• 제목/요약/키워드: Restraint, Physical

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중환자실 환자의 억제대 적용에 대한 가족의 정서적 반응 (Emotional Response of ICU Patients' Family toward Physical Restraints)

  • 강지연;이은남;박은영;이영옥;이미미
    • 성인간호학회지
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    • 제25권2호
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    • pp.148-156
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    • 2013
  • Purpose: The purpose of this study was to investigate the emotional response of family members of physically restrained patients in the intensive care units (ICUs). Methods: The study subjects were 200 family members of ICU patients who had been on physical restraints in two university hospitals. Data were collected using the "Instrument of family's emotional response toward physically restrained patients". Results: The mean score of familial emotional response was 2.69 out of a possible 5. The subcategory of acceptance was the highest with 3.56 points followed by depression (3.02), helplessness (2.94), anxiety (2.87), shock (2.74), avoidance (2.64), and grudge (2.08). Multiple stepwise regression analysis indicated that the age of family members, side effects of restraints, and information provision were the variables influencing on negative emotional response of family. Conclusion: Family members showed slightly negative emotional response toward the physical restraints. This finding could be influenced by their limited knowledge of the need for the restraints. Educational programs or fact sheets to be given to family members may be helpful.

중환자 가족의 신체억제대 사용에 대한 인식: Q방법론적 접근 (Perceptions of Family Care-givers toward Use of Physical Restraints: An Application of Q-methodology)

  • 윤은자;안정화;김정아;전미순
    • 성인간호학회지
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    • 제25권3호
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    • pp.344-355
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    • 2013
  • Purpose: The purpose of this study was to identify on the perceptions of family care-givers toward use of physical restraints according to their values, beliefs, and perceptions using Q methodology. Methods: Thirty-three family care-givers classified 41 selected Q-statements into 9 points standard. The obtained data were analyzed by using a pc QUANL program. Results: Principal component analysis identified 4types of the perceptions of family care-givers toward the use of physical restraints. Type I is 'Rational accepted', which means that they perceived the restraints are essential therapeutic devices and had cooperative attitude to use of medical staffs' restraints. Type II is 'Sardonic sensibility', which means that they have a negative and a cynical attitude to use of physical restraints. Type III is 'Ambivalent', which means that they have conflicts between rationality and emotion, and type IV is 'Practical claim of a right', which means they insist that patients and their family members must be provided with a detailed explanation regarding the application of physical restraints. Conclusion: The findings of this study suggest that perceptions toward the use of physical restraints among family care-givers should be understood for patients' safety and dignity in medical circumstance. Based on the results, this study will be useful in developing the customized nursing intervention for supporting family care-givers' subjectivity considering the Korean context.

노인의 성생활 경험에 대한 서술적 연구 (A study on sexual experiences and behaviors of aged in community)

  • 오진주
    • 한국보건간호학회지
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    • 제12권2호
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    • pp.236-251
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    • 1998
  • This study aimed at comprehending the meaning of sexual life for aged people, their strength of sexual desire and causes of change in their sexual life. It was another purpose to understand the extent of aged people's acknowledging the necessity of sexual consultation. This study adopted descriptive method using open-ended questionaires. The data for study was collected from 26 people over 65 years who reside in communities. It was gathered from April to June of 1998 through interview. The interviewee includes 16 males, 9 females and their average age was 73.3. 19 people among them have spouses. The conclusion of this study can be summarized as follows. 1) Attitude to sexual life: The meaning of sexual life for aged people is categorized as 'sense of duty', 'feeling of intimacy', 'basic desire', 'decrease of meaning' and 'meaningless'. 2) Sexual desire: Sexual desire of aged people is categorized as 'extinction', 'decrease', 'continuation' and 'restraint'. Restraint of sexual desire is due to social convention or the difficulty in fulfilling desire. 3) Causes of troubles in sexual life Causes which lead to troubles in sexual life of aged people can be categorized as 'physical', 'psychological' and 'social'. 'Physical' elements include 'incompetence of erection', 'decrease in duration of erection', 'increase in time needed to re-erection', 'declining of physical strength', 'decrease in vagina secretion' and 'worsening of health'. Among 'psychological' elements 'decrease of self-confidence', 'diminished concern of female aged people' are. 'Social elements' are 'absence of sexual parter', 'circumstances of living' and 'recognition of neighbor'. 4) Response to change of sexual life The reaction of aged people to change of sexual activities is classified as 'positive' and 'negative'. 5) Attitude to the consultation of sexual life of aged people The attitude to the consultation of sexual life in old age is classified as 'negative', 'doubtful' and 'positive'. This study explored the meaning which aged people in community attach to sexual life, the extent of their sexual desire, the causes of troubles in their sexual life, their emotional response to changes in sexual life, their recognition of necessity in sexual consultation. Considering the frequency of the statement, most of aged people who were interviewed thought much of sexual life and put emphasis on it. Those who said that sexual life has decreased meaning or is not important to them are few, Though aged people still maintain sexual desire, most of them have some trouble in sexual life. These trouble changes the sexual life, and results in negative feeling such as depression, renunciation and difficulty in relations. So they acknowledged that sexual consultation is necessary to them.

