• Title/Summary/Keyword: Quality nursing care

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Evaluation of Clinical Usefulness of Critical Patient Severity Classification System(CPSCS) and Glasgow coma scale(GCS) for Neurological Patients in Intensive care units(ICU) (신경계 중환자에게 적용한 중환자 중증도 분류도구와 Glasgow coma scale의 임상적 유용성 평가)

  • Kim, Hee-Jeong;Kim, Jee-Hee
    • Proceedings of the KAIS Fall Conference
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    • 2012.05a
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    • pp.22-24
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    • 2012
  • The tools that classify the severity of patients based on the prediction of mortality include APACHE, SAPS, and MPM. Theses tools rely crucially on the evaluation of patients' general clinical status on the first date of their admission to ICU. Nursing activities are one of the most crucial factors influencing on the quality of treatment that patients receive and one of the contributing factors for their prognosis and safety. The purpose of this study was to identify the goodness-of-fit of CPSCS of critical patient severity classification system(CPSCS) and Glasgow coma scale(GCS) and the clinical usefulness of its death rate prediction. Data were collected from the medical records of 187 neurological patients who were admitted to the ICU of C University Hospital. The data were analyzed through $x^2$ test, t-test, Mann-Whitney, Kruskal-Wallis, goodness-of-fit test, and ROC curve. In accordance with patients' general and clinical characteristics, patient mortality turned out to be statistically different depending on ICU stay, endotracheal intubation, central venous catheter, and severity by CPSCS. Homer-Lemeshow goodness-of-fit tests were CPSCS and GCS and the results of the discrimination test using the ROC curve were $CPSCS_0$, .734, $GCS_0$,.583, $CPSCS_{24}$,.734, $GCS_{24}$, .612, $CPSCS_{48}$,.591, $GCS_{48}$,.646, $CPSCS_{72}$,.622, and $GCS_{72}$,.623. Logistic regression analysis showed that each point on the CPSCS score signifies1.034 higher likelihood of dying. Applied to neurologically ill patients, early CPSCS scores can be regarded as a useful tool.

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Investigating Sexual Function and Affecting Factors in Women with Breast Cancer in Iran

  • Shandiz, Fatemeh Homaee;Karimi, Fatemeh Zahra;Rahimi, Nafiseh;Abdolahi, Mahboubeh;Anbaran, Zahra Khosravi;Ghasemi, Mina;Mazlom, Seyed Reza;Kheirabadi, Aghileh Nasaghchi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3583-3586
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    • 2016
  • Background: Since the breast is strongly relevant to sexual desire, and physical and sexual attractiveness, the high prevalence of breast cancer (BC) in Iran and long-term survival of patients experiencing side effects means that measures to identify associated sexual problems are necessary. Therefore, this study was conducted to assess sexual function and affecting factors in women with BC. Materials and Methods: This cross-sectional study was performed on 94 women with BC, referred to Imam Reza (AS) Hospital, Mashhad, Iran, in 2014. The data were collected through demographic and clinical questionnaires and also a sexual function questionnaire and analyzed using SPSS version 16. Results: The total score of women's sexual function was about $24.3{\pm}4.41$. Of the total, 63 (71.3%) reported sexual dysfunction, for example reduced satisfaction or more pain. Age was the only significantly related factor. Conclusions: Breast cancer can adversely affect women's sexual function and decrease quality of life. Thus, taking measures to overcome women's sexual problems are necessary.

A study of the current ethical situation in organ transplantations in Korea (한국의 장기이식과 관련된 윤리적 고려사항의 분석)

  • 한성숙;황경식;맹광호;이동익;엄영란
    • Journal of Korean Academy of Nursing
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    • v.28 no.1
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    • pp.26-36
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    • 1998
  • This primary study was done to develop an ethical guideline for organ transplantation, a life-saving treatment which helps improve the quality of life. This study tried to identify the current situation in Korea, in terms of ethical considerations in organ transplantations. This study collected basic data in organ transplantations, in the hope that procedure of organ transplantations could be developed that would be fair to both organ donors and recipients. The immediate goals of this study were : 1)to identify staff in charge of organ transplantations and their jobs in the hospital, 2)to survey whether there exists a Hospital Ethics Committee(HEC), 3)to research what consideration are formally taken in selecting recipients, and 4)to accumulate data on how consent from donors are currently obtained. The study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. Organ transplantation coordinators were found in 16 hospitals, but the job description varied among hospitals. The survey showed that all 16 hospitals with an HEC that health care personnel unnecessarily dominate the committee. The study notes that HECs should be vitalized by recruiting, as members, ethicists, theologians, patients, guardians, as well as the general public outside of the hospital. The study revealed that in selecting recipients the hospital take into account ABO blood type, histocompatibility, age, waiting time. and level of patient compliance. Finally, it was shown that in the cases of living donors the transplanting hospitals seek a formal consent, whereas there are no common consenting practice established for cadaveric donors. The study concludes with three proposals. First, a nationwide institution responsible exclusively for procurement and distribution of cadaveric organs for transplantation should be established. Second. we should rebuild the national health insurance system so that have costly organ transplantation expenses are substantially covered. Last, but certainly not least. there is a need to emphasize the HEC's committment to prepare a proper ethical guideline for organ transplantation in general.

