• 제목/요약/키워드: Standard of Care

검색결과 1,361건 처리시간 0.03초

슬관절 치환술 환자의 교육 프로그램 효과에 관한 연구 (Effects of the Educational Program for Patients of T.K.R.A.)

  • 왕미숙
    • 한국간호교육학회지
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    • 제7권1호
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    • pp.68-80
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    • 2001
  • This study is aimed to evaluate the effects of the educational program that is designed to help the patients of T.K.R.A. to improve their self-nursing ability. The research will show how well this program can contribute to raising of their adaptability of everyday life by decreasing the difficulties that the patients had before in their daily life. The sample persons for this research were 40 adult patients who had T.K.R.A. in our hospital, and the data were collected through the questionnaires which were given to them. For the surveying tool, Jette's scale was applied to measure the degree of uncomforting that the patients experienced in their daily life. The materials of report had been gathered from May 1st to December 10th. The collected data were analyzed with real numbers, percentage, average, the standard deviation, TorF test and Pearsons correlation. The results of this study can be summarized like follows: The survey of self-caring exercise part were processed with two groups containing experiment group and contrast group. The exercise which took the highest points in experiment group was repetition of stretching and bending knees with laid down position while taking a walk, repetition of stretching and bending knees with seated on chair position and repetition of stretching and bending knees with laid down position got high points in contrast group. There were distinctive differences in statistics between repetition of stretching and bending knees in laid down position and taking a walk. There was no significant statistical gap between the degrees of inconveniences of daily life that each two groups experienced when we compared the average of the two groups, but 12 out of 20 questions got considerable differences. According to common characters of self-caring, there was a distinctive gap in the group who left the hospital in 14days and the ones who spend more than 30 minutes with exercise. The patient group who left the hospital in fourteen days after T.K.R.A. spent more time doing self-caring exercise. In the relationship between common characters and the degree of difficulties of daily life, Exercising is effective and Spending more that 30 minutes for exercise showed visible differences. The patients who answered that exercise are effective and put more time for it experienced less pain in their everyday life. The data proved by Pearson's correlation showed the relationship between self- caring and the degree of pain of daily life. According to the result, the increasing of self-caring activities helped to down the degree of inconveniences of daily life. This data show that T.K.R.A. reduced self-caring exercise ability and daily life activities. Therefore, the medical staffs who would take care the T.K.R.A. patients should offer stable nursing through well scheduled and education materials for patients. It is also important to encourage the patients to participate to the exercise by showing them how exercise after T.K.R.A. The education program is expecting to guarantee not only the right of patients to get enough information but also effective result to decrease uncomfortable of daily life.

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Accuracy of Frozen Section Analysis of Sentinel Lymph Nodes for the Detection of Asian Breast Cancer Micrometastasis - Experience from Pakistan

  • Hashmi, Atif Ali;Faridi, Naveen;Khurshid, Amna;Naqvi, Hanna;Malik, Babar;Malik, Faisal Riaz;Fida, Zubaida;Mujtuba, Shafaq
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권4호
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    • pp.2657-2662
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    • 2013
  • Background: Intraoperative sentinel lymph node biopsy has now become the standard of care for patients with clinically node negative breast cancer for diagnosis and also in order to determine the need for immediate axillary clearance. Several large scale studies confirmed the diagnostic reliability of this method. However, micrometastases are frequently missed on frozen sections. Recent studies showed that both disease free interval and overall survival are significantly affected by the presence of micrometastatic disease. The aim of this study was to determine the sensitivity and specificity of intraoperative frozen section analysis of sentinel lymph nodes (SLNs) for the detection of breast cancer micrometastasis and to evaluate the status of non-sentinel lymph nodes (non-SLNs) in those patients subjected to further axillary sampling. Materials and Methods: We performed a retrospective study on 154 patients who underwent SLN biopsy from January 2008 till October 2011. The SLNs were sectioned at 2 mm intervals and submitted entirely for frozen sections. Three levels of each section submitted are examined and the results were compared with further levels on paraffin sections. Results: Overall 40% of patients (62/154) were found to be SLN positive on final (paraffin section) histology, out of which 44 demonstrated macrometastases (>2mm) and 18 micrometastases (<2mm). The overall sensitivity and specificity of frozen section analysis of SLN for the detection of macrometastasis was found to be 100% while those for micrometastasis were 33.3% and 100%, respectively. Moreover 20% of patients who had micrometastases in SLN had positive non-SLNs on final histology. Conclusions: Frozen section analysis of SLNs lacks sufficient accuracy to rule out micrometastasis by current protocols. Therefore these need to be revised in order to pick up micrometastasis which appears to have clinical significance. We suggest that this can be achieved by examining more step sections of blocks.

