• Title/Summary/Keyword: Pre-hospital care

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Physical Therapy for Post-Myocardial Infarction (심근경색후 물리치료)

  • Lee, Jeong-Weon
    • Physical Therapy Korea
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    • v.1 no.1
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    • pp.83-87
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    • 1994
  • The purpose of this paper is to provide an overview of the clinical physical therapy program used at the University of Yonsei Rehabilitation Hospital, for the practicing university trained physical therapists who may be unfamiliar with patients who have suffered a myocardial infarction. The four primary phases of the cardiac physical therapy graded exercise program are: 1) coronary care unit program (phase I), 2) general ward program (phase II), 3) convalescence program (phase III), 4) maintenance program (phase IV). The exercise prescription defines the exercise intensity, duration, frequency, and mode of exercise a after pre- discharge low level graded exercise test(LL-GXT) or symptom limited maximum graded exercise test. A typical exercise routine consists of preparation warm-up exercise, therapeutic exercise, cool-down exercise. Physical therapy is involved in the acute care and rehabilitation of the patient after a myocardial infarction. Therefore, the physical therapist must throughly comprehened the cardiac anatomy, cycle, performance, conduction system, pathogenesis, risk factors, and exercise benefits.

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The Change of White Blood Cell Count Following Transfusion in Preterm Neonates (미숙아에서 수혈 후 백혈구수의 변화)

  • Yoon, Soo Young;Lee, Gum Joo;Jung, Gui Young
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.325-330
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    • 2002
  • Purpose : We intended to find out how the red cell transfusion would change the white cell count in preterm neonates under treatment in the intensive care unit. We also speculated whether the magnitude of such a change could indicate a potential neonatal infection. Methods : Total white blood cell count, total neutrophil count, and band count were compared and analyzed retrospectively on 33 preterm neonates who received red cell transfusions in our hospital's intensive care unit over a period of two years and a month. Results : We found a mean change of $1.33{\times}10^3/mm^3$ and $0.55{\times}10^3/mm^3$ in total white blood cell count and total neutrophil count in the first eight hours following the red cell transfusion. No significant change was observed in band count between pre and post-red cell transfusion. Conclusion : A mild increase in the white blood cell count caused by an increase in neutrophil count was observed temporarily following the red cell transfusion. But the white blood cell count returned to the pre-transfusion level in about 24 hours, indicating that such a low level of increase cannot be interpreted as an infection of a preterm neonate.

Effects of Kangaroo Mother Care: A Quasi-Experimental Design

  • Joo-Young, LEE;Do-Young, LEE
    • Journal of Wellbeing Management and Applied Psychology
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    • v.6 no.1
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    • pp.9-15
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    • 2023
  • Purpose: This study aimed to implement safe and suitable kangaroo mother care with healthy mothers and newborns immediately after childbirth. In addition, it aimed to assess its effects on maternal attachment, maternal role confidence, and maternal role satisfaction. Research design, data and methodology: A quasi-experimental design was used with pre and posttests. A total of 58 participants were selected by convenience sampling through public notifications at a women's hospital. The control group performed routine care without providing kangaroo contact, and a posttest was performed four weeks after the pretest. The experimental group comprised healthy mothers who had given birth by cesarean section. They performed kangaroo mother care twice a day (60 min each) for four weeks for their newborns after the protocol was validated by an expert. Results: The results showed significantly higher maternal attachment, maternal role confidence, and maternal role satisfaction in mothers who participated in kangaroo mother care than those who did not. Our findings suggested that kangaroo mother care has a positive effect on the enhancement of maternal attachment and facilitation of maternal role confidence and satisfaction. Conclusions: Thus, the expansion and implementation of kangaroo mother care are necessary to promote healthier mother-child relationships.

Transarterial Therapies for Hepatocellular Carcinoma: a Comprehensive Review with Current Updates and Future Directions

  • Kumar, Yogesh;Sharma, Pranav;Bhatt, Neeraj;Hooda, Kusum
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.473-478
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    • 2016
  • Hepatocellular cancer is a very common cause of cancer related deaths worldwide. Only 30-40% of patients present with early-stage disease open to curative treatments, such as resection or transplantation, while others can only undergo local therapies or palliative care. Various trans-arterial approaches have been used for treatment of hepatocellular carcinoma in patients who need a down-staging to liver transplantation, and who are not candidates for transplantation or radiofrequency ablation. Transarterial chemoembolization (TACE), transarterial embolization (TAE), drug-eluting beads, and radioembolization have been used for locoregional control, and have been shown to prolong the overall survival when compared with supportive care. In this review, we discuss patient selection, pre- and post-procedure imaging, techniques, safety, and clinical outcomes related to these therapies. Newer advances with future directions in various fields related to trans-arterial therapies are also discussed.

