• Title/Summary/Keyword: Pressure Sore

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Analysis of the Difference between Dementia Policy Perception, Dementia Knowledge, Dementia Attitude and Dementia Prevention Behavior according to the General Characteristics of Middle-aged (중년층의 일반적 특성에 따른 치매정책인식, 치매지식, 치매태도 및 치매예방행위 차이분석)

  • Choi, HeeJung;Kim, JiSuk
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.3
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    • pp.125-133
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    • 2020
  • The purpose of this study is to analysis of the difference between dementia policy perception, dementia knowledge, dementia attitude and dementia prevention behavior of middle-aged. The subjects were 217 middle-aged in their 40 to 64 years old who lived in D and G cities. The mean sore of were dementia policy perception 75.42±8.52, dementia knowledge 8.71±1.90, dementia attitude 28.55±5.10, dementia prevention behavior 27.04±3.35. Dementia knowledge were significant differences in gender, number of diseases, source of dementia information. Dementia attitudes were significant differences in gender, age, education, dementia in family, dementia living together, job status, early examination, source of dementia information. Dementia prevention behavior were significant difference in dementia living together and early examination. The most category of dementia prevention behavior was 'cigarette smoking(Inverse question)', and blood pressure and diabetes management' were the lowest. Therefore, development of a professional and systematic dementia education program to raise the awareness of dementia policy among middle-aged adults and form the right dementia knowledge and positive dementia attitude. Development of customized dementia prevention behavior programs to maintain cognitive activities, social activities, proper eating habits, and health care is needed.

Clinical Change of Terminally Ill Cancer Patients at the End-of-life Time (임종 전 말기 암 환자의 임상 증상 및 징후의 변화)

  • Koh, Su-Jin;Lee, Kyung-Shik;Hong, Yeong-Seon;Yoo, Yang-Sook;Park, Hyea-Ja
    • Journal of Hospice and Palliative Care
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    • v.11 no.2
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    • pp.99-105
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    • 2008
  • Purpose: In terminally ill cancer patients, accurate prediction of survival is necessary for clinical and ethical reasons, especially in helping to avoid harm, discomfort and inappropriate therapies and in planning specific care strategies. The aim of the study was to investigate prognostic factor of dying patients. Methods: We enrolled the terminal cancer patients from Kangnam St. Mary's Hospital from 2004 until their death. We observed symptoms shown in dying patients and assess 17 common symptoms shown in terminally ill cancer patients, performance status, pain and analgesic use. Results: Average period from hospitalization to death was 11.7 days. The most important prognostic factor is performance status (KPS), average KPS at enrollment is 48% and at last 48 hours is 25%. Physical symptoms that have significant prognostic importance are poor oral intake, weakness, constipation, decreased Karnofsky performance status, bed sore, edema, jaundice, dry mouth, dyspnea. Dying patients showed markedly decreased systolic blood pressure, cyanosis, drowsiness, abnormal respiration, death rattle frequently at 48 hours before death. Conclusion: If we assess the symptoms more carefully, we can predict the more accurate prognosis. The communication about the prognostic information will influence the personal therapeutic decision and specific care planning.

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Quality Improvement in the Trauma Intensive Care Unit Using a Rounding Checklist: The Implementation Results

