• 제목/요약/키워드: care-bed

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병상에서 장기간 방치 된 뇌성마비 환자 : 증례보고 (A LONG-TERM NEGLECTED BED PATIENT WITH CEREBRAL PALSY : A CASE REPORT)

  • 김도영;양연미;김재곤;이대우
    • 대한장애인치과학회지
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    • 제13권1호
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    • pp.33-36
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    • 2017
  • 뇌성마비 환자들은 식이자세와 잇솔질에 대해 스스로 행동할 수 없기 때문에 의과적 치과적인 문제에 더 취약할 수 밖에 없다. 낮은 사회경제적 지위와 심각한 운동장애를 가진 뇌성마비 환자들은 특히 치과치료에서 소외되기 쉽다. 의과적 치료와 함께 구강관리는 뇌성마비 환자들의 삶의 질에 매우 중요한 관련이 있다. 그러므로, 장애인들의 삶의 질을 향상시키고 의료혜택으로부터 소외되지 않도록 정기적인 검진과 예방치료를 받기 위해서는 국가차원에서 공공의료서비스 및 시스템이 필요하다.

The use of tissue fiducial markers in improving the accuracy of post-prostatectomy radiotherapy

  • Chao, Michael;Ho, Huong;Joon, Daryl Lim;Chan, Yee;Spencer, Sandra;Ng, Michael;Wasiak, Jason;Lawrentschuk, Nathan;McMillan, Kevin;Sengupta, Shomik;Tan, Alwin;Koufogiannis, George;Cokelek, Margaret;Foroudi, Farshad;Khong, Tristan-Scott;Bolton, Damien
    • Radiation Oncology Journal
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    • 제37권1호
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    • pp.43-50
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    • 2019
  • Purpose: The aim of this retrospective study was to investigate the use of a radiopaque tissue fiducial marker (TFM) in the treatment of prostate cancer patients who undergo post-prostatectomy radiotherapy (PPRT). TFM safety, its role and benefit in quantifying the set-up uncertainties in patients undergoing PPRT image-guided radiotherapy were assessed. Materials and Methods: A total of 45 consecutive PPRT patients underwent transperineal implantation of TFM at the level of vesicourethral anastomosis in the retrovesical tissue prior to intensity-modulated radiotherapy. Prostate bed motion was calculated by measuring the position of the TFM relative to the pelvic bony anatomy on daily cone-beam computed tomography. The stability and visibility of the TFM were assessed in the initial 10 patients. Results: No postoperative complications were recorded. A total of 3,500 images were analysed. The calculated prostate bed motion for bony landmark matching relative to TFM were 2.25 mm in the left-right, 5.89 mm in the superior-inferior, and 6.59 mm in the anterior-posterior directions. A significant 36% reduction in the mean volume of rectum receiving 70 Gy (rV70) was achieved for a uniform planning target volume (PTV) margin of 7 mm compared with the Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recommended PTV margin of 10 mm. Conclusion: The use of TFM was safe and can potentially eliminate set-up errors associated with bony landmark matching, thereby allowing for tighter PTV margins and a consequent favourable reduction in dose delivered to the bladder and rectum, with potential improvements in toxicities.

Oral Care Behavior according to Orthodontic Treatment Experience: Use of the 9th National Health and Nutrition Survey

  • Ho-Jin Jeong;Jung-Hwa Lee
    • 대한의생명과학회지
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    • 제30권2호
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    • pp.81-85
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    • 2024
  • Among all subjects who participated in the survey in the 9th 1st year (2022), 2,448 men (44.0%) and 3,166 women (56.0%) aged 12 or older were identified to determine oral care behavior according to orthodontic treatment experience. The purpose was to provide basic data on the oral care of patients wearing orthodontic appliances. 1. When it comes to brushing teeth, brushing before going to bed was the highest. Regarding the use of oral care products, 3,965 people (69.1%) said they 'do not use dental floss', 4,064 people (73.2%) said they 'do not use interdental brushes', and 4,064 people (73.2%) said they used oral rinse. 'I don't do it' was the highest at 4,417 (77.7%), and electric toothbrushes were the highest at 'I don't do it' at 5,241 (93.6%). 2. In terms of the effect of orthodontic treatment experience on toothbrushing time, with orthodontic treatment experience, toothbrushing after breakfast was 0.598 times more likely (P<0.001), and toothbrushing after lunch was 1.482 times more likely (P<0.001). Toothbrushing after dinner was 0.805 times higher (P=0.049), and toothbrushing before going to bed was 1.794 times higher (P<0.001), which was statistically significant. 3. When having orthodontic treatment experience, dental floss was found to be used 1.434 times more often (P=0.002), interdental brushes were used 1.464 times more times (P<0.001), and oral rinses were found to be used 1.457 times more times (P=0.002), which was statistically significant.