Effectiveness of Rapid Response Team on In-hospital Mortality in Patients with Hematologic Malignancy (혈액암 환자의 원내 사망률에 미치는 신속대응팀의 효용성)

  • Park, So-Jung;Hong, Sang-Bum;Lim, Chae-Man;Koh, Youn-Suck;Huh, Jin-Won
    • Quality Improvement in Health Care
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    • v.27 no.2
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    • pp.18-29
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    • 2021
  • Purpose: Patients with hematologic malignancy (HM) typically have a high mortality rate when their condition deteriorates. The chronic progressive course of the disease makes it difficult to assess the effect of intervention on acute events. We investigated the effectiveness of a rapid response team (RRT) on in-hospital mortality in patients with HM. Methods: We retrospectively analyzed the data of patients with HM who admitted to the medical intensive care unit between 2006 and 2015. Clinical outcomes before and after RRT implementation were evaluated. Results: A total of 228 patients in the pre-RRT period and 781 patients in the post-RRT period were included. The overall in-hospital mortality was 55.4%. Patients in the post-RRT period had improved survival; however, they required more vasopressor therapy, continuous renal replacement therapy, and extracorporeal membrane oxygenation. Multivariate analysis revealed that in-hospital mortality was associated with RRT activation (hazard ratio [HR], 0.634; 95% confidence interval [CI], 0.498-0.807; p < .001), neurological disease (HR, 2.007; 95% CI, 1.439-2.800; p < .001), sequential organ failure assessment score (HR, 1.085; 95% CI, 1.057-1.112; p < .001), need for continuous renal replacement therapy (HR, 1.608; 95% CI, 1.206-1.895; p< .001), mechanical ventilation (HR, 1.512; 95% CI, 1.206-1.895; p< .001), vasopressor (HR, 1.598; 95% CI, 1.105-2.311; p = .013), and extracorporeal membrane oxygenation (HR, 1.728; 95% CI, 1.105-2.311; p = .030). Conclusion: RRT activation may be associated with improved survival in patients with HM.

A Correlational Study on the level of Importance & performance of postpartal Care and its Relationship with Women's Health Status (출산경험 여성의 산후관리 중요도, 수행정도 및 건강상태와의 관계 연구)

  • Kim, Tae-Kyung;Yoo, Eun-Kwang
    • Women's Health Nursing
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    • v.4 no.2
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    • pp.145-161
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    • 1998
  • This correlational study sought to find the relationship among women's health status and the level of importance & performance of postpartal care. One hundred thirty three women who live in Seoul and rural area including hospitalized in a general hospital and midwifery clinic were studied from 1st April, 1998 to 25th April, 1998 for 25 days. Data analysis consisted of frequency, percentage, Pearson Correlation Coefficiency, t-test, ANOVA and Sheffe test as a post hoc, using SPSS. The results of analysis were as follows ; mean age of respondents was 31.9 years and mean number of children was 1.8. The most of family type was nuclear family and lived int apartment. Mean frequency of pregnancy was 2.7 times and most women delivered at local clinic, general or University hospital. Mean period of after delivery was 53.7 month. The level of importance and performance of traditional postpartal care (Sanhujori) was more higher than hospital postpartal care. The level of importance, performance of postpartum care and health status had significant relationship. The higher level of importance was, & the higher level of performance was higher, and the higher degree of health status. The factors related to health status were postabortal sahujori period after abortion, nuclear family, the evaluation of sahujori, whether women and followed the caregiver's advice well or not and whether they have physical symptoms or not, at the level of $5{\sim}0.1%$ of significance statistically. The factors related to the level of importance of postpartal care were the number of child, present health status and health status of pre-post of delivery, deliver place and the opinion of effective postpartum care method at the level of $5{\sim}0.1%$ of significance statistically. The factors related to the level of performance of postpartal care were delivery place, the opinion of whether they can do at the hospital or not and whether they have physical symptom or not at the level of $1{\sim}0.1%$ of significance statistically. In conclusion, this finding reconfirmed the relationship among women's health status and the postpartal care. It provides a challenge to the health professional caregivers to research continually and repeatedly and confirm the conceptual model of Sanhujori, reestablish effective and integrative postpartal caring system which contains oriental and western paradigm for women's life long health toward the 21C.

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The Effects of Structured Preoperative Instruction on Anxiety and Self-care Compliance in Patients with Cataract Surgery (구조화된 수술 전 교육이 백내장 수술 환자의 불안과 자가간호 수행에 미치는 효과)

  • Choi, Mi Jung;Park, Jeong Sook
    • Korean Journal of Adult Nursing
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    • v.25 no.4
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    • pp.473-482
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    • 2013
  • Purpose: The purpose of this study was to investigate the effects of a structured preoperative instruction upon anxiety and postoperative self-care compliance. Methods: A randomized control group pre-post design was used. Sixty subjects undergoing cataract surgery were randomly assigned to one of two groups. The instruction consisted of cataract surgery procedure, sensory information, deep breathing, use of eye drop, and post op self-care regimen and was provided to the experimental group with control group receiving an usual treatment. State anxiety NRS, pulse, BP, and self-care compliance scale developed by Cho & Rho were used. Data were collected at two time periods: on the day of surgery in the clinic and prior to anesthesia in the operating room. The postoperative self-care compliance scores were measured at their second visits to the hospital after surgery. Data were analyzed using Kolmogorov Smirnov test, t-test, and Mann-Whitney U test. Results: There were significant differences between the two groups in the postoperative state anxiety (t=-3.57, p=.001) and the postoperative self-care compliance score (t=3.92, p<.001). There were no significant difference between the two groups in the postoperative blood pressure and pulse rate. Conclusion: The results of this study suggest that the structured preoperative instruction could be a nursing intervention for cataract surgery patients.

