A 61-year-old female patient was diagnosed with dilated cardiomyopathy with severe left ventricle dysfunction. Two days after admission, continuous renal replacement therapy was performed due to oliguria and lactic acidosis. On the fifth day, an intra-aortic balloon pump was inserted due to low cardiac output syndrome. Beginning 4 days after admission, she was supported for 15 days thereafter with an extracorporeal left ventricular assist device (LVAD) because of heart failure with multi-organ failure. A heart transplant was performed while the patient was stabilized with the LVAD. She developed several complications after the surgery, such as cytomegalovirus pneumonia, pulmonary tuberculosis, wound dehiscence, and H1N1 infection. On postoperative day 19, she was discharged from the hospital with close follow-up and treatment for infection. She received follow-up care for 10 months without any immune rejection reaction.
Purpose: The purpose of this study was to examine the impairments of body structures, activity limitation, and participation restriction. In addition, we wanted to provide basic data on correlation between impairments of body structures, activity, and participation in Disabled Persons Living at Home. Methods: After selection of 128 people with physical disabilities more than the third level and brain damage disabilities living at home, we conducted testing for impairments of body structures, activity, and participation, according to the ICF checklist. Results: Impairments of body structures was highest in the upper and lower extremity. 2) Mobility, domestic life, and self care were more limited. 3) Also, the structure related to movement showed correlation with mobility, domestic life, and self care. Conclusion: We observed differences in participation and activities of persons with disabilities Living at Home depending on the impairments of body structures. After thorough review of the status of Disabled Persons Living at Home, we decided to appropriate support and social services.
A clinical review was done of 31 children with blunt liver injury who were admitted to the Department of Surgery, Kyungpook National University Hospital between 1981 and 1990. Seventeen of the 31 children required laparotomy(11 primary repairs, 4 lobectomies, 2 segmentectomies). There were two deaths after laparotomy, one due to associated severe head injury and another due to multiorgan failure. The remaining 14 children, who were hemodynamically stable after initial resuscitation and who did not have signs of other associated intraabdominal injuries, were managed by nonoperative treatment. Patients were observed in a pediatric intensive care unit for at least 48 hours with repeated abdominal clinical evaluations, laboratory studies, and monitoring of vital signs. The hospital courses in all cases were uneventful and there were no late complication. A follow-up computed tomography of 7 patients showed resolution of the injury in all. The authors believe that, for children with blunt liver injuries, nonoperative management is safe and appropriate if carried out under careful continuous surgical observation in a pediatric intensive care unit.
Purpose: The purpose of this study was to investigate the knowledge, awareness and performance of COVID-19 infection control among physical therapists and to identify the impact factors on performance Methods: Data were collected from March 16th to March 24th in 2022 from the physical therapist's in Busan. Data analysis was conducted on 170 surveys, after excluding 27 surveys that were found to be unsuitable for data analysis. Results: When correlating the study variables, knowledge and awareness were found to have a positive, meaningful correlation with performance. Performance of COVID-19 personal infection control regression analysis showed that the working department (clinic and long-term care hospital), clinical experience, the more knowledgeable, the awareness (personal), and the more clinical experience had significant positive impacts on the performance of COVID-19 infection control. Performance of COVID-19 treatment room infection control regression analysis showed that the working department (long-term care hospital), educational experience, the awareness (treatment room) had significant positive impacts on the performance of COVID-19 infection control Conclusion: The results of this study may be used as basic data for educating physical therapist's working at the COVID-19 response department. This study suggests that physical therapist's need educational programs to improve their knowledge and awareness and performance of infection control against infectious diseases such as COVID-19. Differentiated physical therapists practice education curricula must be developed and provided after understanding the varying characteristic of physical therapist's with different levels of work experience.
One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.
Significant advances in the diagnosis and medical care of children with chronic kidney disease (CKD) are major reasons for the better survival rates of children and adolescents with CKD than the survival rates reported in previous decades. These patients are reaching adulthood, and therefore require a transition to adult medical care. This transition phase is well-recognized to be associated with considerably increased morbidities and medical problems, such as non-adherence, graft loss after transplantation, and loss to follow-up. Low adherence increases morbidity and medical complications and contributes to poorer qualities of life and an overuse of the health care system. However, these tragic outcomes may be avoidable through a structured and well-defined transition program. In the last decade, there has been increasing interest to resolve these medical and psychological problems that occur during the transfer of young adult patients from pediatric to adult renal units. The aims of a successful transition from pediatric to adult medical care include enhancing the individual development of better health-competence and stabilizing, or even improving, the state of health. This review will focus on various aspects of the transition phase of adolescents who have CKD or who underwent kidney transplantation from pediatric to adult nephrology care.
