self-care knowledge and performance showed significant correlations as well. Conclusions: Individualized patient education was an effective nursing intervention in increasing self-care knowledge and performance for chemotherapy.

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Effects of the Coronavirus Disease 2019 (COVID-19) Pandemic on Outcomes among Patients with Polytrauma at a Single Regional Trauma Center in South Korea

  • Kim, Sun Hyun;Ryu, Dongyeon;Kim, Hohyun;Lee, Kangho;Jeon, Chang Ho;Choi, Hyuk Jin;Jang, Jae Hoon;Kim, Jae Hun;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • 제34권3호
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    • pp.155-161
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    • 2021
  • Purpose: The coronavirus disease 2019 (COVID-19) pandemic has necessitated a redistribution of resources to meet hospitals' service needs. This study investigated the impact of COVID-19 on a regional trauma center in South Korea. Methods: We retrospectively reviewed cases of polytrauma at a single regional trauma center in South Korea between January 20 and September 30, 2020 (the COVID-19 period) and compared them to cases reported during the same time frame (January 20 to September 30) between 2016 and 2019 (the pre-COVID-19 period). The primary outcome was in-hospital mortality, and secondary outcomes included the number of daily admissions, hospital length of stay (LOS), and intensive care unit (ICU) LOS. Results: The mean number of daily admissions decreased by 15% during the COVID-19 period (4.0±2.0 vs. 4.7±2.2, p=0.010). There was no difference in mechanisms of injury between the two periods. For patients admitted during the COVID-19 period, the hospital LOS was significantly shorter (10 days [interquartile range (IQR) 4-19 days] vs. 16 days [IQR 8-28 days], p<0.001); however, no significant differences in ICU LOS and mortality were found. Conclusions: The observations at Regional Trauma Center, Pusan National University Hospital corroborate anecdotal reports that there has been a decline in the number of patients admitted to hospitals during the COVID-19 period. In addition, patients admitted during the COVID-19 pandemic had a significantly shorter hospital LOS than those admitted before the COVID-19 pandemic. These preliminary data warrant validation in larger, multi-center studies.

Direct Switch from Tiotropium to Indacaterol/Glycopyrronium in Chronic Obstructive Pulmonary Disease Patients in Korea

  • Lee, Sang Haak;Rhee, Chin Kook;Yoo, Kwangha;Park, Jeong Woong;Yong, Suk Joong;Kim, Jusang;Lee, Taehoon;Lim, Seong Yong;Lee, Ji-Hyun;Park, Hye Yun;Moon, Minyoung;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • 제84권2호
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    • pp.96-104
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    • 2021
  • Background: Many chronic obstructive pulmonary disease (COPD) patients receiving monotherapy continue to experience symptoms, exacerbations and poor quality of life. This study aimed to assess the efficacy and safety of direct switch from once-daily tiotropium (TIO) 18 ㎍ to indacaterol/glycopyrronium (IND/GLY) 110/50 ㎍ once daily in COPD patients in Korea. Methods: This was a randomized, open-label, parallel group, 12-week trial in mild-to-moderate COPD patients who received TIO 18 ㎍ once daily for ≥12 weeks prior to study initiation. Patients aged ≥40 years, with predicted post-bronchodilator forced expiratory volume in 1 second (FEV1) ≥50%, post-bronchodilator FEV1/forced vital capacity <0.7 and smoking history of ≥10 pack-years were included. Eligible patients were randomized in a 1:1 ratio to either IND/GLY or TIO. The primary objective was to demonstrate superiority of IND/GLY over TIO in pre-dose trough FEV1 at week 12. Secondary endpoints included transition dyspnea index (TDI) focal score, COPD assessment test (CAT) total score, and rescue medication use following the 12-week treatment, and safety assessment. Results: Of the 442 patients screened, 379 were randomized and 347 completed the study. IND/GLY demonstrated superiority in pre-dose trough FEV1 versus TIO at week 12 (least squares mean treatment difference [Δ], 50 mL; p=0.013). Also, numerical improvements were observed with IND/GLY in the TDI focal score (Δ, 0.31), CAT total score (Δ, -0.81), and rescue medication use (Δ, -0.09 puffs/day). Both treatments were well tolerated by patients. Conclusion: A direct switch from TIO to IND/GLY provided improvements in lung function and other patient-reported outcomes with an acceptable safety profile in patients with mild-to-moderate airflow limitation.

