• Title/Summary/Keyword: Supportive Care

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Analysis of the Perception of Hospice and Narcotic Analgesics by Family Caregivers of Terminal Cancer Patient (말기 암 환자 보호자의 호스피스와 마약성 진통제에 대한 인식도 분석)

  • Kwak, Kyung-Sook;Chun, Sung-Ho;Ha, Jung-Ok;Lee, Kyung-Hee
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.106-111
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    • 2006
  • Purpose: In terminal cancer patients, pain control with narcotic analgesics and supportive care by hospice are very useful treatment modality. However, many patients and their caregivers are poorly compliant in using narcotic analgesics for fear of addiction and tolerance. And also many patients and family caregivers are reluctant to accept hospice, presuming that hospice means patient's condition is no longer reversible and progressively deteriorating. The purpose of this study was to evaluate and analyze the perception of using narcotic analgesics and hospice by family caregivers of terminal cancer patients who play a critical role in health care in Korean culture. Methods: A total of 54 terminal ranter patient's family caregivers participated in this study. Questionnaire consisted of 15 questions about narcotic analgesics and hospice. Results: The study revealed following results. 1) family caregivers who are not aware of hospice are more than half (56.7%). 2) 81.8% of family caregivers agreed that hospice care is beneficial to terminal cancer patients. 3) 85.1% of family caregivers were under financial burden. 4) 83.2% of patient complained pain in 24 hours. 3) while 88.5% of family caregivers believed that narcotic analgesics can control pair, 79.1% and 79.6% of them also believed that use of narcotic analgesics would result in addiction and tolerance, respectively. Conclusion: There still exist barriers to family caregivers in using narcotic analgesics for pain control. And also, terminal cancer patient's family caregivers have poor information about hospice. Therefore, educational intervention about narcotic analgesics by pharmacist and doctors are needed for proper pain control for terminal ranter patients. In addition, more precise information about hospice care should be provided for terminal cancer patients and their family caregivers.

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Analysis of Factors Influencing on Food Supplier Selection Criteria in the Health-care Foodservice Operations (의료기관의 식자재 공급자 선정기준에 영향을 미치는 요인 분석)

  • Kim, Jeong-Ri;Choe, Seong-Gyeong;Gwak, Dong-Gyeong
    • Journal of the Korean Dietetic Association
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    • v.8 no.4
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    • pp.372-386
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    • 2002
  • The purposes of this study were to find factor which influence on the selection criteria of food supplier. Questionnaire were distributed to 52 general hospitals with more than 400 beds located in Seoul and Kyongin province, and responded questionnaires were collected from 44 dietetic departments (84.6%) and 18 purchasing departments (34.6%). The main results of this study can be summarized as follows: (1) supplier selection criteria include quality, service, cost and supplier competency. (2) With having been met with tight competition and market opening, hospitals plan a strategy to improve quality, service and they tend to have more interest in various supplier selection criteria. (3) Purchasing departments estimate more highly the rate of reflection in considering supplier selection criteria than the rate of importance about cost criteria, which reveals that purchasing departments sensitively respond to cost cutdown. (4) When selecting suppliers, a significant(p<.01) influence of stability of supplier industry environment on the selecting criteria such as the importances of quality, service, and supplier quality are recognized only after recognizing the stability of food delivery industry. Food supplier industry secures stability more quickly through major companies' participation in food distribution industry and this will reveal the importance of supplier selection criteria. (5) Suppliers which are selected by the quality criteria, service criteria, supplier quality criteria make efforts to communicate with foodservice departments, to give more proper information about substitute food, new product, and to make commitments, while suppliers which are decided by cost criteria do not establish supportive relationships with foodservice departments.

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Ketoprofen Plaster Toxicity Induced Gastrointestinal Hemorrhage in a Dog (케토프로펜 플라스터 독성에 의한 개에서의 위장관 출혈)

  • Park, Hyung-Jin;Choi, Joon-Hyuk;Lee, Woo-Nam;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.31 no.3
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    • pp.220-222
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    • 2014
  • A 14 year-old Shih-tzu was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with a history of foreign body ingestion and vomiting. The vomitus contained ketoprofen plaster, which is used for orthopedic analgesia in humans. Supportive care and gastrointestinal (GI) protective agents were administered, including famotidine, misoprostol, sucralfate, omeprazole, and fluid therapy. However, the clinical signs worsened, and anemia, melena, leukocytosis, and azotemia developed. The patient was diagnosed with GI hemorrhage and underwent a whole blood transfusion followed by barium sulfate administration. After administering barium sulfate as a GI protectant, the clinical signs improved, and the patient was discharged.

Systematic Review of Research into the Psychological Aspects of Prostate Cancer in Asia: What do we Know?