진사탁(陳士鐸) 임상 이론의 특징에 관한 연구 (A Study on Characteristics of Jinsatak(陳士鐸)'s Clinic Theory)

  • 정경호;김기욱;박현국
    • 대한한의학원전학회지
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    • 제22권3호
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    • pp.31-51
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    • 2009
  • The characteristics of Jin's ideas on clinic theory can be arranged as follows. 1. Jin emphasized warming and tonifying[溫補] in treatment and the part that shows this the best is the taking care of[調理] the Vital gate[命門], kidney, liver, and spleen. His ideas were based on his understanding of a human life's origin, and was influenced by Seolgi(薛己), Joheon-ga(趙獻可) and Janggaebin(張介賓)'s Vital gate and source Gi theory(元氣說) so scholastically, he has that in common with them but was later criticized by later doctors such as Oksamjon(玉三尊) as an 'literary doctor(文字醫)' who followed the ideas of "Uigwan(醫貫)". 2. The warming and tonifying school[溫補學派], who were influenced by Taoism, said in their theory of disease outbreak[發病學說] that since one must not hurt one's Yin essence and Yang fire [陰精陽火] there is more deficiency than excess, so that was why they used tonifying methods. Jin was also like them and this point of view is universal in internal medicine, gynecology, pediatric medicine and surgery and so on. 3. Jin, who saw the negative form of pulse diagnosis[診脈] emphasized following symptoms over pulse diagnosis using the spirit of ‘finding truth based on truth[實事求是]' in "Maekgyeolcheonmi(脈訣闡微)", but emphasized 'the combination of pulse and symptoms[脈證合參]'. He understood pulse diagnosis as a defining tool for symptoms, and in "Seoksilbirok(石室秘錄)" simplified pulse diagnosis into 10 methods : floating/sunken(浮沉), slow/fast(遲數), large/fine(大小), vacuous/replete(虛實) and slippery/rough(滑澀). 4. Jin used 'large formulas(大方)' a lot that usually featured a large dose, and in " Bonchosinpyeon(本草新編)" he thought of the seven formulas(七方) and ten preparations(十劑) as the standard when using medicine. He did away with old customs and presented a 'new(新)' and 'extra(奇)' point of view. He especially used a lot of Insam(人蔘) when tonifying Gi and Geumeunhwa(金銀花) when treating sores and ulcers. 5. In the area of surgery Jin gave priority to the early finding and treatment of disease with internal treatment[內治] and was against the overuse of acupuncture. However records of surgical measures in a special situation like lung abscesses(肺癰) and liver abscesses(肝癰), and anesthetic measures using 'Manghyeongju(忘形酒)' and 'Singoiyak(神膏異藥)' and opening the abdomen or skull, and organ transplants using a dog's tongue are important data. 6. Jin stated the diseases of Gi and blood broadly. Especially in the principles of treating blood, blood diseases had to be forwarded[順] and Gi regulation[理氣] was the number one priority and stated the following two treatments. First, in "Jeonggiinhyeolpyeon(精氣引血篇)" of volume 6 of "Oegyeongmieon(外經微言)", for the rules for treating blood he stated the pattern identification of finding Gi in blood and blood in Gi. Second, he emphasized Gi regulation(理氣) in blood diseases and stated that the Gi must be tonifyed after finding the source of the loss of blood.

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영아모의 임신의도와 양육태도의 관계 (A Study of the Relationship between the Intention of pregnancy and the Child-Rearing Attitudes of Mothers with Infants)