Effectiveness after Designation of a Trauma Center: Experience with Operating a Trauma Team at a Private Hospital

  • Kim, Kyoung Hwan;Han, Sung Ho;Chon, Soon-Ho;Kim, Joongsuck;Kwon, Oh Sang;Lee, Min Koo;Lee, Hohyoung
    • Journal of Trauma and Injury
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    • 제32권1호
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    • pp.1-7
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    • 2019
  • Purpose: The present study aimed to evaluate the influence of how the trauma care system applied on the management of trauma patient within the region. Methods: We divided the patients in 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 the Halla Hospital after designation of a trauma center. We compared annual general characteristics, injury severity score, the average numbers of the major trauma patients, clinical outcomes of the emergency department, and mortality rates between the two groups. Results: No significant differences were found in the annual patients' average age ($54.1{\pm}20.0$ vs. $52.8{\pm}18.2$, p=0.201), transportation pathways (p=0.462), injury mechanism (p=0.486), injury severity score (22.93 vs. 23.96, p=0.877), emergency room (ER) stay in minutes (199.17 vs. 194.29, p=0.935), time to operation or procedure in minutes (154.07 vs. 142.1, p=0.767), time interval to intensive care unit (ICU) in minutes (219.54 vs. 237.13, p=0.662). The W score and Z score indicated better outcomes in post-trauma system group than in pre-trauma system group (W scores, 2.186 vs. 2.027; Z scores, 2.189 vs. 1.928). However, when analyzing survival rates for each department, in the neurosurgery department, in comparison with W score and Z score, both W score were positive and Z core was higher than +1.96. (pre-trauma group: 3.426, 2.335 vs. post-trauma group: 4.17, 1.967). In other than the neurosurgery department, W score was positive after selection, but Z score was less than +1.96, which is not a meaningful outcome of treatment (pre-trauma group: -0.358, -0.271 vs. post-trauma group: 1.071, 0.958). Conclusions: There were significant increases in patient numbers and improvement in survival rate after the introduction of the trauma system. However, there were no remarkable change in ER stay, time to ICU admission, time interval to emergent procedure or operation, and survival rates except neurosurgery. To achieve meaningful survival rates and the result of the rise of the trauma index, we will need to secure sufficient manpower, including specialists in various surgical area as well as rapid establishment of the trauma center.

의료분쟁에 관한 보건정책학적 고찰 -응급의료종사자를 중심으로- (The Legal Consideration in Emergency Medical Service System)

  • 강병우
    • 한국응급구조학회지
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    • 제3권1호
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    • pp.91-101
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    • 1999
  • The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

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스마트폰을 이용한 개별화된 관심전환 중재가 수술 전 환아의 불안에 미치는 영향 (Effects of a Smart Phone Individualized Distraction Intervention on Anxiety in Pre-Op Pediatric Patients)

  • 이경아;권미경;김혜원;임지은;표창옥;박찬숙
    • Child Health Nursing Research
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    • 제21권2호
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    • pp.168-175
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    • 2015
  • Purpose: The purpose of this study was to identify whether individualized distraction intervention using a smart phone affected pre-op anxiety of children. Methods: This was a nonequivalent control group pre-post test quasi-experimental design. The participants were 30 children in the experimental group and 30 in the control group. In experimental group, a smart phone individualized distraction intervention was given to children from the reception area to the operation room. Results: For heart rate, there were no statistically significant differences between the experimental group and control group. In the behavioral anxiety response, there were statistically significant differences between the experimental group and control group (t=-3.11, p=.003). Conclusion: The finding suggest that, for pre-op children, the individualized distraction intervention using a smart phone had some significance as a nursing intervention having a positive impact. Such interventions can help pediatric nurses to relieve pre-op anxiety and improve health of children in their care.

Spiritual Care Training for Mothers of Children with Cancer: Effects on Quality of Care and Mental Health of Caregivers

