• 임상간호연구
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• 제26권1호
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• pp.117-130
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• 2020

Purpose: This study aimed to develop a bedside nursing shift report protocol and evaluate the effect of the protocol in a tertiary hospital in South Korea. Methods: The bedside nursing handoff protocol with patient engagement was developed based on the literature review and the validation of an expert group. The effect of the protocol on clinical implication was tested in three medical-surgical units in a tertiary hospital. Outcomes were assessed by patient perception, nurse perception, and reporting time. Data collected from June to August in 2018 and analyzed with descriptive statistics and One-way ANOVA using SPSS version 25.0. Results: The bedside nursing shift report protocol with patient engagement consisted of two steps: nurse to nurse report and bedside report with patients. Nurse's perception with patient engagement was significantly increased after applying protocol (F=17.85, p<.001). Patient's perception was significantly improved in the areas of discharge plan (F=7.86, p<.001), health information privacy (F=4.46, p=.012) and identify attending nurse (F=3.19, p=.042). There were no differences in reporting time between the bedside nursing shift report and a traditional shift report (F=0.61, p=.054). Conclusion: Patient perception was significantly increased, while nurse perception was not different after applying this protocol. For the change in the perception of nurses, education may be preceded to improve nurses' competence for the bedside shift report. Furthermore, the support in enough nurse staffing should be needed for encouraging the bedside shift report. The bedside shift report may enhance patient engagement. Therefore it may improve patient safety and health outcome in clinics.

• 디지털융복합연구
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• 제17권7호
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• pp.265-274
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• 2019

본 연구는 로봇을 이용한 최소침습절개술 접근과 기존의 정중흉골절개술 접근을 이용한 심장판막수술환자를 대상으로 통증, 수면, 자가간호수행을 파악하고 이를 비교분석하기 위한 조사연구이다. 대상자는 서울시 일개 상급종합병원에서 심장수술을 시행한 대상자 중 정중흉골절개술군 64명, 최소침습절개술군 64명을 대상으로 하였다. 자료분석은 SPSS 22.0 프로그램을 이용하여 기술적 통계, ${\chi}^2$ 검증, paired t-test를 시행하였다. 수술 후 2일째, 5일째 모두 통증은 로봇을 이용한 최소침습절개술군이 정중흉골절개술군에 비해 높았다. 통증발생부위는 두 군 모두 수술접근부위로 크게 나타났다. 수면은 수술 후 2일째 정중흉골절개술군에서 높게 나타났으며, 자가간호수행은 최소침습절개술군에서 높게 나타났다. 그러므로 로봇 수술의 재원기간 단축과 빠른 회복 등의 장점에도 불구하고 대상자의 통증관리를 위해 정확한 통증 사정 및 차별화된 프로토콜의 적용이 필요시 된다. 또한 성별, 연령 및 수술방법의 차이를 고려하여 안위를 증진시키기 위한 체계화된 교육 프로그램 중재가 요구되어진다.

• 한국치위생학회지
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• 제19권5호
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• pp.651-664
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• 2019

Objectives: This study surveyed the application of Comprehensive Dental Hygiene Care (CDHC), based on non-surgical periodontal therapy within the educational curricula of Korean universities and examined whether they recognized the need for CDHC. Methods: This study analyzed data from professors of dental hygiene practicum related subjects in 75 Korean universities. The collected data were analyzed using a Chi-square test, a Mann-Whitney U-test, and a Kruskal Wallis test via SPSS (Ver. 21.0). Results: First, the application scope of CDHC was higher in four-year universities than three-year ones with the scope of several characteristics increasing along with enrollment quota. The application scope of dental hygiene plans and actions increased with the number of patient practices in terms of periodontal evaluations. Second, the needs of the dental hygiene courses were more than 4 points in all characteristics. Although four-year universities exhibited higher points than three-year ones, there was no significant difference found except other test. Finally, all universities based their dental hygiene courses on case histories, oral and maxillofacial information, hard tissue modules, periodontal issues, and other tests, with needs also being high. Meanwhile, the application scope of the dental hygiene course evaluations was lowest in all characteristics. Conclusions: There were no significant differences in dental hygiene curricula among the universities. However, highly qualified and standardized educational courses and lectures should be developed by the Korean evaluation center for dental hygiene curricula using various studies as the basis of theory and practical classes, the total number of terms, number of case studies used, number of students per class, ratio of students to professor, and so on.

