• 제목/요약/키워드: Supportive Care

검색결과 411건 처리시간 0.025초

유산소 걷기운동 프로그램이 재가 뇌졸중 환자의 보행, 균형, 일상활동 수행능력, 우울에 미치는 효과 (The Effect of Home stayed Stroke Patients' gait, Valance, Activities of Daily Living, Depression in the Aerobic Walking Exercise Program.)

  • 노국희
    • 재활간호학회지
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    • 제5권2호
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    • pp.193-204
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    • 2002
  • This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of aerobic walking exercise program on the physical & psychological functions of home stayed stroke patients. The data were collected during the period of May 20th to August 15th, 2001. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b)suffering from stroke for 6 months to 5 years, (c)without recognition disorder with the MMSE-K score above 25, (d)below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease (f)able to walk beyond 15 minutes for themselves. The aerobic walking exercise program for the experimental group was aerobic exercise and education and supportive care. The aerobic exercise was 8 weeks' period, three times a week, 35 to 50 minutes a day. And the education and supportive care was consisted of one home visiting and 2 times telephoning a week. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. There was significant difference in the gait speed between the two groups. 2. There was significant difference in the dynamic valance between the two groups. 3. There was significant difference in ADL score between the two groups. 4. There was no significant difference in the depression between the two groups. As shown above, the results of 8 weeks' the aerobic walking exercise program for home stayed stroke patients produced positive effects on gait speed, dynamic valance, ADL score. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.

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이차성 자연기흉 환자에게 폐쇄식 흉관삽입술로 인한 재팽창성 폐부종에 관한 증례보고 (Re-expansion Pulmonary Edema in a patient with Secondary Spontaneous Pneumothorax Following Closed Thoracostomy: A Case Report)

  • 오선우;김수완
    • Journal of Medicine and Life Science
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    • 제18권3호
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    • pp.61-65
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    • 2021
  • Although re-expansion pulmonary edema (RPE) is rare (incidence rate <1%), it is associated with a mortality rate of >20%; therefore, early diagnosis and treatment are important. We report a case of RPE following chest tube insertion in a patient with spontaneous pneumothorax. We have specifically focused on the mechanism underlying RPE and the possible etiology. An 82-year-old man with a history of chronic anemia, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension was referred to the emergency department for management of recurrent right-sided pneumothorax. We performed emergency closed thoracostomy for suspected tension pneumothorax, which led to stabilization of the patient's vital signs; however, he coughed up frothy pink sputum accompanied by severe right-sided chest pain 30 min postoperatively. The patient showed new-onset right pulmonary consolidation on chest radiography, as well as desaturation, tachycardia, and tachypnea and was diagnosed with RPE. He was transferred to the intensive care unit for mechanical ventilation and supportive treatment using diuretics, ionotropic agents, and prophylactic antibiotics. RPE gradually resolved, and the patient was extubated 3 days after admission. He has not experienced recurrent pneumothorax or pulmonary disease for 4 months. We emphasize the importance of RPE prevention and that aggressive ventilator care and supportive treatment can effectively treat RPE following an accurate understanding of the underlying pathogenetic mechanisms and risk factors.

Association of chairside salivary aMMP-8 findings with periodontal risk assessment parameters in patients receiving supportive periodontal therapy