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비만치료에 있어서 중도탈락과 감량 후 체중유지에 영향을 주는 인자들에 대한 고찰 (Review on predictors of dropout and weight loss maintenance in weight loss interventions)

  • 김서영;박영재;박영배
    • 대한한의학회지
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    • 제37권3호
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    • pp.62-73
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    • 2016
  • Objectives: Dropout and weight regain are common problems in most obesity treatments. The purpose of this study was to review previously published study results of the predictive factors associated with dropout during weight loss treatment and weight loss maintenance after successful weight loss. Methods: Authors searched for the articles related to dropout and weight loss maintenance, published from 2007 to 2016 found on Pubmed, Scopus, RISS, and KISS. A total of 19 articles were finally selected. From the study results, unchangeable and changeable predictors were extracted, and these predictors were examined according to dropout and weight loss maintenance categories. Results: The unchangeable predictors of dropout were younger age, lower education level and female, whereas the changeable predictors of dropout were lower initial weight loss, symptoms of depression and body dissatisfaction. The strongest factor for predicting the dropout was initial weight loss. The unchangeable predictors of weight loss maintenance were old age, male and family history of obesity, whereas the changeable predictors of weight loss maintenance were regular exercise, dietary restraint, self-weighing and low depressive symptoms. Initial weight loss, depressive symptoms, body image, dietary restraint, physical activity, weight loss expectation and social support were considered to be dominant factors for weight loss treatments. Conclusions: Our review results suggest that unchangeable and changeable predictors of dropout and weight loss maintenance should be carefully examined during treatments of obesity.

대동물 보정 차량을 이용한 횡와위 자세 육성우의 음경전위술 (Penile Translocation Surgery in Lateral Recumbency of a Calf Using Tilt-Up Mobile)

  • 정재관;문성호;강현구;김일화
    • 한국임상수의학회지
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    • 제29권1호
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    • pp.112-117
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    • 2012
  • This report evaluated the convenience and accessibility of a penile translocation surgery in the lateral recumbency of a calf using a tilt-up mobile compared with that of dorsal recumbency on the ground of a barn. One nine-month-old F-1 (Korean native sire x Holstein dam) calf was sedated with xylazine (0.03 mg/kg, IV) and restrained in the right lateral recumbency position on a tilt-up restraint mobile (90 cm high), whereas the other nine-month-old Korean native calf was administered xylazine (0.3 mg/kg, IV) and restrained in dorsal recumbency position on the ground of a barn, with assistance by one person. For the two calves, lidocaine was administered subcutaneously from the preputial orifice to the S-shaped penis. The preputial orifice was incised, and the preputial sheath and penis were separated bluntly, then laterally translocated to the site toward the left flank at a $40^{\circ}$ angle. Anti-inflammatory drug (ketoprofen) and antibiotics (penicillin) were administered following the surgery. The duration of surgery was 30 min shorter in the calf that received the surgery in lateral recumbency using the tilt-up mobile with operator's standing posture (60 min) than the one that underwent surgery in dorsal recumbency on the ground with operator's bending posture (90 min). One week after the surgery, the operation area, including the translocated preputial orifice, was healed without complications in both cases. The results detailed in this report demonstrate that penile translocation surgery in the lateral recumbency position using a tilt-up mobile might be used conveniently in calves due to the convenience of restraint, reduced surgery time, and reduced physical inconvenience for the surgeon.

