Purpose: The purpose of the study was to investigate symptom clusters experienced by patients on hemodialysis and to identify relations between symptom clusters and quality of life. Methods: Data were collected from 127 patients at 10 local hemodialysis clinics. Symptoms were measured using 10-item physical symptom checklist as well as the Hospital Anxiety depression Scale. Quality of life was measured with the Satisfaction with Life Scale. Data were analyzed using factor analysis, Pearson correlation, and stepwise multiple regression. Results: The most frequently reported symptoms included fatigue, itching, depression, numbness/tingling, and insomnia. Four distinct symptom clusters were identified: cluster 1 was comprised of dry mouth, headache, nausea (gastrointestinal); cluster 2 of decreased appetite, insomnia (basic need); cluster 3 of itching, numbness/tingling (sensory-comfort); and cluster 4 of fatigue, depression (mood-vitality). Among the clusters, the 'basic need' cluster and 'mood-vitality' cluster had a significant negative association with quality of life. The 'mood-vitality' cluster, explained 17.4% of the variance in quality of life. Conclusion: The results of the study indicate that comprehensive symptom assessment provides better symptom management for patients on hemodialysis. Further studies are needed to verify symptom clusters identified in this study.
Objective: This study is about the physical therapy facilities and environmental and service satisfaction of patients visiting in the front military hospitals and divisions. Design: Survey study Methods: Prior to this survey, 28 users of the front division and military hospital were surveyed in advance to verify the survey through reliability analysis. For this survey, 1,300 questionnaires were distributed to seven frontline divisions and three military hospitals, of which 578 military hospitals and 479 divisions were collected. Among them, 1,042 pieces of data were used for the analysis, excluding 15 questionnaires that exceeded the research period of the division. Analysis methods used Cronbach-α and multiple regression for mean comparison analysis, factor analysis for validation, and reliability verification to verify differences between groups. Results: As a result of the satisfaction analysis, the division's stage satisfaction was higher than that of military hospitals, and as a result of analyzing the satisfaction items by sector, accessibility, re-visit doctors, and professionalism accounted for a large portion in the field of physical therapy services. As a result of a regression analysis, the factors that affect the satisfaction of physical therapy had the greatest impact on facility and environmental satisfaction, and expertise in physical therapy services. Conclusions: In the future, it will be necessary to improve the comfort of the physical therapy room and the expertise of physical therapy in order to improve the satisfaction level of physical therapy at military medical facilities.
Purpose: This study was attempted to identify the importance and performance of person-centered care in nurses in intensive care units (ICU) at general hospitals and to derive the priority of practical person-centered care needs and intervention by analysing their needs. Methods: A total of 156 ICU nurses who wrote a written consent participated in a survey questionnaire on person-centered critical care nursing (PCCN). The collected data were analyzed using paired t-test, Borich's needs assessment, and the Locus for Focus Model. Results: All 15 items of person-centered care in ICU nurses were found to be significantly higher in perception of importance than performance level (t=17.98, p<.001). According to the analysis of Borich's needs and the Locus of Focus Model, person-centered care items with highest priority in ICU were therapeutic contact, comfort words and actions, and efforts to empathize with patients in the compassion category. Conclusion: As a strategy to improve the person-centered nursing performance of ICU nurses in the 'individuality', it is necessary for ICU nurses to recognize the ICU patients as an individualized person, not as a disease or machine-dependent entity. Also, it is necessary to develop programs to improve the ICU nurses' compassion competence because 'compassion' was a top priority according to Borich's needs assessment model and the Locus for Focus Model.