병동형 호스피스 대상자를 위한 전인적 호스피스 간호중재 프로그램의 개발 (Development of Wholistic Hospice Nursing Intervention Program for In-patient of Hospice Palliative Care Unit)

  • 강은실;최성은;강성년
    • 호스피스학술지
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    • 제7권1호
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    • pp.29-45
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    • 2007
  • People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

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의료용 침대 및 수술대의 기준규격 연구 (A Study on Standards for Hospital Bed and Operating Table)

  • 박상건;문인혁
    • 재활복지공학회논문지
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    • 제3권1호
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    • pp.35-40
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    • 2009
  • 전동 조절식 의료용 침대나 수술대는 병원에서 환자의 요양시 또는 진료시 자세유지에 사용되는 유용한 기기이지만, 다양한 기능과 복잡한 기구 메커니즘으로 인해 사용상의 안전사고가 빈번하게 발생하는 의료기기의 하나이다. 본 논문에서는 의료기기로서 승인이 필요한 의료용 침대와 수술대의 안전성과 성능에 관한 일반 요구사항 및 시험방법을 제시한다. 각 항목은 관련 국제규격을 바탕으로 구성한다. 연구의 결과는 식품의약품안전청의 의료기기 인허가시 적용되는 기준규격의 개발에 사용될 수 있다.

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중환자부 시설기준 수립을 위한 가이드라인 조사·분석연구 - 미국, 영국, 호주 사례를 중심으로 (A Study on the Architectural Design Guideline for Intensive Care Unit - Focused on Cases of The US, The UK and Australia)

  • 윤우용;채철균
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제21권4호
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    • pp.17-25
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    • 2015
  • Purpose: At the moment, There is a facility standard for intensive care units on the Korea medical services Act. However, the contents of regulation are so limited and difficult to apply. Therefore, it is necessary to draw up the guideline to complement the regulation for efficient operation of intensive care units. This study aims to suggest basic data for guideline of intensive care units. Methods: 2 Methods have been used in this paper. 1) Comparative analysis between the national regulation of Korea with the design standard of the United States America, the United Kingdom and Australia. 2) A literature survey about operation method for intensive care unit, focused on materials published in intensive care medicine society of each country. Results: In comparison with guideline of abroad cases, additional supplement are required, with regard to item such as operation environment, size, nursing manpower ratio, bed space area, space program of intensive care units for healing environment. Implications: This study is a basic research for guideline of intensive care unit, and need to be followed by further study using various perspectives and methods.

조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구 (A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis)

  • 박경숙;정연강
    • 대한간호학회지
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    • 제24권4호
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    • pp.545-556
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    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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중환자실 시설기준 작성을 위한 기본시설 수준 설정 연구 - 국내·외 시설기준 및 국내 종합병원 병상규모 별 시설 현황분석을 기초로 하여 (A Study to define the range of sample size for setting Intensive Care Unit(ICU) facility guidelines - Focused on analysis of guidelines and present of ICUs facilities by general hospitals size)