억제대 적용지침 개발을 통한 불필요한 억제대 적용율 감소 활동 (Decreasing the application rate of unnecessary physical restraint through the establishment of a guideline for restraint application)

  • 곽경선;김성은;배은경;이은숙;이은혜;최윤정;이윤경
    • 한국의료질향상학회지
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    • 제15권2호
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    • pp.93-103
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    • 2009
  • 문제: 억제대 적용에 대한 구체적 적용 지침 없이 의례적으로 억제대를 사용함으로 인해 환자들의 신체적 또는 정신적 안전을 위협할 수 있다. 목적: 완전 진정 상태 이거나 근력이 약하여 발관 능력이 없는 환자에 대한 예방적 적용, 바빠서 환자를 볼 수 없는 경우, 간호사 본인의 판단이 없이 타인의 요구에 따르는 등의 불필요한 억제대 적용이 증가하는 원인을 파악하여 중환자실의 특수성에 맞는 억제대 적용 및 제거 지침을 마련하고자한다. 의료기관: 인천광역시에 소재한 의과대학 소속병원의 집중치료실 질 향상 활동: 불필요한 억제대 적용에 영향을 미치는 요인을 선정하여 개선활동 수행. 개선효과: 억제대 적용에 대한 중환자실 간호사에게 미치는 영향을 보면 태도 정도 p=0.09(p<0.1), 올바른 수행 능력은 p=0.005(p<0.05)로 통계적으로 유의한 것으로 나타났다. 지식 정도 p=0.172(p<0.05) 통계적으로 유의 하지는 않지만 모든 항목이 개선 활동 전 에 비해 2,3차 개선 활동 후에 향상 한 것으로 나타났다. 개선 활동 전에 8.1%였던 간호 기록, 0.7%였던 간호 중재, 0%였던 의사 처방율이 3차 개선 활동 후 3가지 모두 100% 달성되었다. 이는 억제대 적용율 감소 및 부적절한 억제대 적용율은 유의하게 감소 하였다. 교훈: 중환자실 간호사의 억제대 적용에 대한 태도, 지식, 올바른 간호 수행 능력은 지속적으로 재평가 되어지고, 교육내용은 좀 더 나은 간호 제공을 위하여 개발되어져야 할 것이다. 억제대 적용 기준과 제거 기준을 Check List 하여 객관성의 유지를 위한 개선 활동은 계속적으로 Feedback 되어야 할 것이다.

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Neurogenic effect of exercise via the thioredoxin-1/ extracellular regulated kinase/β-catenin signaling pathway mediated by β2-adrenergic receptors in chronically stressed dentate gyrus

