• Title/Summary/Keyword: interventions

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Database for Hospice Nursing in Electronic Medical Record (호스피스 전자기록을 위한 데이터베이스 개발)

  • Kim, Young-Soon;Lee, Chang-Geol;Lee, Kyoung-Ok;Kim, Ok-Kyum;Kim, In-Hye;Kim, Mi-Jeong;Hwang, Ae-Ran;Lee, Won-Hee
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.200-213
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    • 2004
  • Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.

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Music Activities for Facilitation of Developmental Domains for Children from Age Three to Six (3-6세 유아의 영역별 발달 촉진을 위한 단계별 음악치료교육 활동 연구)

  • Lee, Su yeon
    • Journal of Music and Human Behavior
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    • v.3 no.1
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    • pp.29-62
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    • 2006
  • The early development of an infant is crucial due to the enormous impact it has throughout an infant's life. Therefore, it is important to understand the development process of an infant and provide a high-quality educational environment so that an infant can progress at an innate pace to learn how to exercise, understand, speak, socialize, and empathize as well as having a balanced growth. When educating an infant, joy is a substantial factor in the formation of trust and development of relationship that makes education efficient. Music can be an effective means to offer a fun atmosphere vto the infant in which it stimulates active participation of the infant and development of a variety of dimensions to the infant's development. Also, the purpose of music therapy education is utilizes to plan for the different age groups' level of understanding of music and allow the infant to have a positive experience and develop properly. The purposes of this study are as following: to examine characteristics according to an infant' developmental steps thoroughly, to suggest interventions using music therapy education to stimulate development of an infant, to prove that infants age 3 to 6 obtain the necessary ability and skill through the effective educational therapy through music, and finally to create a music program for educating infants or music therapy. This study has examined theories of the music approach targeting infants age 3 to 6 and made character observations of infant' Motor, Cognition, Communication, Socialization, and Emotions. With the basis of the above theory, the different levels of development has been divided, specific goals has been set up according to the levels, and various music therapy education for infants have been created. The music therapy education activity has been approved by five professionals who are renown in their specific field. They made comments that the development levels were properly divided in the paper. They also commented that the music program is adequate for achieving the goal of each developmental level and it stimulates the different levels of an infant's development. In conclusion, the study reflects that the approach of music therapy education stimulates the different levels of infant development. Music therapists can utilize this music program to help handicapped children identify characteristics of progress and develop at their own ability.

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Effect of Supplementation of Fermented Milk Containing Active Peptides(IPP, VPP) in Accordance with Medical Nutrition Therapy in Pre- and Hypertension Subjects (고혈압 전단계 및 고혈압 환자에서 의학영양치료와 병행한 생리활성 펩티드 함유 유산균 발효유 섭취가 혈압에 미치는 영향)

  • Kim, Ji-Young;Kim, Yun-Young;Kim, Hye-Rang;Yun, Sung-Seob;Kim, Wan-Sik;Yea, Hyun-Soo;Chung, Jin-Young;Lee, In-Hoe;Choue, Ryo-Won
    • Journal of the East Asian Society of Dietary Life
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    • v.18 no.6
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    • pp.918-926
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    • 2008
  • It is well known non-drug therapy for hypertension patients can reduce blood pressure. These types of therapy include maintaining ones ideal body weight, quitting smoking, consuming large amounts of fruits and vegetables consuming low levels of saturated fat and salt and regular exercise. Fermented milk protein derived biologically active peptides such as isoleucine-proline-proline_(IPP) or valine-proline-proline_(VPP) have been shown to lower blood pressure in hypertensive subjects. This study was conducted to investigate the antihypertensive effects of medical nutritional therapy _(MNT) in accordance with the consumption of fermented milk enriched with IPP and VPP. To accomplish this, we conducted a randomized case-controlled study of 43 subjects who had blood pressure levels greater than 120/80 mmHg. The subjects in the study group were randomly allocated into two groups, an MNT + fermented milk (100mL/day) group (n=21) and an MNT+L. helveticus fermented milk with tripeptides (IPP=2.2mg, VPP=2.6mg/100mL) group (n=22). The MNT included weight management, reduction of sodium, total fat and saturated fat intake, increased intake of fruits and vegetables, and increased intake of low fat dairy products. The treatments were administered for 12 weeks during which time no drug interventions were conducted. The daily intakes of total calories, fats, cholesterol and Na decreased significantly after 12 weeks of MNT in the control and the experimental groups. In addition, the systolic blood pressure de creased significantly in the control and experimental groups; however, the diastolic blood pressure only decreased significantly in the experimental group. Overall, the results of this study indicate that the intake of fermented milk containing IPP and VPP in conjunction with MNT exerted positive effects on the blood pressure of pre- and hypertensive subjects.

