• 제목/요약/키워드: Surgical education

검색결과 306건 처리시간 0.029초

내ㆍ외과계 환자의 입원스트레스 특성 비교 (Differences in the Characteristics of Hospital Stress between Medical and- Surgical Patients.)

  • 이소우;노유자;김태경
    • 대한간호학회지
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    • 제19권1호
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    • pp.99-107
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    • 1989
  • This study explored differences in how medical and surgical patients compare on the degree of hospital stress and their subjective physical status. Subjects were 343 medical and surgical patients in five university hospitals in Seoul and Taegu. They responded to the Hospital Stress Rating Scale and a self-report on physical status. The controlled variables were age, education, number of previous hospitalizations and seriousness of the illness. Medical and surgical patient differences on nine factors of the hospital stres scale and nine areas of physical conditions were reported as follows edplored : 1. 1) There was not a statistically significant difference at the .05 level in the total mean score for hospital stress between medical patients and surgical patients. 2) The mean score of the factor lack of information (M=2.308) for medical patients was higher than the mean score (M=2.064) of the surgical patients. 3) The mean scores of the factor of discomfort (M=2.130), loss of independence (M=1.889) for surgical patients were higher than for medical patients. 2. 1) There was a statistically significant difference at the .05 level in the total mean score for physical status between medical patients and surgical patients. 2) The mean scores were lower in subjective physical status for surgical patients(S) than for medical patients (M) ; stomach condition (S : M=2.8433, M : M=3.0-000), self-assistance(S : M=3.0373, M : M=3.4498), movement (S : M=2.6716, M : M=3.2392), interest in your surroundings (S : M=3.0522, M : M=3.2632). 3. Patients scoring high on the subjective physical status such as sleep, appetite, stomach condition bowel condition and urination states had higher scores in hospital stress than with patients scoring low on those subjective Physical status. The results suggest that subjective physical status might be on expression of hospital stress. Also patients with high scores in subjective physical statas might be predicted have a high level of stress on admission. And surgical patients had a higher level of hospital stress than medical patients.

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The efficacy of mobile application use on recall of surgical risks in nasal bone fracture reduction surgery

  • Kim, Choong Hyeon;Cheon, Ji Seon;Choi, Woo Young;Son, Kyung Min
    • 대한두개안면성형외과학회지
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    • 제19권1호
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    • pp.41-47
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    • 2018
  • Background: The number of surgical risks recalled by a patient after surgery can be used as a parameter for assessing how well the patient has understood the informed consent process. No study has investigated the usefulness of a self-developed mobile application in the traditional informed consent process in patients with a nasal bone fracture. This study aimed to investigate whether delivery of information, such as surgical risks, through a mobile application is more effective than delivery of information through only verbal means and a paper. Methods: This prospective, randomized study included 60 patients with a nasal bone fracture. The experimental group (n=30) received preoperative explanation with the traditional informed consent process in addition to a mobile application, while the control group (n=30) received preoperative explanation with only the traditional informed consent process. Four weeks after surgery, the number of recalled surgical risks was compared for analysis. The following six surgical risks were explained: pain, bleeding, nasal deformity, numbness, nasal obstruction, and nasal cartilage necrosis. Results: The mean number of recalled surgical risks among all patients was $1.58{\pm}0.56$. The most frequently recalled surgical risk was nasal deformity in both groups. The mean number of recalled surgical risks was $1.72{\pm}0.52$ in the experimental group and $1.49{\pm}0.57$ in the control group. There was a significant association between mobile application use and the mean number of recalled surgical risks (p=0.047). Age, sex, and the level of education were not significantly associated with the mean number of recalled surgical risks. Conclusion: This study found that a mobile application could contribute to the efficient delivery of information during the informed consent process. With further improvement, it could be used in other plastic surgeries and other surgeries, and such an application can potentially be used for explaining risks as well as delivering other types of information.