  • Kim, Mun-Hee;Leem, Yea-Hyun
    • 운동영양학회지
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    • 제23권3호
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    • pp.13-21
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    • 2019
  • [Purpose] Chronic stress is a precipitating factor for depression, whereas exercise is beneficial for both the mood and cognitive process. The current study demonstrates the anti-depressive effects of regular exercise and the mechanisms linked to hippocampal neurogenesis. [Methods] Mice were subjected to 14 consecutive days of restraint, followed by 3 weeks of treadmill running, and were then subjected to behavioral tests that included the forced swimming and Y-maze tests. Protein levels were assessed using western blot analysis and newborn cells were detected using 5-bromo-2'-deoxyuridine (BrdU). [Results] Three weeks of treadmill running ameliorated the behavioral depression caused by 14 days of continuous restraint stress. The exercise regimen enhanced BrdU-labeled cells and class III β-tubulin levels in the hippocampal dentate gyrus, as well as those of thioredoxin-1 (TRX-1) and synaptosomal β2-adrenergic receptors (β2-AR) under stress. In vitro experiments involving treatment with recombinant human TRX-1 (rhTRX-1) augmented the levels of phospho-extracellular signal-regulated kinases 1 and 2 (ERK1/2), nuclear β-catenin, and proliferating cell nuclear antigens, which were previously inhibited by U0216 and FH535 (inhibitors of ERK1/2 and β-catenin/T cell factor-mediated transcription, respectively). The hippocampal neurogenesis elicited by a 7-day exercise regimen was abolished by a selective inhibitor of β2-AR, butoxamine. [Conclusion] These results suggest that TRX-1-mediated hippocampal neurogenesis by β2-AR function is a potential mechanism underlying the psychotropic effect of exercise.

119 구급대원 폭행피해에 대한 법적고찰 및 대응방안에 관한 연구 : 신체보호대를 중심으로 (A study on the violence victimization of the 119 EMT: Focusing on the physical restraints)

  • 박시은;신동민
    • 한국응급구조학회지
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    • 제23권1호
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    • pp.35-48
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    • 2019
  • Purpose: This study aimed to explore the rationality for and countermeasures against the use of prehospital patient restraint (PPR) techniques in efforts to limit violent behavior toward 119 emergency medical technicians (EMTs). Methods: Previous countermeasures to limit violent behavior toward 119 EMTs and medical personnel were focused on strict reactive and passive proactive responses. However, those in support of the countermeasures do not believe that violent and criminal behavior can be limited or extinguished by strengthening the punishment unconditionally. Results: When it comes to the far-reaching effects of stigmatization on people who engage in violent and criminal behavior, it is possible that unconditional punishment leads to more crime, increases the costs of imprisonment, and consequently, adds to the financial burden of the government. Conclusion: Thus, we are faced with an urgent need to prepare legal grounds for the use of PPR techniques by 119 EMTs for agitated or combative patients only, with direct medical oversight. Moreover, the legal foundation for the use of PPR techniques also needs to be established for emergency medical personnel. The use of PPR techniques not only ensures the safety of emergency medical services personnel, but also protects patients from injuring themselves and others.

벼 체세포배를 알긴산 캡슐에 넣어 제작한 건조형 인공종자 (Production of Dry-Type Artificial Seeds Using Alginate-Encapsulated Rice Somatic Embryos)

  • 정원중;민성란;송남희;유장렬
    • 식물조직배양학회지
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    • 제22권1호
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    • pp.1-5
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    • 1995
  • 벼의 인공종자를 무균상에서 건조시킴으로써 건조형 인공종자를 제조하였다. 1/2 MS배지에서 80%의 수분 손실률을 가진 인공종자는 20%가 발아하였다. 0.1 mg/L ABA가 첨가된 알긴산용액으로 제조한 인공종자는 0-90%의 수분손실률에서 최고 1.7배까지 발아율이 향상되었다. 이러한 결과는 ABA가 인공종자의 제조 및 건조과정에서 물리적 혹은 생리적인 저해에 대한 보호기능을 나타낸 것으로 사료된다.

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정신장애 환자의 치과치료 (DENTAL TREATMENT OF PSYCHIATRIC PATIENTS)

  • 문성용;김수관
    • 대한장애인치과학회지
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    • 제2권1호
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    • pp.1-9
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    • 2006
  • Patients with severe mental problems have difficulty maintaining good oral hygiene, so that the incidence of dental disease is greater, the disease is more severe, and the progression is much faster in these patients. Generally, they require physical restraint, drug-induced sedation, and general anesthesia since they are not cooperative. In many cases, these patients have systemic disease, so that the prognosis after dental treatment depends highly on the management of existing diseases. The problems related to treating these patients are examined and methods of using general anesthesia and sedatives are further examined to propose better ways of treating these patients.

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