• 제목/요약/키워드: after-school care

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The effect of a nutritional education program on the nutritional status of elderly patients in a long-term care hospital in Jeollanamdo province: health behavior, dietary behavior, nutrition risk level and nutrient intake

  • Kim, Bok-Hee;Kim, Mi-Ju;Lee, Yoon-Na
    • Nutrition Research and Practice
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    • 제6권1호
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    • pp.35-44
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    • 2012
  • This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P<0.001) and of depression (P<0.001) improved significantly and that dietary behavior scores also improved significantly (P<0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P<0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.

Self-Care Education Programs Based on a Trans-Theoretical Model in Women Referring to Health Centers: Breast Self-Examination Behavior in Iran

  • Ghahremani, Leila;Mousavi, Zakiyeh;Kaveh, Mohammad Hossein;Ghaem, Haleh
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권12호
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    • pp.5133-5138
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    • 2016
  • Background: Breast cancer is one of the most common cancers and a major public health problem in developing countries. However, early detection and treatment may be achieved by breast self-examination (BSE). Despite the importance of BSE in reducing the incidence of breast cancer and esultant deaths, the disease continues to be the most common cause of cancer death among women in Iran.This study aimed to determine the effects of self-care education on performance of BSE among women referring to health centers in our country. Materials and Methods: This quasi-experimental interventional study with pretest/posttest control group design was conducted on 168 women referred to health centers. The data were collected using a validated researcher-made questionnaire including demographic variables and trans-theoretical model constructs as well as a checklist assessing BSE behavior. The instruments were administered to groups with and without self-care education before, a week after, and 10 weeks after the intervention. Then, the data were entered into the SPSS statistical software (version 19) and analyzed using independent sample t-tests, paired sample t-test, repeated measures ANOVA, Chi-square, and Friedman tests (p<0.05). Results: The results showed an increase in the intervention group's mean scores of trans-theoretical model constructs (stages of change, self-efficacy, decisional balance, and processes of change) and BSE behavior compared to the control group (p<0.001). Conclusion: The study confirmed the effectiveness of aneducational intervention based ona trans-theoretical model in performing BSE. Therefore, designing educational interventions based on this model is recommended to improve women's health and reduce deaths due to breast cancer.

치주치료 후 유지치주치료의 효과에 관한 평가 : 1년 관찰 (The effect of supportive periodontal therapy after periodontal treatment : A 1-year follow up.)

  • 김신영;김용건
    • 대한치과의사협회지
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    • 제55권1호
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    • pp.22-29
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    • 2017
  • Purpose : Preservation of the periodontal health of the treated patient requires supportive periodontal therapy for the elimination of periodontal disease. After Phase I therapy is completed, patients are placed on a schedule of periodic recall visits for maintenance care to prevent recurrence of the disease. The amount of tooth loss would be the most relevant criterion in an evaluation of the effect of periodontal treatment, but this would require studies with extremely long follow-up periods. Thus the most commonly used outcome criteria in clinical research have been clinical attachment level change, reduction of pocket depth and bleeding frequency. The purpose of this case study is to identify the effect of supportive periodontal therapy after periodontal flap surgery. Materials & Methods : Following routine hygienic phase of treatment, patients with chronic periodontitis received surgical periodontal treatment. Bleeding on probing, pocket depth and clinical attachment level were measured at baseline, pre-operation and 1 year follow up. All procedures were performed by one operator. Results : One year a total of 28 patients (58sites) to recheck remained, when conducted maintenance program after periodontal flap surgery was observed reduction of bleeding frequency, pocket depth and improvement of clinical attachment level. Conclusion : The results from this study indicate that supportive periodontal therapy after periodontal flap surgery is effective for reduction of bleeding frequency, pocket depth and gain of clinical attachment level.

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보건소 진료실을 이용한 개별보건교육이 고혈압혼자의 지식, 자기효능감, 자가간호행위에 미치는 효과 (Effect of Individual Health Education the Medical Clinic of Public Health Centers on Knowledge, Self-efficacy, and Self-care behavior in Clients with Hypertension)