Purpose: The study aim was to provide basic data needed for formulating systematic visiting nursing strategies by comprehending the characteristics and self-care ability of the object families of public health centers in Korea. Method: The research examined 252 families and 339 family members of the vulnerable class that were registered in a visiting nursing program of an urban public health center. The data of 220 families were analyzed using descriptive analysis, t-test, and ANOVA, after excluding any incomplete data. Result: 1. The most frequent characteristics of families were solitary families (52.8%) and financially vulnerable families (87.3%). The most frequent way of family detection was request of the community office. 2. The most frequent type of family problems were vulnerable families (93.2%), followed by patient families (91.0%). 3. The mean score was 11.67 for family self-care ability. 4. The variables of the number of family members, disease type of the patient family members, and the type of vulnerable family showed a significant difference of family self-care ability. Conclusion: This study suggests that vulnerable families demand specific nursing interventions focused on their own problems and that visiting nurses need to obtain and use supportive resources.
Journal of Korean Academic Society of Home Health Care Nursing
/
v.23
no.2
/
pp.121-128
/
2016
Purpose: This study was aimed at constructing and examining the effects of a laughter therapy program for elderly patients in long-term care hospitals. Methods: A prospective, two-group quasi-experimental design was used and 50 patients (25 experimental and 25 control group patients) from two long-term care hospitals in Gyeonggido province, South Korea, were study participants. The experimental group received 24 laughter therapy sessions twice a week for 12 weeks, and the control group received laughter therapy after data collection. Data were collected between May 26 and August 17, 2014. Results: The level of cognitive function for the experimental group increased(t=3.27, p=.002). The level of forced vital capacity (t=2.78, p=.008) and forced expiratory volume in 1 second (t=4.94, p<.001) increased among members of the experimental group. Conclusion: These results indicated that the laughter program was effective in improving cognitive and pulmonary functions among older patients who were receiving long-term care in hospitals. This program could be used for community-based elderly patients.
This study intended to deeply understand teachers' experiences about their self-supervision at after-school nurseries through many different stories. This study composed field texts based on the data collected through face-to-face talks with participants, their journals, and e-mails and phone conversations given and taken with participants for a total of 4 months from September to the end of December, 2012. The teachers all had ten years teaching experience, and worked as after-school nursery teachers in S-gu, S-si. The study found many things such as experiencing the joy of learning things that were unknown through self-supervision, hardship involved in self-supervision, co-workers dedicated to joint learning, and time and spaced used to better understand children. The study figured out that the meaning of self-supervision lay in the pursuit of learning and bright eyes(seeing what was not seen before), despite the difficult condition to self-supervise, the after-school nursery teachers unceasing passion for self-supervision brings happiness within oneself. As a result, this study discussed the implications which the experience of after-school nursery teachers who found a happy meaning of life through self-supervision in spite of the actual difficult conditions offered to after-school nursery teachers.
School activities which are opened after-school or during a vacation have been social issues as our society is nuclearized and both parents are working, so that elementary school students and middle school students are less taken care of and less concerned by their parents. It is regrettable that students are spending too much time on private academies in the situation where they cannot help but staying alone after school and where frantic fever of private education pervades their lives. For the sake of those students, the Ministry of Education announced, "Each school can open its after-school programs or vacation programs based on students and their parents' demands making it a rule of a student's voluntary participation. After school programs for elementary and middle school students are operated by local communities providing extra courses or programs in addition to regular classes. Those programs are paid by participants or supported by financial aids in order to decrease parents' burdens of costs of private education and to reduce educational gaps between rich and poor children or between the regions. After school programs are either curricular or non-curricular educational activities with students' voluntary participation, and the programs are meant to supplement and strengthen the role of public school education. Non-curricular courses that consist of various programs, in particular, are receiving good reputations by students and parents. Therefore, this study develops and operates "children's making D.I.Y. furniture" program that is one of non-curricular courses and an activity-oriented art program for children to improve their designing creativity and to help them experience their future jobs in advance. The purpose of this study is to analyze advantages and disadvantages of the program using survey and assessment methods and to find out a developmental direction focused on future-oriented and specialized educational programs for children.
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