  • Schmalz, Gerhard;Kummer, Max Kristian;Kottmann, Tanja;Rinke, Sven;Haak, Rainer;Krause, Felix;Schmidt, Jana;Ziebolz, Dirk
    • Journal of Periodontal and Implant Science
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    • 제48권4호
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    • pp.251-260
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    • 2018
  • Purpose: The aim of this retrospective cross-sectional study was to evaluate whether salivary findings of active matrix-metalloproteinase 8 (aMMP-8) chairside (point of care; POC) tests were associated with periodontal risk assessment parameters in patients receiving supportive periodontal therapy (SPT). Methods: A total of 125 patients receiving regular SPT were included, and their records were examined. The following inclusion criteria were used: a diagnosis of chronic periodontitis, at least 1 non-surgical periodontal treatment (scaling and root planning) with following regular SPT (minimum once a year), at least 6 remaining teeth, and clinical and aMMP-8 findings that were obtained at the same appointment. In addition to anamnestic factors (e.g., smoking and diabetes), oral hygiene indices (modified sulcus bleeding index [mSBI] and approximal plaque index), periodontal probing depth simultaneously with bleeding on probing, and dental findings (number of decayed, missing, and filled teeth) were recorded. Salivary aMMP-8 levels were tested using a commercial POC test system (Periomarker, Hager & Werken, Duisburg, Germany). Statistical analysis was performed using the t-test, Mann-Whitney U test, Fisher's exact test, and ${\chi}^2$ test, as appropriate (P<0.05). Results: Only the mSBI was significantly associated with positive salivary aMMP-8 findings (aMMP-8 positive: $27.8%{\pm}20.9%$ vs. aMMP-8 negative: $18.0%{\pm}14.5%$; P=0.017). No significant associations were found between aMMP-8 and smoking, diabetes, periodontal parameters, or parameters related to the maintenance interval (P>0.05). Conclusions: Salivary aMMP-8 chairside findings were not associated with common parameters used for periodontal risk assessment in patients receiving SPT. The diagnostic benefit of POC salivary aMMP-8 testing in risk assessment and maintenance interval adjustment during SPT remains unclear.

Prevalence and abundance of 9 periodontal pathogens in the saliva of periodontally healthy adults and patients undergoing supportive periodontal therapy

  • Jung, Woo-Ri;Joo, Ji-Young;Lee, Ju-Youn;Kim, Hyun-Joo
    • Journal of Periodontal and Implant Science
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    • 제51권5호
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    • pp.316-328
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    • 2021
  • Purpose: This study aimed to examine the prevalence and abundance of 9 representative periodontal pathogens in the saliva samples of periodontally healthy subjects (PH) and patients with periodontitis who underwent supportive periodontal therapy (SPT). The age-specific distribution of these pathogens in periodontally healthy individuals was also analyzed. Methods: One hundred subjects (aged >35 years) were recruited (50 each in the PH and SPT groups) between August 2016 and April 2019. The prevalence and abundance of periodontal pathogens in the PH group were compared with those in periodontally healthy young subjects (94 subjects; aged <35 years), who were included in our previous study. DNA copy numbers of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn), Campylobacter rectus (Cr), Peptostreptococcus anaerobius (Pa), and Eikenella corrodens (Ec) were analyzed using real-time polymerase chain reaction. Results: The detection frequencies of all pathogens, except Aa, were high in the PH and SPT groups. The ranking order of pathogen DNA copy numbers was similar in both groups. In both groups, Fn had the highest abundance, Aa had the lowest abundance. Additionally, Td was significantly more abundant in men than in women in both groups (P<0.05). Compared with the PH group, the SPT group exhibited significantly lower total bacteria and Fn abundance and higher Pg abundance (P<0.05). The age-specific pathogen distribution analysis revealed a significantly low Aa abundance and high Tf and Cr abundance in the PH group. Conclusions: The clinical parameters and microbial profiles were similar between the SPT and PH groups. However, patients with periodontitis require supportive care to prevent recurrence. As the abundance of some bacteria varied with age, future studies must elucidate the correlation between age-related physiological changes and periodontal bacterial composition.

Clinical Dental Hygienists' Experience of the Prevention Based Incremental Oral Health Care: Applying Focus Group Interviews

  • Bae, Soo-Myoung;Lee, Hyo-Jin;Shin, Bo-Mi
    • 치위생과학회지
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    • 제20권2호
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    • pp.107-117
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    • 2020
  • Background: In this study, we tried to comprehensively explore clinical dental hygienist's experience of a prevention-based incremental oral health care program, which was pilot-operated by dental clinics, define prevention-based incremental oral health care as experienced in the field, and identify factors to be considered. Methods: This study conducted a focus group interview with five dental hygienists who participated in an ongoing oral management pilot project in 2016. The interview was conducted by a researcher, and the co-research team attended as progress assistants and recorded characteristics of the participants, main dictations, and non-verbal characteristics. All interviews were recorded and underwent thematic analysis to examine the questions of the study as the main axis. Results: As a result of the study, 65 meaningful statements were extracted by code, integrated into 24 sub-categories, and structured into 11 categories. Finally, four keywords were drawn: characteristics, facilitating factors, conflicting factors, and improvement measures for prevention-based incremental oral health care. Regarding prevention-based incremental oral health care in dental clinics, dental hygienists were highly aware of the physical and mental burdens of personalized treatment and education for each individual. They were responsible for the patient and for facilitating changes in the behavior of the client, leading to professional satisfaction. The dental team's cooperation and supportive attitude were found essential to continue oral health care in the dental clinic. Conclusion: Through dental team-based treatment philosophy sharing and collaboration, it is possible to provide prevention-based incremental oral health care in dental clinics. In future, it is necessary to develop a system for establishing a sustainable preventative management system for public health promotion.