의사와 간호사의 외과적 손씻기에 관한 지식, 태도 및 실천에 대한 조사 연구 (A Survey on the Performance of Surgical Hand Scrubs)

  • 윤혜상
    • 대한간호학회지
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    • 제26권3호
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    • pp.591-604
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    • 1996
  • The surgical hand scrub (SHS) is the single most important procedure in the prevention of post-operative wound infections and yet it remains the most violated of all infection control procedures. The purpose of this study was to gain an overview of SHS habits in operative th atre personnel and to determine knowledge and attitudes to identify whether there is a need for improvement. The subjects for this study included 79 doctors and 94 nurses working in the operative th atres of four hospitals in Incheon City and Kyungki Province. Related data were collected from July 25 to August 10, 1995 by the author. The data were analyzed using descriptive stat-istics and Chi-squre test. The results of the study are summarized as follows : 1. Nurses felt that they conducted SHS for a longer period of time than doctors did(X=20.1, P=.005). 2. Nurses and doctors had some knowledge of slip-ping rings off fingers and the length of nails, but they lacked knowledge on the duration of SHS, handwashing after an operation and on manicure. 3. There were many reasons given for insufficient SHS included : 1) because they were so busy (38%). 2) brushes were too harsh(19.7%). 3) operations were very simple(18.7%). 4) surgical latex gloves provide functional barrier(11.6%). 5) SHSs were troublesome(7.4%) 6) there were no clocks near the sinks(2.5%) and 7) the operative patients were administered antibiotics after operartion(2.1%). 4. Most of nurses and doctors considered SHS to be important in prevention against post operative infections. 5. Nurses were found to do a thorough SHS, but residents were found to neglect SHS. 6. Considering prevention against postoperative infections, most nurses and doctors considered aseptic techniques, environment-sanitary management and SHS more important than the use of antibiotics, the resistance of patients or the method of operation. 7. Half of the nurses and doctors(54.3%) considered surgical latex gloves to function well as a barrier. 8. Half of the nurses (56.4%) and doctors(51.9%) learned SHS as part of the curriculum in their school education and the rest(nurses : 95.7%, doctors : 74.7%) learned SHS as part of their In Service Education. In conclusion, these findings suggest a need to develop an educational program on surgical hand scrub and hospital infection control for surgical personnels, to install clocks near the hand scrub sinks, to consider a violation report for negligent surgical hand scrubs, and to develop a soft brush for hand scrubs in order to increase performance of the surgical hand scrub.

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Validation of a Cognitive Task Simulation and Rehearsal Tool for Open Carpal Tunnel Release

  • Paro, John A.M.;Luan, Anna;Lee, Gordon K.
    • Archives of Plastic Surgery
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    • 제44권3호
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    • pp.223-227
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    • 2017
  • Background Carpal tunnel release is one of the most common surgical procedures performed by hand surgeons. The authors created a surgical simulation of open carpal tunnel release utilizing a mobile and rehearsal platform app. This study was performed in order to validate the simulator as an effective training platform for carpal tunnel release. Methods The simulator was evaluated using a number of metrics: construct validity (the ability to identify variability in skill levels), face validity (the perceived ability of the simulator to teach the intended material), content validity (that the simulator was an accurate representation of the intended operation), and acceptability validity (willingness of the desired user group to adopt this method of training). Novices and experts were recruited. Each group was tested, and all participants were assigned an objective score, which served as construct validation. A Likert-scale questionnaire was administered to gauge face, content, and acceptability validity. Results Twenty novices and 10 experts were recruited for this study. The objective performance scores from the expert group were significantly higher than those of the novice group, with surgeons scoring a median of 74% and medical students scoring a median of 45%. The questionnaire responses indicated face, content, and acceptability validation. Conclusions This mobile-based surgical simulation platform provides step-by-step instruction for a variety of surgical procedures. The findings of this study help to demonstrate its utility as a learning tool, as we confirmed construct, face, content, and acceptability validity for carpal tunnel release. This easy-to-use educational tool may help bring surgical education to a new- and highly mobile-level.