  • 심정하
    • 대한간호학회지
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    • 제27권2호
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    • pp.454-464
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    • 1997
  • The purpose of this study was to identify the correlation between the intention of pregnancy and the child rearing attitudes of mothers with infants. The data was collected from 138 mothers by means of an interview and questionnaire in a period from April 1 to April 30, 1997, when they came to have their infants vaccinated at one hospital and one health care center. The collected data was analyzed by means of the SPSS Program using percentage, means and standard deviation in each area and the ANOVA and Pearson Correlation Coefficient. The results of this study were as follows : 1. It showed that the mother's degree of intention of pregnancy was 3.90(±1.49) among the possible score of 0∼5 and the score of child rearing attitudes was 70.1 among the possible score of 20∼100. The mom score of the items was 3.50(±.36) among the possible score of 0∼5. 2. There was a significant relation between the intention of pregnancy and child rearing attitudes. It was mildly positive but was significant (r=.21, p<0.05). 3. There was a significant relation between the period from marriage to the time of pregnancy and the intention or pregnancy(F=.57, p<0.05). Also, it was found out that the group of mothers who became pregnant later than 12 months after marriage wanted after pregnancy more than the group of women who were pregnant within 12 months after marriage(F=11.30, p<0.01). 4. There was a significant relation between the period from marriage to the time of pregnancy and child rearing attitudes(F=4.14, p<0.05), It showed that the child rearing attitudes of the group of women who became pregnant later than 12 months after marriage was positive(F=11.42, p<0.01). Also, in case that the both the husband and wife decided on the pregnancy, the child rearing attitudes were more positive (F=7.15, p< 0.05). In conclusion, when the intention of pregnancy was stronger, the subjects' child rearing attitudes were more positive. Also when both the husband and wife decided on the pregnancy, the attitudes were more positive. So it seems that both husband and wife should discuss and agree upon pregnancy, having a sufficient period during which both the spouses prepare for the intention of pregnancy. Additionally, it is suggested that when the husband and wife are doing family planning, it would be beneficial to use a program of 'Woman's Intention on Pregnancy' during this process.

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The Effect of Glasthma Syrup in Asthma: a study protocol for a triple-blind randomized controlled trial

  • Derakhshan, Ali Reza;Saeidinejat, Shahin;Khadem-Rezaiyan, Majid;Asnaashari, Amir-Mohammad-Hashem;Mirsadraee, Majid;Salari, Roshanak;Jabbari-Azad, Farahzad;Jalali, Shima;Jalali, Shabnam
    • 대한약침학회지
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    • 제25권3호
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    • pp.233-241
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    • 2022
  • Objectives: Asthma is a chronic disease, and the demand for herbal medicines in this field has increased in recent years. The new findings highlight the role of the gut-lung axis in the pathophysiology of asthma. Hence, this study will evaluate the safety and efficacy of Glasthma syrup, an herbal formula based on Persian medicine, in improving asthma and regulating intestinal permeability. The formula consists of five herbal ingredients that have anti-inflammatory effects on the respiratory tract, also known as gut tonics. Methods: The study will be conducted as a placebo-controlled, triple-blind, randomized trial. It will consist of a 4-week intervention followed by a 4-week follow-up period. The target sample size is 20 patients with moderate asthma aged 18 to 60 years. Eligible participants will be randomly assigned to either the experimental group or the control group in equal numbers. Patients in the experimental group will take Glasthma syrup (7.5 mL, twice a day), while patients in the control group will take a matching placebo. Both groups will receive a 4-week combination of a long-acting beta2 agonist and a leukotriene modulator as standard of care. Inhaled corticosteroids can be used as rescue medication as needed. Results: The primary outcomes are asthma symptom scale, lung function, and intestinal permeability. Secondary outcomes include quality of life, symptom recurrence rates, and blood tests. A safety assessment will also be conducted during the trial. Conclusion: In this trial, the effects of Glasthma syrup in patients with moderate asthma will be examined. The study will also assess the effects of the formulation on the gut-lung axis by simultaneously monitoring the gut permeability index, asthma symptoms, and lung function.

입원중인 조기 진통 임부의 신체적, 정서적 상태와 간호요구에 대한 연구 (A Study on the Physical and Emotional Status, and Nursing Needs of the Pregnant Women Hospitalized by Premature Labor.)