Purpose: This study aimed to identify clinical characteristics of South Korean pediatric inflammatory bowel disease (IBD) in a children's hospital over the past 5 years, with a specific focus on comparing the features observed between Crohn's disease (CD) and ulcerative colitis (UC). Additionally, it aimed to examine the nursing diagnoses given to patients. Methods: This retrospective study analyzed the medical records of Korean pediatric patients under 18 years of age who were diagnosed with IBD and hospitalized at a children's hospital in Seoul, South Korea, from January 2017 to December 2021. Results: The number of pediatric patients diagnosed with IBD steadily increased. This finding was particularly prominent for CD patients, the majority of whom were male. Pediatric patients with CD had significantly higher rates of abdominal pain and perianal lesions, while pediatric patients with UC had a higher rate of bloody stool. Laboratory findings indicated that CD patients had higher levels of inflammatory markers and lower albumin levels than UC patients. The nursing diagnoses given during hospitalization mostly related to safety and protection, physical comfort, and gastrointestinal function. Conclusion: This study provides insights into Korean pediatric IBD patients, enabling early detection and the development of nursing intervention strategies. From a comprehensive perspective, nursing care should not only address patients' physical needs but also their psychosocial needs.
Purpose: This study was undertaken to review the precise morphological patter'ns of polydactyly of the foot and to evaluate outcomes of surgical interventions. Materials and Methods: The records of patients who had polydactyly of foot from 1983 to 2000 were reviewed retrospectively. 29 duplicated toes(24 patients) were analyzed. All cases were evaluated and classified with Temtamy and McKusick's axial pattern, Watanabe's morphologic pattern and level of duplication. Clinical evaluation was performed according to Phelps and Grogan's. Mean age at surgery was 5.7 years(range: 10 months$\sim21$ years). All the patients were subsequently evaluated during mean 17 months(range: 13 months-$\sim5$ years). Results: Preaxial polydactyly was seen in 3 cases, central polydactyly in 3 cases, postaxial polydactyly in 22 cases and remaining 1 case was multiple my involvement. Only 2 patients have familial history and the most common associated anomaly was hand deformity(20.8%). Clinical results were excellent in 14 cases, good in 5 cases, poor in one. 17 patients(70%) were operated before 6 years olds and they had better results than those of who were operated after 6 years olds. Conclusion: The Method of surgical correction for the polydactyly should be individualized by its morphological pattern because the purpose of operation was to give comfort in wearing shoes and patient's psychological relief. This study showed that polydactyly of the foot could be corrected surgically with good results in most cases, and the better results would be achieved if the operation is performed before preschool age according to its individualized pattern of duplication.
This study was designed to measure viscosity, osmolality and in vitro flow rates via nasogastric tubes for 6 types of commercially available and 9 hospital-blenderized enteral solutions and to examine the effect of viscosity and osmolaility of enteral formula on the flow rates in gravity drip administration. Each solution was infused through 18, 16, 14, 12 French sizes of silicone rubber tube. Flow rates were measured six times at $25^{\circ}C$ using formula bags and drip sets hung at a uniform height on a intravenous drip stand with tube uniformly positioned in collecting container. Viscosity ranged widely from 16.0 to 195.5 cps with mean, 64.61$\pm$64.42 for hospital-blenderized formula while mean viscosity of commercial formula was 7.60$\pm$4.84 cps. Mean osmolality of commercial formula and hospital-blenderized formula were 370$\pm$100.80, 540.33$\pm$89.37 mOsm/kg respectively. There was negative relationship between viscosity of formula and flow rates through tubes but no significant relationship between flow rates and osmolalty. Some of hospital-blenderized formula was too viscous to be infused througth tube with gravity drip administration and the recipe of formula requires to be modiifed. On the other hand, commercial formula with the low viscosity flows too rapidly with large bore size tubes. Smaller size of tube must be selected for hyperosmolar solution to decrease possible side effects associated with tube feeding. Two kinds of regression equations for flow rates obtained according to viscosity and tube sizes were also presented for the purpose of practical uses. In conclusion, this study emphasizes that viscosity of fomula, osmolality, patient's tolerance and comfort, caloric density should be considered in the selection of tubes for gravify drip administration.