  • 이현정
    • 한국보건간호학회지
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    • 제18권1호
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    • pp.80-89
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    • 2004
  • This study focused on individual health education for people with hypertension who were being seen in public health centers. The program was an adjusted intervention program that considered the characteristics of each individual and reflected the individual's will to change. Each individual had a different lifestyle with different characteristics and habits so the study considered these individual's characteristics. A comparison was done of knowledge related to hypertension, self-efficacy, and self-care in these individuals. In order to determine the effectiveness of education given by the nurses the variables were measured before and after the individual health education program. The participants in this study were 85 people with hypertension who were seen at a public health center in G city. They were assigned to an experimental group (43) and a control group (42). A tool developed by Park Young-Im (1994) was used to measure knowledge related to hypertension and self-efficacy. A tool developed by Lee Young-Whee (1994) was used for self-care. Data collection was done for 10 weeks from March 24 to May 31, 2003 using interviews with questionnaires. The following is a summary of the results of the study. Hypothesis 1, 'the experimental group which had the individual health education will have higher knowledge scores on hypertension than the control group that did not have the individual health education' was supported (t=4.17, P=0.00). Hypothesis 2, 'the experimental group which had the individual health education will have higher self-efficacy scores than the control group that did not have the individual health education' was supported (t=4.06, P=0.00). Hypothesis 3, 'the experimental group which had the individual health education will have better self-care ability than the control group that did not have the individual health education' was supported (t=4.94, P=0.00). Based on the results of this study, the public health centers should develop an educational program that uses a variety of visual aids and assess the effects of the education on patients with different chronic diseases. After the development of an inclusive education program which will standardize health education effectively and provide a variety of teaching methods, study is needed to measure changes in lifestyle after education and to determine how much knowledge related to hypertension, self-efficacy, and self-care increase

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환자호소에 대한 해결시간 단축을 위한 기초조사연구 (An analysis of in-patient complaints and subsequent intervention)

  • 김용순;박지원;박연옥
    • 한국의료질향상학회지
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    • 제4권1호
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    • pp.64-80
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    • 1997
  • Background : An important issue in health care today is in trying to center service around the hospitalized patient. There is a "Kindness Movement" developing now, where in the focus of Health Care is being changed from simply treating the basic physical needs of the patient with sophisticated technology, to keeping emotional well being healthy with more humane and attentive treatment. In our attempt to reach the goal of a completely satisfied patient, we undertook a study of the common complaints of patients, and the subsequent nature of the interventions. Method : The study was carried out in two stages, first the patients made known their complaints by filling out questionnaires, then we collected data on the attempts to alleviate the complaints. The questionnaire provided 19 different complaints, which were then analysed for such variables as content, source of complaint, persons treating the complaint, and length of time and method used to solve the complaint. Results : 1. The Chief complaints made by patients(99.1%) were of physical discomfort, such as pain, nausea, vomiting, indigestion, diarrhea and constipation. 2. The complaints were voiced primarily by either of the patient's family, or by the patients themselves(78.4). 3. The complaints were intervened by nurses alone(53.5%), physicians alone(25.5%), or by nurses and physicians together(19.25%). 4, The method by which the complaints were resolved included the utilization of prescriptions(55.7%), further explanation and education(25. 5%) and notification after treatment(13.2%). 5. Most complaints were voiced during the dayshift(42.6%, 7:00-15:00), followed by the evening shift(36.0% 15:00~22:00), and then the nightshift(21.3 %, 22:00-07:00). 6. The time required for successful resolution of the patient's problems varied from 10~88.9min, according to the nature of the complaint. Conclusion : Hopefully by knowing beforehand the nature of both complaint and intervention, we can anticipate problems and shorten reaction time, in order to provide for a more satisfied patient.

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구강건강행태 및 치과의료서비스 이용과 치주질환과의 관련성 (A study of the relationship between oral health behaviors, use of dental clinics and periodontitis)

  • 최혜정;이명선
    • 한국학교ㆍ지역보건교육학회지
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    • 제14권3호
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    • pp.89-99
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    • 2013
  • Objectives: This study was designed to examine the effects of oral health behaviors and use of dental clinics on periodontal diseases in women, the purpose of this study is to provide basic information to develop program for dental health promotion in young women. Methods: We conducted a survey targeting 486 women that agreed with the survey and were going to dental clinic from October 1, 2013 to October 18, 2013. We surveyed them by self-administered questionnaire and analyzed it by SPSS Win 19.0 program. Results: 1. For differences in periodontitis according to general characteristics, if th age is high, ratio of periodontitis is high. Married woman is higher than single one in ratio of periodontitis. Also the more number of birth, the higher ratio of periodontitis is.(p<.05) 2. For differences of periodontitis by dental care behavior, ratio of periodontitis of non-smokers is significantly low. For one that brush one's teeth broadside, the ratio of periodontitis is high.(p<.05) 3. For differences of periodontitis by use of dental clinic service, ratio of periodontitis of one that have more times visit to a dental clinic, more annual average cost for dental care, and regular dental check-ups is relatively low.(p<.05). 4. For determinant factors influencing on periodontitis, ratio of periodontitis of one that is old, have more stress, have a low level of education, and have preventive dental care is high. Ratio of periodontitis of one that have less toothbrushing and brush one's teeth after having lunch or a snack and before sleeping is significantly low. Conclusions: From this study, dental health behavior as the factor influencing on periodontitis of young women is statistically meaningful. Because this dental health behavior has a lot of potential to be improved by government and local community efforts such as education and social support, we think that systematic and various educational program development is needed to strengthen self dental care ability effectively with policy support.