  • 윤형진;조준영
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제23권3호
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    • pp.47-56
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    • 2017
  • Purpose : This study is a basic research to establish guidelines for healthcare facility in Korean healthcare market. As a first step, it is a main purpose for making beginning point of ICU guideline to set a basic level of ICU facility size and quality by analysis current ICU facilities and existed domestic guidelines : law, criteria of healthcare insurance review and assessment service, credit of Korea institute for healthcare accreditation. Methods : First of all, the all requirements of existed guidelines are put together and summarized. The summary is compared with that of US, UK, and Australia to know its quality difference with international market. In addition, all hospitals in Korean market are classified based on total bed number and ICU bed number to know the most occupied facility size range in the market. Second of all, by comparing 15 ICUs' current setting of the public general hospital, a general condition of ICU facility would be extracted based on function, floor area per bed, services Results : 72.8% of hospitals in Korea are belonging below 500 beds hospital. Among them 200-299 beds hospitals occupied 35.3% and are shown as the most occupied hospital size. As 15 public general hospitals are analyzed, it is clear that the more bed size and services the more ICU area per bed. As a result it is sure that the 300~500 bed may be a clear line as a general ICU condition whose function and bed number relatively consistent in the range. Implications : to keep the qualified medical environment and contemporary hospital trend, the guideline as a minimum requirement keep naturally out from current healthcare settings and should reflect their limit to reconcile with the new trend in the market.

종합병원 의료인의 교육훈련 인식이 의료인 상호간 커뮤니케이션에 미치는 영향 (The Effects of Supplementary Education Awareness on Interpersonal Communication for Health Care Providers)

  • 정상진
    • 한국산학기술학회논문지
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    • 제19권11호
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    • pp.411-420
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    • 2018
  • 본 연구는 종합병원 의료인의 교육훈련 인식이 의료인 상호간 커뮤니케이션에 미치는 영향을 파악하기 위한 목적으로 수행된 연구이다. 자료조사는 광주광역시, 전라남도 소재 29개 종합병원에서 근무하는 의료인 433명을 대상으로 2018년 6월 8일부터 2018년 6월 25일까지 자료를 수집하였다. 자료 분석은 t-검정과 분산분석, 사후검정, 상관관계 및 단계적 회귀분석을 실시하였다. 연구결과 인구사회학적 특성 및 건강관련 특성과 의료인 상호간 커뮤니케이션 차이를 검정한 결과 연령, 학력, 병상규모, 직업만족도, 소재지, 건강상태, 건강관리 교육경험, 우울경험에서, 교육훈련 인식은 연령, 병상규모, 직종, 급여수준, 의료기관 종류, 직업만족도, 소재지, 건강상태, 건강관리 교육경험, 만성질환 여부에서 통계적으로 유의한 차이가 있었다. 의료인 상호간의 커뮤니케이션에 미치는 영향 요인으로 학력, 건강관련 교육경험에서 긍정적인 영향을 미쳤고, 연령과 병상규모(801병상 이상), 직업만족도에서는 연령이 높을수록, 병상규모가 801병상 이상인 경우, 직업에 만족하지 못할수록 부정적인 영향을 미쳤으며, 교육훈련 하부요인인 지원환경, 학습전이, 성과에서 영향을 미쳤다. 이러한 연구를 바탕으로 교육훈련 계획수립 시 성과와 지원환경, 학습전이를 높일 수 있는 교육훈련 프로그램 구축이 필요하며, 의학 및 간호학생들의 교육 과정에 커뮤니케이션의 정규 교육과정을 도입. 의료인 상호간 커뮤니케이션을 높여 환자에게 안전한 의료서비스를 제공해야 할 것이다.

노약자를 위한 침대의 매트리스에 관한 연구 (The Study of Bed Mattress for the Elderly)

  • 이세환
    • 한국가구학회지
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    • 제24권2호
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    • pp.191-207
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    • 2013
  • Bed for elderly and disabled, including the United States developed the industry Americas, and European countries, mainly in the production of products has dominated the world market. In large hospitals, and dependent products are sold at high prices. On the other hand, improvement of living standards of our country and to the advancement of residential culture of the demand for luxury products is increasing. The study of the elderly Edition mattresses have been developed mainly in Europe to maximize the use of sleep can increase the efficiency of products has been studied. Due to the increase in elderly population Elderly Hospital, which is installed in the elderly silver town Edition requires the dissemination of the mattress in the bedroom several times a day resting and sleeping, eating, etc. Designing a variety of actions are needed. Edition of the elderly in Korea developed the design of bed with bed design and the manufacturer and the Institute for Ergonomics, welfare agencies and to build organic cooperation system under the direction of a professional designer to develop and you need to configure the space and the results of such actions by the distribution of cheap materials, ergonomic mattress for optimal development of behavior analysis to the need to promote the convenience of the user.

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