Objective: Poor experience with Invisalign treatment affects patient compliance and, thus, treatment outcome. Knowing the potential discomfort level in advance can help orthodontists better prepare the patient to overcome the difficult stage. This study aimed to construct artificial neural networks (ANNs) to predict patient experience in the early stages of Invisalign treatment. Methods: In total, 196 patients were enrolled. Data collection included questionnaires on pain, anxiety, and quality of life (QoL). A four-layer fully connected multilayer perception with three backpropagations was constructed to predict patient experience of the treatment. The input data comprised 17 clinical features. The partial derivative method was used to calculate the relative contributions of each input in the ANNs. Results: The predictive success rates for pain, anxiety, and QoL were 87.7%, 93.4%, and 92.4%, respectively. ANNs for predicting pain, anxiety, and QoL yielded areas under the curve of 0.963, 0.992, and 0.982, respectively. The number of teeth with lingual attachments was the most important factor affecting the outcome of negative experience, followed by the number of lingual buttons and upper incisors with attachments. Conclusions: The constructed ANNs in this preliminary study show good accuracy in predicting patient experience (i.e., pain, anxiety, and QoL) of Invisalign treatment. Artificial intelligence system developed for predicting patient comfort has potential for clinical application to enhance patient compliance.
The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.
Internet websites are excellent resources for younger people to gain information related to breastfeeding. So in this study, we evaluated the breastfeeding knowledge of university students, as well as the currently available website information on breastfeeding. Among the criteria, the six most important evaluation categories for the breastfeeding information on websites were selected and identified. The study participants completed the modified Williams and Hammer's tool, in order to evaluate their breastfeeding knowledge. An additional tool took into consideration the website breastfeeding information criteria, to evaluate the Korean websites. This 34 item tool was categorized into milk supply, comfort during breastfeeding, health of the baby and mother, social support, presentation of message, and products or financial motivation. Thirty-seven websites related to breastfeeding were evaluated, and the results were then discussed by nursing students. The students in this study were not knowledgeable on breastfeeding management with regard to the expression and storage of breast milk, the prevention and care of sore nipples, or use of breastfeeding aids. The breastfeeding information found on the Korean websites received positive evaluations for milk supply, comfort during breastfeeding, and health of the baby and mother. However, the educational content on social support, the message presentation, and the product areas on websites were rare or required additional information from breastfeeding specialists. In conclusion, based on our empirical survey, we need to design websites and evaluation tools for accurate website information regarding the social and economic benefits of breastfeeding, so that Korean women are better motivated to breastfeed by the information they obtain through the Internet.
In spite of the progress in techniques and materials of the prosthodontic rehabilitation of patients with complete edentulous arches, prosthodontists still face patients' complaints about dissatisfaction and discomfort from their dentures. In the past several decades, prosthodontists tried to find the factors that influence the patient's satisfaction with dentures. However the results are contraversial especially with the psychological factor. In this study using 'patient denture satisfaction questionnaire' and Hopkins Symptom Checklist, we tried to find the correlation between the patient's denture satisfaction and the patient's psychological aspects. 23 complete edentulous patients who have visited the Department of Prosthodontics, Yonsei University Dental Hospital from September 1998 to June 1999 for complete denture treatment were asked to complete the questionnaires 4 to 6 weeks after the upper and lower complete delivery. After the measurement of validity of the questionnaires, correlations between the patient's general satisfaction with their new upper and lower complete dentures and the other satisfaction questions including the satisfactions with esthetics, retention, mastication, speech, comfort and other people's opinion and between the patient's general satisfaction with their new upper and lower complete dentures and the 5 symptoms of Hopkins Symptoms Checklist including somatic, obsessive-compulsive, interpersonal sensitivity, depression and anxiety were analyzed. Among the several satisfaction questionnaire items, comfort with the lower denture showed highest relation to the patient's general satisfaction with dentures. However, only the anxiety scale of Hopkins Symptoms Checklist among the other symptom scales was related to the patient's general satisfaction with dentures. The two questionaires used in this study turned out to be valid means of analyzing patient's denture satisfaction and psychological status before and after the complete denture treatment.
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