  • Chambers, Suzanne Kathleen;Hyde, Melissa Karen;Ip, David Fu-Keung;Dunn, Jeffrey Charles;Gardiner, Robert Alexander
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2621-2626
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    • 2013
  • Background: To review the peer reviewed literature on the psychological aspects of the prostate cancer experience of men in Asia. Materials and Methods: Medline and PsycINFO, CINAHL, ProQuest, and Web of Science (1999 - November Week 4, 2012) were searched. Inclusion criteria were: included men with prostate cancer and/or their partners or caregivers who identify as Asian recruited in an Asian country; and assessed health-related quality of life, psychological and social adjustment relating to prostate cancer and published in English after $1^{st}$ January 1999 and prior to $30^{th}$ November, 2012. Study aims; design; quality; level of evidence, and key results were assessed. Results: 43 articles met all inclusion criteria and were retained for initial review. Of these most focussed on health-related QOL with only five evidence Level IV studies from Japan and Taiwan including a specific psychological focus. Of these, one was a cross-sectional case control study; three were cross-sectional descriptive quantitative designs; one was a cross-sectional descriptive qualitative study. From the data available, a substantive sub group of men with prostate cancer (approximately one third) in these countries experience clinically high psychological distress and decision regret. Conclusions: Research on the psychological needs of men with the increasingly prevalent condition of prostate cancer in Asian countries is scant with only a small number of low level evidence descriptive studies identified. Future research to underpin the development and evaluation of effective and culturally relevant psychological and supportive care interventions for such men is urgently needed.

Evaluating of Validity on Peri-operative Hypothermia Management Evidence Based Guideline (저체온 관리 근거중심 가이드라인의 국내 타당성 검증)

  • Hong, Sung-Jung;Lee, Eunjoo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.1
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    • pp.331-343
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    • 2014
  • The purpose of this study was to evaluate the appropriateness and applicability of a evidence-based peri-operative hypothermia management guideline developed by NCC-NSC in Korea using expert group. The expert group was composed of 180 registered nurses in surgical units and recovery room, and physicians (surgeons and anesthesiologists) who had enough experiences and knowledgeable on the management of surgical patients. Validity of guidelines were evaluated in terms of appropriateness and applicability using 9 point scale. Most of the recommendations in the guideline received high score of above 6-8 point both in appropriateness and appropriateness. However, most of the recommendations were received significantly lower score in applicability than appropriateness. This research can be used as a step to develop more acceptable hypothermia management guideline for the patients undergoing abdominal surgery in Korean. In addition, further studies which identify the barriers that inhibit applicability of recommendations should be investigated.

Job-related Difficulties of Charge Nurses - Applied Parse's Human Becoming Research Method - (주임간호사가 경험하는 직무와 관련된 어려움 - Parse의 인간되어감 연구방법 적용 -)

  • Lee, Gyounghee;Kim, Junghee;Lee, Younghee;Lee, Miyoung;Lee, Okja;Im, Sookbin
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.359-371
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    • 2014
  • Purpose: This study was done to identify the core concepts and structure of difficult experiences of charge nurses in general hospitals. Methods: Data were collected from August 1 to September 5, 2014. Participants were 10 nurses from general hospitals in D and S cities. Parse research method was applied to examine lived experiences of the participants. The procedure of study was based on dialogical engagement and data were analyzed by extraction-synthesis and interpreted heuristically. The research question was "Would you tell me about your difficult experiences as a charge nurse?" Results: Job-related difficulties of the charge nurses were conflicts due to ineffective communication, heavy workload, not feeling respected, role conflict, and struggling to overcome difficulties with sense of responsibility to the work. The conceptual integration was: to be in the process of being originated and transformed through connecting-separating and enabling-limiting with valuing. Conclusion: Structural conversion of these concepts reveals that charge nurses suffer from the job-related difficulties identified in this study, but they endure to proceed with a sense of mission. It is suggested that supportive interventions should be made to let charge nurses express their feelings, identify their needs, and develop self-care or coping skills for themselves.

BLEEDING CONTROL BY THE CIRCUMFERENTIAL SUTURE & DRAINAGE ON ACTIVE BLEEDING INCISION & DRAINAGE SITE OF TEMPORAL SPACE ABSCESS DUE TO ADVANCED ODONTOGENIC INFECTION IN A MULTIPLE MEDICALLY COMPROMISED DISABLED PATIENT : REPORT OF A CASE (다발성 전신질환 장애환자에서 진행성 치성감염에 의한 측두간극농양 절개 배농시 창상주위 봉합과 배농술에 의한 과도한 출혈조절 : 증례보고)

  • Son, Jeong-Seog;Oh, Ji-Hyeon;Yoo, Jae-Ha
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.9 no.1
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    • pp.30-35
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    • 2013
  • The four principles of treatment of odontogenic infection are as follows : (1) removal of the cause, (2) establishment of drainage, (3) institution of antibiotic therapy, and (4) provision of supportive care, including proper rest and nutrition. A separate incision is required to establish drainage, especially in the case of extensive fascial space infections. There are four principle causes for active bleeding in the immediate incision & drainage phase; (1) vascular wall alteration (infection, scurvy, chemicals), (2) disorder of platelet function, (3) thrombocytopenic purpuras, (4) disorders of coagulation (liver disease, anticoagulation drug). If the hemorrhage from incision & drainage site is aggressive, the site must be packed with proper wet gauze and wound closure & drainage dressing are applied. The specific causes of bleeding may be associated with hypoxia, changes in the pH of blood & chemical changes affecting vascular contractility and blood clotting. This is a case report of bleeding control by the circumferential suture & drainage on active bleeding incision & drainage site of temporal space abscess due to advanced odontogenic infection in a multiple medically compromised disabled patient.