• 대한정형외과학회지
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• 제55권2호
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• pp.117-126
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• 2020

슬관절의 퇴행성 관절염에서 슬관절 전치환술은 널리 시행되고 있고 그 빈도도 점점 증가되고 있다. 수술 후 일상생활로의 복귀, 근력 및 운동범위의 회복 등 기능 회복을 위한 노력이 이루어져야 하고 이는 환자 요인, 수술 술기 및 재활 등 다양한 관점에서 접근해야 한다. 환자의 연령이나 비만의 정도, 성별, 대퇴사두근의 근력 등이 수술 후 기능 회복에 영향을 줄 수 있고 환자의 기대치나 만족도 같은 정신적인 상태도 영향을 준다. 기능 회복을 위하여 수술 전부터 환자교육 및 통증 조절, 대퇴사두근 근력의 강화 같은 치료를 시행할 수 있다. 수술 후 냉찜질 및 압박, 경피적 전기 신경 자극 치료, 신경근육 전기 자극 치료, 저주파 저강도 자기장 치료, 대퇴사두근의 근력운동, 관절범위 운동과 같은 물리치료도 적용할 수 있다. 최근에는 수중에서 근력과 균형감각을 회복시키는 수 치료도 점점 시행되는 추세이다. 이런 기능 회복을 위한 치료들은 수술 후 단기적으로만 시행될게 아니라 장기적으로 꾸준히 시행되는 것이 중요하며 술자는 환자의 상태나, 순응도, 사회적, 심리적 상황 등을 고려하여 적절히 적용하여야 한다.

• 대한영상의학회지
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• 제81권2호
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• pp.310-323
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• 2020

선천성 심장질환의 치료에 있어서 그 해부학적인 구조를 올바르게 이해하는 것은 아주 중요하다. 이러한 선천성 심장질환의 구조적인 특징을 이해하는데 있어서 삼차원 프린팅 모델을 이용하는 것은 아주 효과적이다. 기존에 얻어진 전산화단층촬영이나 자기공명영상 혹은 심장 초음파 검사의 자료만으로는 정확한 복잡심장기형의 특징을 이해하는 것이 어려운 경우가 있으며, 삼차원 프린팅 모델의 사용이 이러한 제한점 들을 극복하는데 도움을 줄 수 있다. 최근 들어서는 삼차원 프린팅 모델을 이용해 선천성 심장질환의 교육과 수술 전 시뮬레이션 그리고 치료의 방침을 결정하는데 많은 도움을 받고 있으며, 실제 구체적인 환아들의 예를 통해서 이를 살펴보고자 한다. 또한 향후 그 기술의 발전 방향에 대해 알아보고, 심장외과 의사의 관점에서 수술 수기의 발전이나 훈련 등 여러 방면의 이용에 대해서도 살펴보고자 한다.

• Korean Journal of Radiology
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• 제23권4호
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• pp.413-425
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• 2022

Objective: We compared appendiceal visualization on 2-mSv CT vs. conventional-dose CT (median 7 mSv) in adolescents and young adults and analyzed the undesirable clinical and diagnostic outcomes that followed appendiceal nonvisualization. Materials and Methods: A total of 3074 patients aged 15-44 years (mean ± standard deviation, 28 ± 9 years; 1672 female) from 20 hospitals were randomized to the 2-mSv CT or conventional-dose CT group (1535 vs. 1539) from December 2013 through August 2016. A total of 161 radiologists from 20 institutions prospectively rated appendiceal visualization (grade 0, not identified; grade 1, unsure or partly visualized; and grade 2, clearly and entirely visualized) and the presence of appendicitis in these patients. The final diagnosis was based on CT imaging and surgical, pathologic, and clinical findings. We analyzed undesirable clinical or diagnostic outcomes, such as negative appendectomy, perforated appendicitis, more extensive than simple appendectomy, delay in patient management, or incorrect CT diagnosis, which followed appendiceal nonvisualization (defined as grade 0 or 1) and compared the outcomes between the two groups. Results: In the 2-mSv CT and conventional-dose CT groups, appendiceal visualization was rated as grade 0 in 41 (2.7%) and 18 (1.2%) patients, respectively; grade 1 in 181 (11.8%) and 81 (5.3%) patients, respectively; and grade 2 in 1304 (85.0%) and 1421 (92.3%) patients, respectively (p < 0.001). Overall, undesirable outcomes were rare in both groups. Compared to the conventional-dose CT group, the 2-mSv CT group had slightly higher rates of perforated appendicitis (1.1% [17] vs. 0.5% [7], p = 0.06) and false-negative diagnoses (0.4% [6] vs. 0.0% [0], p = 0.01) following appendiceal nonvisualization. Otherwise, these two groups were comparable. Conclusion: The use of 2-mSv CT instead of conventional-dose CT impairs appendiceal visualization in more patients. However, appendiceal nonvisualization on 2-mSv CT rarely leads to undesirable clinical or diagnostic outcomes.