Responsibilities and Difficulties of Caregivers of Cancer Patients in Home Care

  • Ugur, Ozlem;Elcigil, Ayfer;Arslan, Deniz;Sonmez, Ayfer
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.725-729
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    • 2014
  • Background: Having been known as a virulent disease in 1970s, cancer is now onsidered a chronic disease and 64% of cancer patients live for five years after diagnosis. Home care has gradually gained more importance and it is a great burden on the shoulders of caregivers. Caregivers have to undertake the responsibility of the cancer patient's home management, and organize care and arrange health care services according to the ever-changing condition of patients. Caregivers should be prepared for home care so they can provide accurate and complete care to patients. This descriptive study aims to investigate challenges that caregivers encounter in the home care of patients and the reasons for these challenges. Materials and Methods: The research group consisted of caregivers of outpatients in a daily treatment center in a university hospital. The research sampling consisted of 137 voluntary caregivers of patients who attended the Daily Treatment Center for control, chemotherapy or other supportive cares services between January-June, 2011. Data were collected with face-to-face interviews in the Daily Treatment Center. Ethics Committee approval was taken university hospital; caregivers and their patients were informed about the research and their approval was taken as well. Results: It was found that 54.01% of caregivers help patient's nutrition, 50.36% help medicine use, 26.28% help oral hygiene, 26.28% help to meet urinary needs and 51.82% help to change clothes, 69.34% of caregivers help to change bed sheets, 38.69% help the patient to communicate with their environment and 71.53% help to bring the patient to hospital or outside. Conclusions: This study, it was found that caregivers experience challenges due to following factors: patient nutrition, medicine use, oral and body hygiene, colostomy maintenance and stomach tube feeding, concern of dropping the patient, feeling incompetency in body temperature and fever control, fatigue, and lack of personal time.

시뮬레이션을 활용한 LGBT 간호 교육의 효과 (Effects of LGBT Nursing Education Using Simulation)

  • 강숙정;민혜영
    • 여성건강간호학회지
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    • 제25권4호
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    • pp.379-391
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    • 2019
  • Purpose: As health care needs for Lesbian, Gay, Bisexual and Transgender (LGBT) are becoming increasingly important, it has become imperative for the nurses to be attentive towards their health problems and provide nursing care with an open-minded attitude. Due to limited opportunity to provide direct nursing care to LGBT patients, it is hypothesized that simulation would provide good opportunity for students to experience LGBT nursing care in a safe environment. This study was conducted to develop and apply simulation of LGBT nursing care to ultimately provide unbiased nursing care for LGBT population and prepare basic data for LGBT nursing education. Methods: This study was a single-group pre-post experimental design study for 57 senior nursing students based on the comparison of existing LGBT knowledge, general attitude towards LGBT, and nursing attitude towards LGBT before and after simulation. The scenario content included discussion of coming out issue, providing sexual health information, and supportive nursing care for LGBT population. Data were analyzed with descriptive statistics and Wilcoxon signed rank. Results: Simulation education-led to a significant increase in LGBT knowledge and nursing attitude. However, there was no change in the general attitude towards LGBT. Conclusion: The results of this study suggest that LGBT education using simulation may be effective for nursing students and nurses from the point of concern for LGBT population. It is hypothesized that future LGBT educational programs might need more detailed information from both care recipients and nurses. Finally, LGBT education needs to be included in the nursing education curriculum.