DISASTER PSYCHIATRY IN CHILDREN & ADOLESCENTS (소아 ${\cdot}$ 청소년의 재해정신의학)

  • Lee, So-Young Irene
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.38-46
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    • 2002
  • Disaster psychiatry is a new emerging area of psychiatry, in which psychiatrists help to minimize psychological impact of a disaster and to reduce secondary morbidities. In our society, more children and adolescents are facing disasters nowadays. Thus, the necessity for the disaster psychiatry is increasing. After a trauma, children express various symptoms in relevance to their age, development, and their environmental support. The recovery from the disaster and its long-term effect are also influenced by those factors. Psychiatric intervention in a disaster consists mainly of crises intervention and supportive psychotherapy, which includes counseling the victims, educating and providing information to the public, providing support and consultation to the community, and referring of at-risk or severely impaired individuals for more intensive clinical evaluation and care. In addition to a summarized concept of disaster psychiatry, this article presents the adverse psychological effects of children and adolescents exposed to disaster and issues related to the psychiatric intervention.

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A Clinical Study of Probable Acute Axonal Guillain-Barré Syndrome Occurring at a Mental Hospital (한 정신병원에서 발생한 급성 축삭성 길랑-바레 증후군으로 추정되는 환자들에 대한 임상적 연구)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.81-88
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    • 2000
  • Background : Guillain-$Barr{\acute{e}}$ syndrome(GBS) is characterized clinically by acute flaccid paralysis, areflexia, and albumino-cytologic dissociation. Based on electrophysiology and pathology, GBS can be divided into either predominantly demyelinating or predominantly axonal patterns. Objectives : The clinical and laboratory status of probable acute axonal GBS occurring at a mental hospital was evaluated. Methods : Eight schizophrenia patients with probable acute axonal GBS were analyzed. Results : The mean age of the patients was 38 years old. Most of the patients were men. All patients showed an acute ascending paraparesis and/or quadriparesis with areflexia, and all have a history of schizophrenia for 3~20 years. The diseases occurred predominantly in the summer and electrodiagnostic studies revealed axonal patterns. The patients were treated by supportive care, except one patient with intravenous immunoglobulin. The prognosis was improved in 3 ; no change in 4 and 1 became aggravated. One patient with acute motor-sensory axonal neuropathy had a recurrence after 10 months of the first attack. Conclusions : Axonal GBS has been considered uncommon clinically or electrophysiologically, but 8 probable acute axonal GBSs occurring at a mental hospital have been diagnosed in 3.5 years.

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Surfactant Replacement Therapy for RDS: a Collaborative Study of 72 Multi-center Trials in Korea (2010) and a Review of Korean Experiences over 20 Years (2010년 전국 72개 병원에서 신생아 호흡곤란증후군의 폐 표면활성제 치료 결과: 지난 20년간의 비교)

  • Bae, Chong-Woo;Hahn, Won-Ho;Chang, Ji-Young;Kim, Sung-Mi
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.409-411
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    • 2011
  • In Korea, pulmonary surfactant (PS) replacement therapy in respiratory distress syndrome (RDS) was started in 1991 since when Surfacten$^{(R)}$ was imported from Japan. At the present time, Surfacten$^{(R)}$, Newfactan$^{(R)}$, Curosurf$^{(R)}$, and Infasurf$^{(R)}$ are available in Korea. The governmental health insurance covers the expense for multiple dose treatment since 2002 and the early prophylactic treatment (BW: <1,250 g or GP: <30 wks) since 2011. We undertook a multi-institutional collective study to evaluate the outcomes of PS over past 20 years in Korea (Period-I; 1990/91, P-II; 1996, P-III; 2002, and P-IV; 2007, P-V; 2010). There were 60 RDS neonates with PS treatment in P-I (16 hospitals), 1,179 in P-II (64), 1,595 in P-III (62), 1,921 in P-IV (57), and 3,160 in P-V (72). Decreased mortality rate, defined as the percentage of neonates who died within 28 days of birth, was seen between periods, P-V vs P-I, II, III, and IV (mortality rate: 10.1% vs. 40.0%, 30.0%, 18.7%, and 14.3%). We conclude that PS therapy contributed to improve remarkable outcome in RDS neonates over the last 20 years in Korea. However, more efforts should be made to optimize PS therapy for better outcome. Multiple PS doses for relapse and poor response, early prophylactic use, and better supportive care for pre-term infants are mandatory.