  • Chang, Ye Rim;Chang, Sung Wook;Kim, Dong Hun;Yun, Jeongseok;Yun, Jung Ho;Lee, Seok Won;Jo, Han Cheol;Choi, Seok Ho
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.113-119
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    • 2017
  • Purpose: Despite the numerous protocols and evidence-based guidelines that have been published, application of the therapeutics to eligible patients is limited in clinical settings. Therefore, a rounding checklist was developed to reduce errors of omission and the implementation results were evaluated. Methods: A checklist consisting of 12 components (feeding, analgesia, sedation, thromboembolic prophylaxis, head elevation, stress ulcer prevention, glucose control, pressure sore prevention, removal of catheter, endotracheal tube and respiration, delirium monitoring, and infection control) was recorded by assigned nurses and then scored by the staff for traumatized, critically ill patients who were admitted in the trauma intensive care unit (ICU) of Dankook University Hospital for more than 2 days. A total of 170 patients (950 sheets) between April and October 2016 were divided into 3 periods (period 1, April to June; period 2, July to August; and period 3, September to October) for the analysis. Questionnaires regarding the satisfaction of the nurses were conducted twice during this implementation period. Results: Record omission rates decreased across periods 1, 2, and 3 (19.9%, 12.7%, and 4.2%, respectively). The overall clinical application rate of the checklist increased from 90.1% in period 1 to 93.8% in period 3. Among 776 (81.7%) scored sheets, the rates of full compliance were 30.2%, 46.2%, and 45.1% for periods 1, 2, and 3, respectively. The overall mean score of the questionnaire regarding satisfaction also increased from 61.7 to 67.6 points out of 100 points from period 1 to 3. Conclusions: An ICU rounding checklist could be an effective tool for minimizing the omission of preventative measures and evidence-based therapy for traumatized, critically-ill patients without overburdening nurses. The clinical outcomes of the ICU checklist will be evaluated and reported at an early date.

Treatment of Extremely High Risk and Resistant Gestational Trophoblastic Neoplasia Patients in King Chulalongkorn Memorial Hospital

  • Oranratanaphan, Shina;Lertkhachonsuk, Ruangsak
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.925-928
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    • 2014
  • Background: Gestational trophoblastic neoplasia (GTN) is a spectrum of disease with abnormal trophoblastic proliferation. Treatment is based on FIGO stage and WHO risk factor scores. Patients whose score is 12 or more are considered as at extremely high risk with a high likelihood of resistance to first line treatment. Optimal therapy is therefore controversial. Objective: This study was conducted in order to summarize the regimen used for extremely high risk or resistant GTN patients in our institution the in past 10 years. Materials and Methods: All the charts of GTN patients classified as extremely high risk, recurrent or resistant during 1 January 2002 to 31 December 2011 were reviewed. Criteria for diagnosis of GTN were also assessed to confirm the diagnosis. FIGO stage and WHO risk prognostic score were also re-calculated to ensure the accuracy of the information. Patient characteristics were reviewed in the aspects of age, weight, height, BMI, presenting symptoms, metastatic area, lesions, FIGO stage, WHO risk factor score, serum hCG level, treatment regimen, adjuvant treatments, side effects and response to treatment, including disease free survival. Results: Eight patients meeting the criteria of extremely high risk or resistant GTN were included in this review. Mean age was 33.6 years (SD=13.5, range 17-53). Of the total, 3 were stage III (37.5%) and 5 were stage IV (62.5%). Mean duration from previous pregnancies to GTN was 17.6 months (SD 9.9). Mean serum hCG level was 864,589 mIU/ml (SD 98,151). Presenting symptoms of the patients were various such as hemoptysis, abdominal pain, headache, heavy vaginal bleeding and stroke. The most commonly used first line chemotherapeutic regimen in our institution was the VAC regimen which was given to 4 of 8 patients in this study. The most common second line chemotherapy was EMACO. Adjuvant radiation was given to most of the patients who had brain metastasis. Most of the patients have to delay chemotherapy for 1-2 weeks due to grade 2-3 leukopenia and require G-CSF to rescue from neutropenia. Five form 8 patients were still survived. Mean of disease free survival was 20.4 months. Two patients died of the disease, while another one patient died from sepsis of pressure sore wound. None of surviving patients developed recurrence of disease after complete treatment. Conclusions: In extremely high risk GTN patients, main treatment is multi-agent chemotherapy. In our institution, we usually use VAC as a first line treatment of high risk GTN, but since resistance is quite common, this may not suitable for extremely high risk GTN patients. The most commonly used second line multi-agent chemotherapy in our institution is EMA-CO. Adjuvant brain radiation was administered to most of the patients with brain metastasis in our institution. The survival rate is comparable to previous reviews. Our treatment demonstrated differences from other institutions but the survival is comparable. The limitation of this review is the number of cases is small due to rarity of the disease. Further trials or multicenter analyses may be considered.