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One-year evaluation of the national health screening program for infants and children in Korea (영유아 건강검진 시행 초기 1년의 결과 분석)

  • Moon, Jin Soo;Lee, Soon Young;Eun, Baik-Lin;Kim, Seong Woo;Kim, Young Key;Shin, Son Moon;Lee, Hye Kyoung;Chung, Hee Jung
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.307-313
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    • 2010
  • Purpose : Results of the Korea National Health Screening Program for Infants and Children, which was launched in November 2007, were evaluated for future research and policy development. Methods : Data from a total of 2,729,340 cases were analyzed. Five visiting ages, such as 4, 9, 18, 30, and 60 months, were included. Several parameters such as stunting, obesity, and positive rate of developmental screening were also analyzed. Telephone survey was performed in 1,035 users. For the provider survey, 262 doctors participated in our study. Results : The overall participation rate of users was 35.3%. This participation rate showed a decrement tendency to old age and low income. Only 6.9% of users participated in oral screening. Health screening was performed mainly in private clinics (82.6%). The recall rate of 4 months program users at the age of 9 months was 57.3%. The positive rate of screening was 3.1%, and was higher in the low-income group. By telephone survey, users reported that questionnaires were not difficult (94%) and overall satisfaction was good (73%). Longer duration of counseling was related with more satisfied users. Counseling and health education were helpful to users (73.2%). Doctors agreed that this program was helpful to children (98.5%). Conclusion : Korea National Health Screening Program for Infants and Children was launched successfully. Participation rate should be improved, and a quality control program needs to be developed. More intensive support following this program for children of low-income families may lead to effective interventions in controlling health inequality. Periodic update of guidelines is also needed.

A Study of well-being in Caregivers Caring for Chronically Ill Family Members (만성 질환자 가족의 부담감에 관한 연구)

  • 서미혜;오가실
    • Journal of Korean Academy of Nursing
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    • v.23 no.3
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    • pp.467-486
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    • 1993
  • Today, more chronically ill and handicapped people are being cared for at home by a family member caregiver. The task of caring for a family momber may mean that the caregiver has less time and money and more work which may result in increased fatigue and symptoms of illness. This study was done to examine the well-being of family caregivers. Fifty three family caregivers were interviewed. Concepts were measured using existing tools and included : Burden(25 item 5 point scale), Social sup-port (21 item 7 point scale), Health status defined by a symptom checklist(48 item S point scale), and Well -being defined by a quality of life scale (14 item 7 point scale) and caregiving activities. Data collection was done by interview and Q-sort. Social support and well - being were positively correlated as were symptoms and burden. Symptoms and burden were negatively correlated with social support and well-being. Items on the quality of life scale had a mean score range from 3.09 to 4.96. Quality of life related to income was lowest (3.09) but the desire to use more money for the patient was rated 2.90 on the burden scale where the item means ranged from 0.73 to 3.55. The high mean of 3.55 was for obligation to give care and the low 0.73 was (or not feeling that this was helping the patient. Mean scores for symptoms ranged from 0.26 to 2.15 with the 2.15 being for “worry about all the things that have to be done.” Over half of the patients were dependent for help with some activities of daily living. The caregivers reported doing an average of 3.40 out of five patient care activities including bathing (77.4%), shampooing (67.9%), and washing face and hands (49.1%), and 3.74 out of seven home maintenance activities including laundry (98.1%), cooking (83.0%), and arranging bed-ding(75.5%). The caregivers reported their spouse as one of the main sources of social support, including in times of loneliness and anger The mean score for loneliness as burden was 2.15 and ranked fourth and 31 (58.5%) of the sample reported being lonely recently and not being satisfied with the support received. Similarly anger caused by the patient was given a mean score of 2.13, and anger was reported to have been present recently by 38 (71.7%) of the sample and satis-faction with the support given was low. Having someone to help deal with anger ranked twelfth out of 21 items on the social support scale and had a mean score of 3.98 (range 3.49 to 5.98). Spouses were reported as a major source of social support but the fact that 50% of the caregivers were caring for a spouse, may account for the quality of this source of social support having been affected. These caregivers faced the same problems as others at the same stage of life. but because of the situation, there was a strain on their resources, particularly financial and social. In conclusion it was found that burden is correlated negatively to quality of life and positively to symptoms, but in this sample, symptoms and bur-den were scored relatively low. Does this indicate that the caregivers accept caregiving as part of their destiny and accept the quality of their lives with burden and symptoms just being a part of caregiving\ulcorner Does the correlation between the bur-den and symptoms indicate they are a measure of the same phenomenon or that the sample was of a more mobile, less burdened group of caregivers\ulcorner Quality of life was the one variable that was significant in explaining the varience on burden. Further study is needed to validate the conclusions found in this study but they indicate a need for nurses to ap-proach these caregivers with a plan tailored to each individual situation and to give consideration to interventions directed at improving quality of life and expanding social support networks for those caring for spouses.