Nursing Home Employee and Resident Satisfaction and Resident Care Outcomes

  • Plaku-Alakbarova, Bora;Punnett, Laura;Gore, Rebecca J.;Procare Research Team
    • Safety and Health at Work
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    • 제9권4호
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    • pp.408-415
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    • 2018
  • Background: Nursing home resident care is an ongoing topic of public discussion, and there is great interest in improving the quality of resident care. This study investigated the association between nursing home employees' job satisfaction and residents' satisfaction with care and medical outcomes. Methods: Employee and resident satisfaction were measured by questionnaire in 175 skilled nursing facilities in the eastern United States from 2005 to 2009. Facility-level data on residents' pressure ulcers, medically unexplained weight loss, and falls were obtained from the Centers for Medicare and Medicaid Services Long-Term Care Minimum Data Set. The association between employee satisfaction and resident satisfaction was examined with multiple and multilevel linear regression. Associations between employee satisfaction and the rates of pressure ulcers, weight loss, and falls were examined with simple and multilevel Poisson regression. Results: A 1-point increase in overall employee satisfaction was associated with an increase of 17.4 points (scale 0-100) in the satisfaction of residents and family members (p < 0.0001) and a 19% decrease in the incidence of resident falls, weight loss, and pressure ulcers combined (p < 0.0001), after adjusting for staffing ratio and percentage of resident-days paid by Medicaid. Conclusion: Job satisfaction of nursing home employees is associated with lower rates of resident injuries and higher resident satisfaction with care. A supportive work environment may help increase quality of care in the nation's nursing homes.

심혈관질환자의 회복력에 대한 개념분석 (Concept Analysis of Resilience in Patients with Cardiovascular Diseases)

  • 신수진;정덕유;황은희
    • 대한간호학회지
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    • 제39권6호
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    • pp.788-795
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    • 2009
  • Purpose: The purpose of this study was to define and clarify the concept of 'resilience' in patients with cardiovascular diseases. Methods: A hybrid model was used to develop the concept of resilience. The model included a field study carried out in Cheonan, Korea. The participants in this study were 9 patients with cardiovascular diseases who underwent a percutaneous coronary intervention. Results: The concept of resilience was found to be a complex phenomenon having meanings in two dimensions: the personal-dispositional and interpersonal dimensions. Four attributes and seven indicators were defined. Conclusion: A resilient person was defined as one who has a positive attitude toward restoration, the power to reconstruct and control his/her disease (personal dimension), and support from a supportive system with supportive persons (interpersonal dimension). In the clinical setting, resilience plays an important role in managing the care plans of cardiovascular patients. Therefore, nurses who work closely with patients suffering from cardiovascular diseases should be aware of the attributes and indicators of resilience to enhance the resilience of their patients.

뇌혈관질환자에게 적용가능한 간호결과 분류체계의 타당성 검증 (Validation of the Nursing Outcomes Classification on Cerebrovascular Patients)

  • 김영화;소향숙;이은주;고은
    • 성인간호학회지
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    • 제20권3호
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    • pp.489-499
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    • 2008
  • Purpose: The purpose of this study was to assess the importance and contribution of 9 nursing outcomes and their indicators that could be applied to cerebrovascular patients. Methods: Data were collected from 175 neurosurgical nurses working at two university affiliated hospitals and five secondary hospitals located in Gwang-ju. The Fehring method was used to estimate outcome content validity(OCV) and outcome sensitivity validity(OSV) of nursing outcomes and their indicators. Stepwise regression was used to evaluate relationship between outcome and its indicators. Results: The core outcomes identified by the OCV were Tissue Perfusion: Cerebral, Nutritional Status, Neurological Status, and Wound Healing: Primary Intention, whereas highly supportive outcomes identified by the OSV were Oral Health, Self-Care: ADL, and Nutritional Status. All the critical indicators selected for Fehring method were not included in stepwise regression model. By stepwise regression analysis, the indicators explained outcomes from 19% to 52% in importance and from 21% to 45% in contribution. Conclusion: This study identified core and supportive outcomes and their indicators which could be useful to assess the physical status of cerebrovascular patients. Further research is needed for the revision and development of nursing outcomes and their indicators at neurological nursing area.

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