• 대한통합의학회지
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• 제12권3호
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• pp.37-47
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• 2024

Purpose : Cancer survivors often suffer from postoperative sequelae. the diagnosing and provision of manual therapy using spiral taping significantly improves the quality of life of cancer patients. The aim of this case study is to investigate the immediate effects of spiral taping on pain, range of motion (ROM), chemotherapy-induced peripheral neuropathy (CIPN), and lymphedema following breast cancer surgery. Methods : The taping techniques were performed as follows by spiral taping. The measurements were taken before, in the middle, and after taping using a mobile phone camera, tape measure, and a numerical rating score (NRS). The evaluation employed a single-group pre-post design based on a primitive experimental design. Results : Out of four patients, all four exhibited Reverse circle flow energy (RCFE), Passive cervical right (Rt) rotation test, anterior-posterior movement pattern, nerve type (+), cold energy (CE), sangcho acupuncture point, blood clot, hwal point. Comparing before and after treatment, almost all values were reduced to zero after treatment in terms of pain complaints. The lack of range of motion (ROM) caused by the shortened tissue after surgery did not increase. The range of motion (ROM) lost due to pain returned to normal. The circumference of lymphedema did not show a tendency. The symptoms of CIPN improved. Conclusion : There was a significant change in joint range of motion, with pain decreasing, but there were structural limitations in the tissue due to total resection, and the chemotherapy-induced peripheral neuropathy scale. It was effectively treated surgical site pain, axillary membrane syndrome-induced pain, and unexplained pain. While there was a treatment effect for lymphedema in the evaluation of circumference values, there was no significant change in circumference. There was a significant effect on chemotherapy-induced peripheral neuropathy, particularly in treating numbness in the feet, which is a side effect of TC anticancer drugs. This case study found that spiral balance taping provides a rapid therapeutic effect for most side effects in patients who have undergone total breast cancer resection. However, the generalization is limited due to the small sample size, and further research is needed to determine the extent to which the effects of one treatment are maintained.

• 대한간호학회지
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• 제29권4호
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• pp.929-939
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• 1999

The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3625-3628
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• 2014

Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.

• 한국어류학회지
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• 제19권4호
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• pp.371-377
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• 2007

Passive integrated transponder (PIT) telemetry는 어류의 개체군 동태와 군집 구조, 이동을 연구하는데 유용하게 사용되는 방법으로 가볍고 크기가 작기 때문에 한국에 서식하는 소형 어류(TL<100 mm)의 연구에도 적용이 가능하다. 본 연구에서는 PIT tag을 소형 잉어과 어류에 삽입한 후 생존율을 파악하여 tag의 적용성과 활용 가능성을 타진하였다. 생존율 실험에 사용된 어류는 모두 잉어과 어류 4종으로 Carassius gibelio langsdorfi (n=34, 체장: $91.9{\pm}0.9mm$, 체중: $21.2{\pm}0.9g$),Hypophthalmichthys molitrix (n=16, 체장: $75.1{\pm}0.9mm$, 체중: $6.0{\pm}0.2g$), Pseudorasbora parva (n=30, 체장: $51.4{\pm}1.1mm$, 체중: $2.7{\pm}0.2g$)와 Phoxinus phoxinus (n=37, 체장: $70.6{\pm}1.4mm$, 체중: $8.2{\pm}0.5g$)이며, 1년생 이하의 작은 개체들만 이용하였다. 실험에 사용된 tag은 소형 (길이 11.0 mm, 반경 2.1 mm, 무게 0.088 g), 중형 (길이 20 mm, 반경 3.5 mm, 무게 0.102 g), 대형(길이 30 mm, 반경 3.5 mm, 무게 0.298 g)의 3종류를 사용하였다. 어류 복강에 tag을 삽입한지 30일 이후 실험에 사용된 총 117개체의 생존율은 58.1%였다 (대형, 50.0%; 중형, 57.5%; 소형, 61.4%). Tag의 크기에 따라 생존율은 다양하였는데 이는 실험에 사용된 개체마다 복강의 크기다 달랐기 때문이다. 또한 외과적 수술과정에서 내부 장기의 손상으로 생존율이 감소하였을 것으로 판단되었다. 본 실험결과 국내에 서식하고 있는 소형 담수어류에도 PIT tag 적용이 가능할 것으로 사료되었으며 이후 현장에서 적용한다면 어류 생태 연구에 있어 효율적일 것으로 판단된다.