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Appling Nursing Theory to Clinical Practice of Home Health Care (가정간호실무에 적용가능한 이론적틀)

  • Woo, Seon-Hye
    • Journal of Home Health Care Nursing
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    • v.11 no.1
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    • pp.5-13
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    • 2004
  • The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

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Development of a Home-based Nursing Intervention, Mothering Program for Low-Birth-Weight Infants (저체중출생아를 위한 가정간호형 모성역할중재 프로그램 개발과 그 효과에 대한 연구)

  • Han, Kyung-Ja
    • Journal of Home Health Care Nursing
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    • v.8 no.1
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    • pp.5-24
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    • 2001
  • The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

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A Study on Stage of Concern, Level of Use, Innovation Configuration, and Intervention demand of Teachers in Culinary Practice Education (조리실습 교육에 대한 교사의 관심도, 실행 수준, 실행 형태 및 지원 요구도 조사)

  • Park Eun-Sook;Kim Young-Nam
    • Journal of Korean Home Economics Education Association
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    • v.18 no.3 s.41
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    • pp.41-60
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    • 2006
  • The system of teaching culinary practice needs drastic modification to catch up with dietary life and education curriculum changes. To reflect such changes, it is necessary to instill a strong will and interest as well as educational environment improvement in teachers. In this sense, this study researched the teachers' stages of concerns, levels of use, innovation configuration, and intervention demands, based on the CBAM(Concerns Based Adoption Method) developed by Hord et. al. For the survey, 500 questionnaires sent by mail and 187 were analyzed by SPSS/win 10.0 program. The results are summarized as follows. 1) The teachers stages of concerns on culinary practice is assessed to be in the lowest level of perceptual stage, which indicates a state of indifference. 2) In terms of the levels of use, routine use was the highest, followed by refinement use, integrated use, research use, and reinvent use in descending order. Mechanical use posted the lowest level. Even though the stages of concern showed the beginning stage, the Level of use was relatively high. 3) About the innovation configuration, approximately 30% of the teachers were not accomodate the culinary practice referred to the 7th National Education Curriculum. 4) According to the intervention demands on culinary practice education, it was found that teachers generally wanted more interventions in every component. Among the intervention components, the highest demand was on the support for facility. Demand on the financing is the second highest. Teachers in the level of routine use demanded more information and materials supply and individual encouragement, but teachers in the level of preparation needed study opportunity for training on operation skills more.

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Ethnosientific Approach of Health Practice in Korea (한국인의 건강관행에 대한 민속과학적 접근)