Development of an Algorithm for the Prevention and Management of Pressure Ulcers (입원 환자의 욕창예방과 중재를 위한 알고리즘 개발)

  • Kim, Jin-Mi;Park, Jeong-Sook
    • Korean Journal of Adult Nursing
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    • v.22 no.4
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    • pp.353-364
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    • 2010
  • Purpose: The purpose of this study was to develop an algorithm for preventing and managing of pressure ulcer and to verify the its appropriateness. Methods: The first step was development of a pre-algorithm through a literature review and expert opinion. The second step was to establish content validity by submitting the algorithm questionnaires about the content to 12 experts. The third step was the revision of the algorithm. The fourth and last step was to establish the clinical validity of the algorithm with 25 experienced nurses. Results: For the ease of the practitioner the algorithm for prevention and the management of pressure ulcers was confined to one page depicting the main algorithm pathway and seven stepwise guidelines. The guidelines included skin care of pressure ulcer prevention, mechanical loading care, support surface care, reposition care of pressure ulcer, and Stages II, III and IV explanations along with debridement/wound irrigation and infection control. Most of all algorithm courses chosen more than 80% of agreement by expert index of content validity. The usefulness, appropriateness, and convenience of the algorithm were demonstrated through clinical validity with intensive care unit and ward nurses. Conclusion: The algorithm will improve the quality of pressure ulcer nursing care as it provides a model for decision making for clinical nurses as well as providing consistent and integrated nursing care for patients with pressure ulcer throughout an institution.

The Effects of a Death Preparation Education Program on Death Anxiety, Death Attitudes, and Attitudes toward End-of-Life Care among Nurses in Convalescent Hospitals

  • Chu, Eun-yeong;Jang, Sun-hee
    • Journal of Hospice and Palliative Care
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    • v.24 no.3
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    • pp.154-164
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    • 2021
  • Purpose: The purpose of this study was to examine the effects of a death preparation education program for nurses working in convalescent hospitals on death anxiety, death attitudes, and attitudes toward end-of-life care. Methods: This was a quasi-experimental study with a non-equivalent control group, pre-test and post-test design. Among 53 participants, 26 were assigned to the non-equivalent experimental group and 27 to the control group. The program was performed in the formats of lectures, video-watching, group discussions, and sharing, and consisted of 10 sessions held twice a week, for 5 weeks (90 minutes per session). Data were analyzed using descriptive statistics, the t-test, and the chisquare test in SPSS version 21.0. Results: Significant differences between the experimental and control groups were observed in death anxiety (t=7.62, P<0.001), death attitudes (t=-7.58, P<0.001), and attitudes to end-of-life care (t=-10.30, P<0.001). Conclusion: It was confirmed that the death preparation education program reduced death anxiety and had a positive effect on death attitudes and attitudes toward end-of-life care. Based on the results of this study, it is expected that specialized and systematic education that can increase the implementation and stability of death preparation education in various fields, including nursing, will have a positive effect on both hospice patients and members of society more broadly.

Does Cervical Screening in Young Women Aged 20-25 Years Lead to Unnecessary and Harmful Interventions?

  • Al-Kalbani, Moza;Price, John;Thompson, Gwen;Ahmad, Sarfraz;Nagar, Hans
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6557-6559
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    • 2015
  • Background: Cervical human papillomavirus (HPV) infection among young women (20-25 years of age) is common and normally transient. There are growing concerns that referral to a colposcopy clinic may lead to unnecessary treatment with an increased risk of obstetric complications. Therefore, the purpose of this study was to determine the level of intervention for cervical abnormalities in this age group of the Northern Ireland population. Materials and Methods: A review of all serial new patients under 25 years of age, who were referred to colposcopy clinics in Northern Ireland between January 1, 2009 to June 30, 2009 formed the basis of this study. Results: During the study period, a total of 4,767 women under 25 years of age were screened. Two-hundred-and-thirty-four (4.9%) cases were referred to the colposcopy clinics. The cervical cytology results were: high-grade abnormality in 35%, and low-grade abnormality in 31% of these cases. One-hundred-and-seventy-eight (76%) of the referred women received at least one treatment. One-hundred-and-twenty-one of 234 (51.5%) women underwent an excisional treatment with histology showing the presence of high-grade abnormalities (CIN2-3) in 52%, CIN1 in 28%, and Koilocytosis or normal tissue in 20% of this sub-group of cases. Conclusions: Screening women under the age of 25 years cause unnecessary referral for colposcopy. This may also result in considerable anxiety and psychosexual morbidity. It leads to an over-treatment with a potential of negative impact on the future pregnancy outcomes (including pre-term delivery, low birth weight, and pre-term premature rupture of membranes).