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A Survey Study on Needs for the Construction of the CSFT (Cluster with a Strongpoint for Field Training) (CSFT-구축 수요도에 관한 조사 연구)

  • Lee, Jae-Hong;Kang, Kyu-Hun;Kwon, Won-An;Kim, Gi-Chul;Kim, Chang-Tae;Min, Dong-Gi;Lee, Jin-Hwan
    • PNF and Movement
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    • v.11 no.1
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    • pp.27-33
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    • 2013
  • Purpose : The purpose of this research was to research on Needs for the Construction of the CSFT(Cluster with a Strongpoint for Field Training) on students and professors of health-related majors. Methods : We investigated 164 students and professors using a self-reporting method with experience of Field Training. A statistical analysis was performed using SPSS 17.0 for window version. Results : It showed that educational satisfaction had scored 4.05 in curriculum, 4.00 in environment, 3.52 in schedule, 3.71 in evaluation and 3.71 in teaching and 3.84 in industrial-college systems for Field Training. Needs for the Construction of the CSFT had scored 4.17 in $mean{\pm}standard$ deviation. Conclusion : Characterization of Nursing, Department of Health and local health care environment and conditions, if you think the quality of education for the Department of Health Nursing, gradually, the acquisition and improvement of the base hospital is necessary. Therefore, it is considered to be institutionalized by installing the strongpoint hospital at least one in each region, so that they can contribute to the improvement of people's health.

Nursing Quality Improvement for Acute Stroke Patients through the Use of NIHSS (NIHSS 활용을 통한 뇌졸중 환자 간호의 질향상 전략)

  • Park, Kyung-Hyun;Song, Young-Ae;Kong, Hye-Sung;Na, Hwa-Ju;Ryu, Soo-Kyung;Park, So-Young;Kim, Sang-Hee;Choi, Hye-Rim;Bae, Hee-Jun;Han, Moon-Gu;Yang, Mi-Hwa
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.73-81
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    • 2009
  • 문제: 뇌졸중 환자를 돌보는 간호현장에서는 급성기 뇌졸중 환자의 증상악화에 대한 조기사정과 적절한 대처가 매우 중요한 문제이다. 그러나 임상현장에서는 이를 객관화하고 수치화하여 모든 의료진이 의사소통할 수 있는 유용한 도구를 사용하고 있지는 못하는 실정이다. 이러한 문제를 해결하기위해 NIHSS(National Institute of Health Stroke Scale)를 신경과 진료의사를 중심으로 활용하고 있지만 아직 간호현장에서는 보편적으로 사용하지 않고 있다. 이에 뇌졸중 환자 간호에 NIHSS를 활용하여 뇌졸중 증상악화의 조기사정과 빠른 대처로 궁극적으로는 뇌졸중 환자 간호의 질을 보다 향상시키기 위하여 본 활동이 시도되었다. 목적: 첫째, 간호사의 NIHSS 측정 신뢰도의 현수준을 점검하고 이를 향상시키기 위한 프로그램을 개발 적용한다. 둘째, 간호사가 급성기 뇌졸중환자에게 NIHSS 측정을 통하여 뇌졸중 악화를 얼마나 예측할 수 있는지 분석하고 이를 향상시킬 수 있는 방법을 모색한다. 셋째, 궁극적으로 급성기 뇌졸중 환자의 증상악화의 조기 발견과 치료를 위한 의료진의 올바른 대처지침을 마련하여 이를 적용한다. 의료기관: 경기도에 소재한 대학병원의 뇌졸중 집중치료실. 질 향상 활동: 첫째, 간호사의 NIHSS 측정 신뢰도 향상을 위해 "NIHSS 간호사 교육 프로그램"을 마련하였다. 둘째, NIHSS 측정을 통한 뇌졸중 악화 예측율 향상을 위하여 "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"을 개발하고 추적 관찰하였다. 개선효과: NIHSS 측정 신뢰도는 질 향상 활동 전 89%에서 92%로 향상되었다. 그리고 간호사의 뇌졸중 악화 양성 예측율은 58.7%에서 87.1%로 향상되었다(참고 : 간호사의 뇌졸중 악화 음성 예측율 100% 유지). 즉 "NIHSS 간호사 교육 프로그램 활용", "뇌졸중 악화 발생 시 의사, 간호사 대처 활동 프로토콜"의 적용으로 뇌졸중의 조기 발견 및 치료가 가능하였고, 향후 환자 예후에 긍정적인 영향을 줄 수 있을 것이라 기대된다.