  • Borjalilu, Somaieh;Shahidi, Shahriar;Mazaheri, Mohammad Ali;Emami, Amir Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.545-552
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    • 2016
  • Background: The purpose of this study was to explore the effectiveness of a spiritual care training package in maternal caregivers of children with cancer. Materials and Methods: This study was a quasi-experimental study with pretest and posttest design consisting of a sample of 42 mothers of children diagnosed as having cancer. Participants were randomly assigned to either an experimental or a control group. The training package consisted of seven group training sessions offered in a children's hospital in Tehran. All mothers completed the Spirituality & Spiritual Care Rating Scale (SSCRS) and the Depression, Anxiety and Stress Scale (DASS-21) at pre and post test and after a three month follow up. Results: There was significant difference between anxiety and spiritual, religious, Personalized care and total scores spiritual care between the intervention and control groups at follow-up (P<0.001).There was no statistically significant difference in stress and depression scores between the intervention and the control groups at follow-up. Conclusions: Findings show that spiritual care training program promotes spirituality, personalized care, religiosity and spiritual care as well as decreasing anxiety in mothers of children with cancer and decreases anxiety. It may be concluded that spiritual care training could be used effectively in reducing distressful spiritual challenges in mothers of children with cancer.

초기 대응자에 따른 수지 손상 환자의 병원 전 단계 응급처치 실태와 만족도 (Survey on Prehospital Services for Acute Traumatic Hand Injury and Patient Satisfaction)

  • 윤순영;김민숙;오경옥;정지영;전명희;엄동춘
    • 한국간호교육학회지
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    • 제15권2호
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    • pp.274-284
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    • 2009
  • Purpose: This study surveyed how victims with acute traumatic hand injuries received pre-hospital care and how satisfied they were with that care. Method: A total of 100 adults were interviewed using a questionnaire at one microsurgical clinic in Korea. Results: Only 12 patients (12.0%) were transported by the ambulance and the others by private or company's vehicles. Only 9 patients (9.0 %) were able to get appropriate first response from the EMTs or industrial health providers at the scene of the accidents. The mean time required for transportation from the scene of the accident to the operation room of the microsurgical clinic was $372.65{\pm}719.17$ minutes. Most of the patients were satisfied with the pre-hospital care provided by the EMT or industrial health providers but dissatisfied with that provided by lay persons. Conclusion: This study demonstrates that there is a lack in the first response provided at the scene and the activation of EMS (Emergency Medical System) for acute hand injury. It is necessary to educate the public about the appropriate first response and rapid transportation to the appropriate microsurgical clinic.

말기암환자의 가정간호 사정도구 개발 (The Development of a Homecare Nursing Assessment Tool for Terminal Cancer Patients)

  • 김혜영;정현숙;전병학;조영이
    • 가정∙방문간호학회지
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    • 제18권2호
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    • pp.108-117
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    • 2011
  • Purpose: The purpose of this study is to develop a homecare nursing assessment tool for terminal cancer patients, testing the validity and reliability of the tool. Methods: This was a methodological study. The tool was developed in four stages: first, preliminary items were developed based on Gordon' functional health pattern model; second, a panel of specialists reduced the number of preliminary items using validity tests for content; third, final items were selected from the results of a pre-test. Finally, from August 4th, 2011 to August 26th, 2011, reliability and validity were tested using a sample of 125 terminal cancer patients in Seoul and Gyeonggi-do. Results: The final tool consisted of 39 items, with Cronbach's ${\alpha}$ 0.70. Using factor analysis, 10 factors were extracted; the correlation coefficient of these was over 0.3. Conclusion: The tool developed in this study was identified as having a high degree of reliability and validity. Given this, the tool can be effectively utilized for implementing and improving home care for patients with terminal cancer.

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Recipient Management before Lung Transplantation

  • Kim, Hyoung Soo;Park, Sunghoon
    • Journal of Chest Surgery
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    • 제55권4호
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    • pp.265-273
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    • 2022
  • Lung transplantation is considered a viable treatment option for patients with end-stage lung disease. Recent decades have seen a gradual increase in the number of lung transplantation patients worldwide, and in South Korea, the case number has increased at least 3-fold during the last decade. Furthermore, the waiting list time is becoming longer, and more elderly patients (>65 years) are undergoing lung transplantation; that is, the patients placed on the waiting list are older and sicker than in the past. Hence, proper management during the pre-transplantation period, as well as careful selection of candidates, is a key factor for transplant success and patient survival. Although referring and transplant centers should address many issues, the main areas of focus should be the timing of referral, nutrition, pulmonary rehabilitation, critical care (including mechanical ventilation and extracorporeal membrane oxygenation), psychological support, and the management of preexisting comorbid conditions (coronary artery disease, diabetes mellitus, gastroesophageal reflux disease, osteoporosis, malignancy, viral infections, and chronic infections). In this context, the present article reviews and summarizes the pre-transplantation management strategies for adult patients listed for lung transplantation.