  • 김귀분;최연희
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.396-417
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    • 1991
  • In order that nursing care an essential quality of nursing practice be acceptable and satisfying, it is necessary that client's culture be respected and that nursing practice be appropriate to that culture. Since cultural elements are an important influence on health practices and life patterns related to medical treatment, recovery from and prevention of disease, nurses need to have an understanding and knowledge of social and cultural phenomena to aid in the planning of nursing interventions. To understand the health practices surrounding health and illness, the health beliefs and practices of both folk and professional healing systems should be ascertained. Cultural data are required to provide care of high quality to clients and to reduce possible conflict between the client and the nurse. It is nursing's goal to provide clients from various cultures with quality nursing care which is satisfying and valuable. The problem addressed by this study was to identify Korean health practices which would contribute to the planning of professional caring practice with the culture : ultimately this study was intended to make a contribution to the development of the science of nursing. The concrete objectives of this study were ; 1) to identify Korean health practices, 2) to interpret the identitial health practices through traditional cultural thought, and 3) to compare the Korean health practices with those of other cultures. The investigator used the ethnosceintific approach outlined by spradly in a qualitative study. To discover ancestral wisdom and knowledge related to traditional health practeces, the subjects of this study were selected from residents of a small rural mountain village in south west Korea, a place considered to be maintaining and transmitting the traditional culture in a relatively well -preserved state because of being isolated from the modern world. The number of subjects was 18, aged 71 to 89. Research data were collected from January 8 to March 31, 1990. Five categories of health practices were identified : “Manage one's own mind”, “Moderation in all thing”, “Live in accord with nature”, “Live in mutuality with others”, and “Live to the best of one's ability”. Values derived from these ways of thinking from Confucianism, Taoism and Buddhism help fashion a traditional way of life, examplified by the saying “Benifience to all”. Korean thought and philosophy is influenced primerily by Confucianism, Confucian principles of ethics, embedded deeply in the peoples' minds, form the idea that “heaven and human being are intimately united” based on concept that “heaven is, so to speak, reason”. Twoe Gae's theory of existential subjectivity develops the concept of self which is the basis of the spirit of reverence in modern Confucian philosophy. The human md is granted from heaven out of the idea of matter, and what control the mind is the spirit of reverence. Hence the idea of “The primacy of the mind" and provided that one should control one's own mind. The precepts of duty to parents, respect for elders and worship of ancestors, and moderation in all behavior put a restraint on life which directed that one live earnestly according to Nature's laws with their neighbors. Not only Confucianism, but also Buddism and Taoism have had an important effect upon these patterns of ideas. When compared with western culture, Korean health practices tend to be more inclusive, abstract and intuitive while westerner health practices found to be mere concrete, practical and personal. Values and beliefs based and pragmatism and existentialism infuence western civilization, Ethical values may be founded on utilitarianism, which considers what is good for the persons in their circumstances as the basis of conduct and takes a serious view of their practical lives including human aspirations rather than an absolute truth. These philosophical and ethical ideas are foundations for health practices related to active, practical and progressive attitudes. This study should be enable nursing not only to understand clients as reflections of the traditional culture when planning nursing practice, but to dovelop health education corresponding to cultural requiments for the purpose of protection against disease and improvement of health, and thus promote sound health practice. Eventually it is hoped that through these processes quality nursing care as the central idea of the science of nursing will be achieved.

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Clinical Features Affecting the Efficacy of Systemic Clonazepam for Management of Burning Mouth Syndrome (구강작열감증후군의 치료를 위한 전신적 클로나제팜의 투여 시 환자의 임상적 특징에 따른 효능의 차이에 관한 연구)

  • Min, Bo-Kyong;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.37 no.3
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    • pp.161-167
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    • 2012
  • Burning mouth syndrome(BMS) is defined as chronic, painful burning sensation in the oral mucosa. Treatments for BMS include medication and psychiatric interventions. Capsaicin, alpha-lipoic acid, and topical and systemic clonazepam showed more effective in reducing the symptoms of BMS in the previous studies. The purpose of this study is to evaluate of the therapeutic efficacy of systemic clonazepam in BMS and to elucidate the relationships between such a efficacy and various clinical features, including age, pain intensity, pain duration, previous dental history and condition of oral mucosa. A retrospective clinical records audit was performed of patients diagnosed with BMS between January 2011 and August 2012. Patients were prescribed 0.5 mg clonazepam two times daily. Pain was assessed by patients on an 11-point numeric rating scale (NRS; 0 to 10) before and 1-2 weeks after systemic administration of clonazepam. The efficacy of clonazepam was evaluated in terms of patient's age, initial pain intensity, pain duration, presence or absence of precipitating event, condition of the tongue, presence or absence of denture. A total of 50 patients (46 women, 4 men) were included in this study. The patients were divided into two or three groups according to above clinical features. The amount of mean NRS reduction in patients with severe initial pain was $3.33{\pm}2.74$, whereas that in patients with mild initial pain was $1.64{\pm}1.54$. The amount of mean NRS reduction in oldest patients was $3.53{\pm}1.94$ (${\geq}$70yrs), and those in another younger patients were $2.88{\pm}1.80$(< 60yrs) and $1.54{\pm}2.86$(60yrs ${\leq}$ age < 70yrs), respectively. It was concluded that the older patients and the patients with higher intensity of initial pain tend to show better efficacy of clonazepam. However, There were no statistically significant differences according to pain duration, presence or absence of precipitating events, tongue fissuring, and wearing dentures.