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Quality of life and its related factors in patients with Korean chronic obstructive pulmonary disease (만성폐쇄성폐질환 환자의 삶의 질 관련요인)

  • Bang, So Youn
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.5
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    • pp.1349-1360
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    • 2016
  • The purpose of this study was to identify the degree of quality of life (QoL) and its related factors in patients with Korean Chronic Obstructive Pulmonary Disease (COPD). With data collected by Korea National Health and Nutrition Survey in 2013, general and disease-related variables, pulmonary function test, and EuroQol-5Dimension (EQ-5D) were analyzed. The mean of EQ-5D index was 0.916 in patients with COPD and 0.941 in non-COPD. The EQ-5D index and its sub dimensions (mobility, self-care, usual activity, pain/discomfort, anxiety/depression) of COPD patients were significantly lower than that of non-COPD. However, difference in COPD patients' airway limitation was significant only for self-care of EQ-5D (${\chi}^2=9.50$, p=.013). The related factors of QoL in COPD patients were age, gender, level of education, quartile of household income, smoking status, and number of comorbid diseases. Based on the results, it is important to pay close attention to COPD patients' QoL as well as comprehensive interventions which possibly improve their QoL.

Health-related Quality of Life of Patients With Diabetes Mellitus Measured With the Bahasa Indonesia Version of EQ-5D in Primary Care Settings in Indonesia

  • Muhammad Husen Prabowo;Ratih Puspita Febrinasari;Eti Poncorini Pamungkasari;Yodi Mahendradhata;Anni-Maria Pulkki-Brannstrom;Ari Probandari
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.5
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    • pp.467-474
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    • 2023
  • Objectives: Diabetes mellitus (DM) is a serious public health issue that places a heavy financial, social, and health-related burden on individuals, families, and healthcare systems. Self-reported health-related quality of life (HRQoL) is extensively used for monitoring the general population's health conditions and measuring the effectiveness of interventions. Therefore, this study investigated HRQoL and associated factors among patients with type 2 DM at a primary healthcare center in Indonesia. Methods: A cross-sectional study was conducted in Klaten District, Central Java, Indonesia, from May 2019 to July 2019. In total, 260 patients with DM registered with National Health Insurance were interviewed. HRQoL was measured with the EuroQol Group's validated Bahasa Indonesia version of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) with the Indonesian value set. Multivariate regression models were used to identify factors influencing HRQoL. Results: Data from 24 patients were excluded due to incomplete information. Most participants were men (60.6%), were aged above 50 years (91.5%), had less than a senior high school education (75.0%), and were unemployed (85.6%). The most frequent health problems were reported for the pain/discomfort dimension (64.0%) followed by anxiety (28.4%), mobility (17.8%), usual activities (10.6%), and self-care (6.8%). The average EuroQoL 5-Dimension (EQ-5D) index score was 0.86 (95% confidence interval [CI], 0.83 to 0.88). In the multivariate ordinal regression model, a higher education level (coefficient, 0.08; 95% CI, 0.02 to 0.14) was a significant predictor of the EQ-5D-5L utility score. Conclusions: Patients with diabetes had poorer EQ-5D-5L utility values than the general population. DM patients experienced pain/discomfort and anxiety. There was a substantial positive relationship between education level and HRQoL.

A Diagnostic Study on High School Students' Health and Quality of Life - Based on the PRECEDE model - (고등학생의 건강 및 삶의 질에 대한 진단적 연구 - PRECEDE 모형을 근간으로 -)