Predicting recurrence in oral cavity cancers: a review of 116 patients with buccal mucosa carcinoma in northwestern India

  • Pinakin Patel;Pranav Mohan Singhal;Kamal Kishor Lakhera;Aishwarya Chatterjee;Agil Babu;Suresh Singh;Shubhra Sharma;Bhoopendra Singh Gora;Naina Kumar Agarwal
    • 대한두개안면성형외과학회지
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    • 제24권5호
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    • pp.211-217
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    • 2023
  • Background: Oral cavity cancers, the second most common type in India, are responsible for 10% of the overall cancer burden. With a recurrence rate of 30% to 40% and a 5-year survival rate of 50%, these malignancies account for substantial morbidity and mortality. Despite advances in treatment modalities, survival rates following treatment completion have not improved significantly. The present study aimed to establish specific epidemiological and pathological factors responsible for recurrence after treatment completion in buccal mucosa cancers. Methods: A retrospective analysis of the data of 116 patients treated for biopsy-proven cancers of the buccal mucosa was undertaken 1 year after treatment completion. Factors such as age, sex, education, lymphovascular invasion, extranodal extension (ENE), perineural invasion, depth of invasion, and pathological margin status were compared between patients who presented with recurrence and those who did not. Statistical significance was set at p< 0.05. Results: Of the 116 patients, 40 (34.5%) developed a recurrent disease within 1 year. The mean age of the study population was 43.3 years, and males constituted 91.4% of the included patients. Ipsilateral buccal mucosa was the commonest site of disease recurrence. Neck node metastasis, ENE, and margins of resection < 5 mm were significantly related to the recurrence of disease. However, surprisingly, lymphovascular invasion, perineural invasion, and depth of invasion > 10 mm did not show statistically significant associations. Conclusion: Neck node metastasis, ENE, and margins of resection < 5 mm were the histopathological factors associated with recurrence in cancers of the buccal mucosa.

Non-Surgical Management of Gastroduodenal Fistula Caused by Ingested Neodymium Magnets

  • Phen, Claudia;Wilsey, Alexander;Swan, Emily;Falconer, Victoria;Summers, Lisa;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권4호
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    • pp.336-340
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    • 2018
  • Foreign body ingestions pose a significant health risk in children. Neodymium magnets are high-powered, rare-earth magnets that is a serious issue in the pediatric population due to their strong magnetic force and high rate of complications. When multiple magnets are ingested, there is potential for morbidity and mortality, including gastrointestinal fistula formation, obstruction, bleeding, perforation, and death. Many cases require surgical intervention for removal of the magnets and management of subsequent complications. However, we report a case of multiple magnet ingestion in a 19-month-old child complicated by gastroduodenal fistula that was successfully treated by endoscopic removal and supportive care avoiding the need for surgical intervention. At two-week follow-up, the child was asymptomatic and upper gastrointestinal series obtained six months later demonstrated resolution of the fistula.

Significance of Preoperative Prone Position Computed Tomography in Free Hand Subaxial Cervical Pedicular Screwing

  • Istemen, Iismail;Arslan, Ali;Olgune, Semih Kivanc;Afser, Kemal Alper;Acik, Vedat;Arslan, Baris;Okten, Ali Ihsan;Gezercan, Yurdal
    • Journal of Korean Neurosurgical Society
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    • 제64권2호
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    • pp.247-254
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    • 2021
  • Objective : The subaxial cervical pedicle screwing technique shows powerful biomechanical properties for posterior cervical fusion. When applying a pedicle screw using the freehand technique, it is essential to analyse cervical computed tomography and plan the surgery accordingly. Normal cervical computed tomography is usually performed in the supine position, whereas during surgery, the patient lies in a prone position. This fact leads us to suppose that radiological evaluations may yield misleading results. Our study aimed to investigate whether there is any superiority between preoperative preparation on computed tomography performed in the prone position and that performed in the supine position. Methods : This study included 17 patients (132 pedicle screws) who were recently operated on with cervical vertebral computed tomography in the prone position and 17 patients (136 pedicle screws) who were operated on by conventional cervical vertebral computed tomography as the control group. The patients in both groups were compared in terms of age, gender, pathological diagnosis, screw malposition and complications. A screw malposition evaluation was made according to the Gertzbein-Robbins scale. Results : No statistically significant difference was observed between the two groups regarding age, gender and pathological diagnosis. The screw malposition rate (from 11.1% to 6.9%, p<0.05), mean malposition distance (from 2.18 mm to 1.86 mm, p <0.05), and complications statistically significantly decreased in the prone position computed tomography group. Conclusion : Preoperative surgical planning by performing cervical vertebral computed tomography in the prone position reduces screw malposition and complications. Our surgical success increased with a simple modification that can be applied by all clinicians without creating additional radiation exposure or additional costs.