  • 이평숙;유은광
    • 여성건강간호학회지
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    • 제2권1호
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    • pp.88-105
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    • 1996
  • The purpose of this study was to find out physical and emotional status, and nursing needs of the pregnant women who were hospitalized by premature labor. The research respondents were 96 from four university hospitals located in Seoul, from June 30, 1996 to September 15, 1995. The research instrument was consisted of 14 items of physical status(discomforts) (Cronbach's=0.86), 17 items of emotional status (Cronbach's=0.89), 33 items of nursing needs (Cronbach's=0.94), and they were measured by 5 level of Likert Scale. The data were analyzed by frequency, percentage, mean standard deviation, ANOVA, Pearson correlation coefficient as the statistical techniques in the program of SPSS/$PC^+$. The findings were as follows : 1. The perception of physical status was mainly about physicl discomforts during the hospital stay. It included four categories about 'absolute bed rest' 3.48, 'hospital foods' 3.38, 'health care teams' 2.93, 'hospital environment' 2.83 in order of mean of discomforts. The most discomfortable one was "malodor by not doing personal hygiene." The next one was "urination and defecation on the bed using bedpan." 2. The perception of the emotional status was about negative mood related to 'fetus', 'hospitalization' perse, 'personal situation.' The highest score of negative mood was "I am afraid that the baby's condition will be bad if I deliver it before full term." The next one was "I am anxious about whether my baby will be in incubator if I deliver it before full term." 3. The highest mean score among items of nursing needs was "Nurses observe whether the labor come or not with concerns." The next one was "Nurses observe the fetal movement and check up the fetal heart sound." The lowest one was "Nurses help me when I need bedpan." 4. Nursing needs were consisted of four categories : professional, educational, emotional, and physical. The mean score of them was high in professional, educational, emotional, and physical need in order. 5. The physical status was related to "Experience of treatment for maintenance of pregnancy" and "Experience of hospitalization by premature labor". The emotional status was related to "Type of delivery" and "Type of habitation." 6. In the correlation of physical and emotional status, it showed positive correlation between them. The higher score of physical discomfort, the higher score of negative mood(r=0.5113, p=0.0001).

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Subcutaneous emphysema related to dental procedures

  • Jeong, Cheol-Hee;Yoon, Seungkyu;Chung, Seung-Won;Kim, Jae-Young;Park, Kwang-Ho;Huh, Jong-Ki
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제44권5호
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    • pp.212-219
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    • 2018
  • Objectives: The objective of this study was to analyze 11 cases of subcutaneous emphysema associated with dental procedures from a single hospital and discuss approaches for accurate diagnosis and treatment of the condition. Materials and Methods: The medical records of 11 patients who were treated for subcutaneous emphysema related to dental procedures between January 2009 and April 2017 were analyzed retrospectively. Patients with subcutaneous emphysema within the facial area or that spread to the neck and beyond, including the facial region, were assigned to two groups and compared in terms of age, sex, and durations of antibiotic use, hospitalization, and follow-up until improvement. The correlation between location of the origin tooth and range of emphysema spread was analyzed. Results: The average durations of antibiotic use during conservative treatment and follow-up until improvement were 8.55 days (standard deviation [SD], 4.46 days) and 1.82 weeks (SD, 1.19 weeks), respectively. There was no intergroup difference in duration of antibiotic use (P=0.329) or followup (P=0.931). Subcutaneous emphysema was more common after dental procedures involving the maxilla or posterior region than after those involving the mandible or anterior region. There was no significant difference in air distribution according to location of the air orifice (maxilla, mandible, or both; P=0.106). Conclusion: Upon adequate conservative treatment accompanied by prophylactic antibiotic treatment considering the risk of infection, patients showed signs of improvement within a few days or weeks. There was no significant difference in treatment period between patients with subcutaneous emphysema localized to the facial region and those with subcutaneous emphysema spreading to the neck or beyond. These findings need to be confirmed by analysis of additional cases.

기능성 소화불량증 환자에서 침구 처치 후 다채널 위전도 소견의 변화 (Changes in Multi-channel Electrogastrography after Acupuncture Treatmet in Patients with Functional Dyspepsia)

  • 김유승;류봉하;김진성;홍인아;박영선;정용재;오승환;한가진
    • 동의생리병리학회지
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    • 제24권1호
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    • pp.152-157
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    • 2010
  • The aim of this study was to investigate the effects of traditional Korean medical therapy in patients with functional dyspepsia evaluted using multi-channel electrogastrography. Before the treatment, the EGG of 14 outpatients (male 3, female 11) with functional dyspepsia were recorded and their dominant frequency(DF), percentage of gastric slow waves, percentage of Power ratio, and percentage of slow wave couplings were analysed. For 8 weeks, the patients received acupuncture treatment. After 8 weeks, EGG was rechecked and compared with the previous data. After treatment, normogastria was significantly increased in channel 1 and channel 3($53.70{\pm}18.94$% vs $72.64{\pm}15.49$% in channel 1, P<0.05; $79.74{\pm}18.09$ vs $90.86{\pm}8.86$ in channel 3, P<0.05). arrythmia was significantly decreased in channel 3($14.34{\pm}15.21$ vs $5.93{\pm}6.90$, P<0.05). The patients who had less severe decrease in EGG indexes showed improvement of those indexes through 8 weeks of outpatient care. EGG channel 3 was shown to be the most adequate standard of evaluation. But there was no significant improvement in slow wave coupling rate which is a new index of multichannel EGG.