  • Yoo Jae-Soon;Hong Yeo-Shin
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3
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    • pp.78-98
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    • 1997
  • Health education, as the most fundamental concept for national health promotion, alms for developing the self-care ability of the general public. High school days are regarded as the period when most important physical, mental and social developments occur, and most health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw in that health-related subjects are divided and taught under various subjects areas at school. In order to achieve the goal of school health education, it is essential to make a systematic assessment of the learner's concerns connected with his health and life, and the factors affecting them. So far, most of the research projects that had been carried out for improving high school health education were limited in their concerns to a particular aspect of health. Even though some had been done in view of comprehensive school health education, they failed to Include a health assessment of the learner. Therefore, in this study the high school students' concerns related to health and life were investigated in the first place on the basis of the PRECEDE model, developed by Green and others for the purpose of a comprehensive diagnostic research on high school health education. This study was done in two steps : one was the basic study for developing research instrument and the other was the main one. The former was conducted at five high schools in Seoul and Cheongju for 2 months-beginning in March, 1996. The students were asked to respond to questions related to their health and lives in unstructured open-ended question forms. On the basis of analysis of the basic study, the diagnostic instruments for the quality of life, health problems, health behavior and educational factors were constructed to be used for the collection of data for main study. An expert panel and the pilot study were used to improve content validity and reliability of the instruments. The reliability of the instruments was measured at between .7697 and .9611 by the Cronbach $\alpha$. The data for this study were collected from the sample consisted of the junior and senior classes of twenty general and vocational high schools in Seoul and Cheongju for two months period beginning in July, 1996. In analyzing the data, both t-test and $X^2$-test were done by using SAS-$PC^+$ Program to compare data between the sexes of the high school students and the types of high school. A canonical correlation analysis was carried out to determine the relationships among the diagnostic variables, and a multivariate multiple regression analysis was conducted by using LISREL 8.03 to ascertain the influences of variables on the high school students' health and quality of life. The results were as follows : 1) The findings of the hypothesis tests (1) The canonical correlation between the educational diagnosis variables and behavioral, epidemiological, social diagnosis variables was .7221, which was significant at the level of p<.001. (2) The canonical correlation between the educational diagnosis variables and the behavior variables was .6851, which also was significant (p<.001). (3) The canonical correlation between the behavioral diagnosis variables and the epidemiological variables was 4295, which was significant (p<.001). (4) The canonical correlation between the epidemiological diagnosis variables and the social variables was .6005, which was also significant (p<.001). Therefore, the relationship between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the multi-dimensional factors affecting high school students' health and quality of life. Health behavior self-efficacy, the level of parents' interest and knowledge of health, and the level of the perception of school health education, all of which are the educational diagnostic variables, are the most influential variables in students' health and quality of life. In particular, health behavior self-efficacy, a causative factor, was one of the main influential variables in their health and quality of life. Other diagnostic variables suggested in the steps of the PRECEDE model were found to have reciprocal relations rather than a unidirectional causative relationship. The significance of this research is that it has diagnosed the needs of high school health education by the learner-centered assessment of variety of factors related to the health and the life of the students. This research findings suggest an integrated system of school health education to be contrived to enhance the effectiveness of the education by strengthening the influential factors such as self-efficacy to improve the health and quality of the lives of high school students.

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Convergence review of Factors related to Empowerment of Patients with Chronic Diseases in Korea (국내 만성질환자 임파워먼트 관련요인 고찰에 대한 융합연구)

  • Kim, Jiyoung
    • Journal of the Korea Convergence Society
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    • v.11 no.8
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    • pp.381-390
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    • 2020
  • The aim of this study was to review studies on factors related to empowerment of patient with chronic diseases in Korea. By a literature search of databases, a total of 14 quantitative studies published in both Korean and English between January 2011 and April 2020 were identified. All the studies used a cross-sectional design and the majority of the studies used regression analyses. In 4 (28.6%) studies adopted Diabetes Empowerment Scale-Short Form (DES-SF) as the instrument to measure empowerment. The results confirm that self-care, social support, health literacy, and quality of life are associated with empowerment of patients with chronic diseases in Korea. This study will provide basic data with developing instruments and intervention programs of empowerment of patients with chronic diseases in Korea.

Knowledge, Using Attitude and Education Demand of Analgesics on Hospitalized children's Mothers (입원아동 어머니의 진통제 지식과 사용태도 및 교육요구)

  • Oh, Jin-A;Kim, Hye-Jin;Kim, Kyung-Mi;Kwon, Jin-Young
    • Korean Parent-Child Health Journal
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    • v.12 no.2
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    • pp.177-187
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    • 2009
  • Purpose: Mothers are primary care taker for hospitalized children and they have an important role for the management of children's pain. This study was purposed to provide basic data needed in constructing the educational contents about pain management for the hospitalized children. Method: The research subjects were 165 mothers of children hospitalized at a general hospital in Busan. The questionnaire were composed of knowledge of, using attitude toward and education demand on analgesics. The data were collected from August 1 to September 30, 2009. Data were analyzed by SPSS 17.0 program. Results: The overall mean score of correct answers on knowledge about analgesics was 26.9% and using attitude toward analgesics was $25.55{\pm}4.03$. And demand of education was $3.98{\pm}0.66$. Conclusions: The level of mothers' knowledge about analgesics was very low and using attitude toward analgesics was passive. The hospitalized children's mothers need more knowledge and liberalness attitude toward analgesics. And various and sufficient educational program about analgesics and pain management for hospitalized children's mothers can be contribute to improve the quality of life of them.

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