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산후풍 한의표준임상진료지침을 위한 환자의 의료 이용 경험 및 인식도 조사 (A Survey on Patient's Experience and Perception on Health Care Utilization for Developing of a Korean Medicine Clinical Practice Guideline for Puerperal Wind Disorder)

  • 권나연;김동일;윤영진;박장경
    • 대한한방부인과학회지
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    • 제35권2호
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    • pp.54-69
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    • 2022
  • Objectives: The purpose of this study is to reflect the patient's perspective in the process of developing Korean medicine clinical practice guideline (CPG) of puerperal wind disorder by survey. Methods: Five hundred fifty patients were surveyed from November 3rd, 2021 to November 8th, 2021 by internet. This study is an exploratory cross-sectional survey study, and descriptive statistics and frequency analysis were conducted on respondents' general characteristics, postpartum symptoms, the history of using treatment institution for puerperal wind disorder, satisfaction of medical institutions and perception of postpartum care. Results: Survey results showed that 92.0% of respondents experienced symptoms after childbirth, and 56.2% of the symptoms were arthralgia, followed by obesity with 41.8%. Among puerperal wind disorder patients, 34.2% had treatment history, and 54.3% received Korean medical treatment. Treatment satisfaction was confirmed to be higher in Korean medical treatment. The necessity of postpartum care was recognized at 95.7% of respondents, and the performance rate of traditional Korean postpartum care was also high. Conclusions: Based on a realistic patient-centered basis, it is a study that can lay the foundation for standardizing Korean medicine treatment and strengthening coverage in the future.

Risks for Readmission Among Older Patients With Chronic Obstructive Pulmonary Disease: An Analysis Using Korean National Health Insurance Service - Senior Cohort Data

  • Yu Seong Hwang;Heui Sug Jo
    • Journal of Preventive Medicine and Public Health
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    • 제56권6호
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    • pp.563-572
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    • 2023
  • Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea's circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service's Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.

근치적 절제 후 재발한 1,2기 비소세포폐암 환자의 임상상 (Clinical Characteristics of Recurred Patients with Stage I,II Non-Small Cell Lung Cancer)

  • 함형석;강수정;안창혁;안종운;김호철;임시형;서지영;김관민;정만표;김호중;김진국;권오정;심영목;이종헌
    • Tuberculosis and Respiratory Diseases
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    • 제48권4호
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    • pp.428-437
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    • 2000
  • 배경 및 방법 : 근치적 절제술 후 재발한 비소세포폐암 환자의 임상적 특징과 재발 양상을 알아보고자 1994년부터 삼성서울병원에서 근치척 절제술을 시행한 1,2기 비소세포폐암환자 256명중 1년 이상 추적 관찰이 가능하였던 234명을 대상으로 후향적 조사를 하여 다음과 같은 결과를 얻었다. 결 과 : 1) 전체 환자의 남녀 비율은 3.1:1이었고 연령의 중앙값은 63세로서 평균 추척 기간은 732일(365일~1,695일)이었다. 234명중 재발한 환자는 62명으로 26.5%였고 재발 기간은 수술후 평균 358.8일이었다. 2) 재발군과 비재발군의 임상양상을 비교하면 재발군의 연령이 많았으며($63.2{\pm}8.8$세 vs. $60.3{\pm}9.8$세, p=0.043), 재발율은 2기 환자가 1기 환자보다 높았다(6.0% vs. 21.2%, p<0.001). 원발암의 크기는 비재발군($3.74{\pm}1.75\;cm$)이 재발군($5.45{\pm}3.22\;cm$) 보다 작았고(p<0.001), 2cm 미만에서 재발이 발견된 경우는 없었다. 3) 원격 재발군과 국소성 재발군과의 분석에서 빈도는 원격 재발(66.1%)이 국소성 재발(33.9%)보다 많았고, 원격 재발은 여자가 남자보다 많았다(11/12명, 91.7% vs. 30/50 명, 60.0%. p=0.037). 선암이 편평세포상피암보다 원격 재발율이 높았고(20/25명, 80.0% vs. 15/29 명, 51.7%. p=0.030). 뇌전이 발생율이 선암(50.0%)에서 편평세포상피암(13.3%)보다 높았다(p=0.024). 4) 평균 생존 기간은 $1437.6{\pm}40.3$일이었고, 병기가 높을수록 생존기간이 길었다(log rank p<0.001). 결 론 : 1,2기 비소세포폐암의 근치적 절제술 후 재발은 26.5%에서 일어났고 종양의 크기 및 병기가 재발에 관련된 인자였다. 원발암의 크기가 2cm미만일 경우 재발된 경우가 없어 예후가 좋을 것으로 기대되며, 재발암 중에서는 여성과 선암에서 원격 재발율이 높았고 특히 뇌전이는 선암에서 많이 발생하여 수술 전 뇌영상 검사에 대한 전향적 연구가 필요할 것으로 생각된다.