화협옹주 출토 화장품(갈색 고체) 성분 분석 및 재현연구 (Component Analysis and Reproduction of a Brown Solid Cosmetic Excavated from Tomb of Princess Hwahyeop)

  • 이채훈;류송이;이한형;김효윤;김성미;정용재
    • 보존과학회지
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    • 제36권5호
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    • pp.430-439
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    • 2020
  • 본 연구에서는 화협옹주 회곽함에서 출토된 화장품 중 갈색 고체 잔여물이 나타난 화장품을 중점으로 연구를 진행하였다. 이 화장품은 1752년 부장된 회곽함 안의 청화백자합에서 출토되었다. 국립고궁박물관에서는 유물분석과 문헌조사를 진행하였다. 이를 바탕으로 출토화장품의 원재료와 제조법을 추정하여 크림 형태의 화장품재현을 시도하였다. 이후 출토품과 유사한 열화 양상을 확인하기 위하여 고온, 자외선, 이산화탄소 조건에서 열화를 시행하였다. 이에 따른 변화와 화장품으로써의 효과를 확인하고자 과학적 분석과 기능성 평가를 진행하였다. 유지류가 높은 비율로 혼합된 재현품에서는 고온열화가 진행됨에 따라 색차값이 약 32 차이가 나타났고, O-H 결합과 C=C 결합에서 화학적 변화가 발생하여 유지류 산화가 발생한 것을 확인할 수 있었다. 또한, 자외선 열화를 통해서는 pH 값이 노출 시간에 따라 산성화되는 것을 확인할 수 있었다. 재현품의 기능성 평가로 진행한 차폐율은 현대 화장품의 차폐 기준치보다 낮게 나타났다.

노인의 사회적 지지와 삶의 질에 관한 연구 -일반가정노인과 양로원노인을 대상으로- (A Study on Social Support and the Quality of Life in the Elderly(The comparative analysis between home residents and institution residents))

  • 채수원;오경옥
    • 대한간호학회지
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    • 제22권4호
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    • pp.552-568
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    • 1992
  • Recent improvements in the standard of living, national income and medical care, and a decline in the infant death rate which have occurred related to economic growth and modernization, have led to a longer average life-span and a higher ratio of elderly people in the total population, Therefore, not only in the field of nursing science, but also in the field of many other discipline, issues concerning the elderly have been given increasing interest. A great deal of effort has been spent on increasing the quality of life for elderly people. This study was conducted to analyze the correlation between social support and quality of life. The sample consisted of III subjects residing at home and 107 subjects residing in institutions all of whom were over 65 years of age. The data collection period was from October 23, 1990 to January 26, 1991. Social support was measured using the Norbeck social Support Questionnaire developed by Norbeck, translated by Oh, Ka Sil and quality of life was measured using the QOL scale developed by No, You Ja. Data were analyzed using pereentages, t-test, Pearson Correlation Coefficient and ANOVA. The results of this study are as follows : 1. There was a statistically signifivant difference in the level of social support between the two groups (t=-8.83, p<.001), The elderly at home reported a much higher level of social support. 2. There was a statistically significant difference in the level of QOL between the two groups (t=-5.77, p<.001) . The elderly at home reported a much more positive quality of life. 3. There was a positive correlation between social support and QOL for the elderly at home ard it was statistically significant (r=.32, p<.001). 4. There was a postitive collealtion between social support and QOL for the elderly in institutions and it was also statistically significant (r=.19, p<.05). 5. The relationship between the general characteristics of the elderly at home and the variables of social support and of QOL were as follows ; 1) according to sex(t=10.57, p<.01) and the number of offspring(F=6.19, p<.01), there was a statistically significant difference in social support. 2) according to amount of Pocket money, there was a statistically significant difference in QOL(F=2.98, p<.05). 6. The relationship between the general characteristics of the elderly in institutions and the two variables were as follows ; 1) according to sex(t=6.24, p<.05), the number of offspring(F=6.16, p<.001) and religion (F=2.58, p<.05), there was a statistically significant difference in social support. 2) according to religion, there was a statistically significant difference in QOL(F=2.90, p<.05). In conclusion, it can be said that social support is an important variable related to QOL in the elderly and that social support levels are higher for the elderly residing at home. Therefore, more specific and objective approaches and efforts are needed to effectively use resources to maintain the elderly at home and to enhance social support available to the elderly in institutions and thereby increase QOL regardless of residence.

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