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Perfluorocarbon이 기도 상피세포 Chemokine 발현에 미치는 영향에 관한 연구 (Perfluorocarbon Does Not Inhibit Chemokine Expression in Airway Epithelial Cells)

  • 서지영;강경우;박상준;정만표;김호중;최동철;이종헌;권오정
    • Tuberculosis and Respiratory Diseases
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    • 제48권2호
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    • pp.223-235
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    • 2000
  • 배 경: 액체환기가 손상된 폐에 긍정적인 영향을 주는 한 기전으로 perfluorocarbon(PFC)이 기도상피세포에서 chemokine발현을 억제할 수 있는 지를 관찰하기 위해 본 연구를 시행하였다. 방 법: 기도 상피세포로는 A549 세포주를, PFC로는 perfluorodecalin을, PFC의 노출은 Transwell$^{(R)}$배양접시의 lower chamber를 이용하여 시행하였다. PFC가 말초혈액 탄핵구층(peripheral blood mononuclear cell : PBMC)의 기능을 억제해서 A549세포의 chemokine 발현을 억제할 수 있는지를 관찰하기 위해서 PBMC를 분리하여 Transwell$^{(R)}$ 접시에서 배양하면서 lipopolysaccharide(LPS, 10 ${\mu}g/mL$)로 자극과 PFC의 노출에 따라 군을 나누었으며 24시간 후 그 배양 상층액을 포함한 conditioned media(CM)으로 24시간 동안 A549세포를 자극한 후 chemokine발현을 측정하였다. 또한 PFC가 직접 기도 상피세포의 기능을 억제할 수 있는 지를 관찰하기 위해서 A549 세포를 Transwell$^{(R)}$ 접시에서 배양하면서 interleukin-l$\beta$(IL-1$\beta$, 10 ng/ml), TNF-$\alpha$(10 ng/ml)로 각각 혹은 동시에 24시간동안 자극하면서 PFC노출여부에 따른 IL-8과 RANTES발현 정도를 비교하였다. Chemokine 발현은 IL-8과 RANTES의 단백에 대한 ELISA와 mRNA는 Northern analysis를 통하여 분석하였다. 결 과: 1. LPS로 자극한 PBMC의 배양상층액을 포함한 CM로 A549세포를 자극하였을 때 IL-8과 RNATES mRNA 발현과 면역반응성 단백 생성이 의미 있게 상승하였으나(p<0.05) PFC노출여부에 따른 유의한 차이는 관찰할 수 없었다. 2. TNF-$\alpha$와 IL-1$\beta$ 모두 A549세포에서 IL-8과 RANTES mRNA자발현과 면역반응성 단백 생성의 증가를 가져왔으나(p<0.05) PFC노출에 따른 유의한 차이는 관찰할 수 없었다. 결 론: 기도 상피세포의 chemokine발현 감소를 통한 항염증 작용은 액체환기시 보이는 염증반응 감소에 큰 기여를 하지 않을 것으로 생각되며 추후 액체환기시 관찰되는 염증반응의 감소의 기전에 대한 연구가 더 필요할 것으로 사료된다.

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