• Title/Summary/Keyword: older patient

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Nurses' Awareness and Performance about Evidence-based Pain Management in Older Adults (병원 간호사의 근거중심 노인통증관리 지침에 대한 인지도와 수행도)

  • Kim, Eun-Kyoung;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.24 no.1
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    • pp.20-30
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    • 2012
  • Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

Health Literacy and Health Behaviors among Older Adults with Cardio-cerebrovascular Disease Residing in Rural Areas (농촌 지역 심뇌혈관질환 노인의 건강정보이해능력과 건강행위)

  • Lee, Myung Suk
    • Korean Journal of Adult Nursing
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    • v.29 no.3
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    • pp.256-265
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    • 2017
  • Purpose: The aim of this study was to identify levels of health literacy and reported health behaviors among older adults with cardio-cerebrovascular disease residing in rural areas. Methods: A cross-sectional survey was conducted with a convenience sample of 134 older people (mean age=75.5 years, 71.6% Female) registered at seven health centers. The structured questionnaires were used to measure levels of health literacy and health behaviors. Results: The average functional health literacy score was $6.08{\pm}3.04$, and the health behavior score was $62.92{\pm}6.45$. Respectively health behavior was positively associated with health literacy. Education, economic status, number of family members, number of social activities and health literacy were contribution factors explaining 40.64% of the variance in health behavior. Health literacy specifically explained 12.5% of health behavior. Conclusion: These findings suggest that strategies for improving health behaviors and reducing health inequalities may benefit from adopting a stronger focus on health literacy within prevention, patient education, and other public health interventions. Further longitudinal studies are needed to help confirm that improving health literacy in the elderly may be effective in changing health behaviors.

Patient-Controlled Analgesia Using Fentanyl or Butorphanol Mixed with Ketorolac after Tonsillectomy in Children (소아 편도적출술 후 Ketorolac과 함께 Fentanyl 또는 Butorphanol을 이용한 통증자가조절법)

  • Kim, Dong-Hee;Lee, Jung-Min
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.200-204
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    • 1999
  • Background: Patient-controlled analgesia (PCA) has proven to be safe and effective in children from age 5 years, and older and compares favourably with continuous morphine infusion in the older child. We compared fentanyl and butorphanol for opioid use in PCA with ketorolac to determine a suitable drug combination for post-tonsillectomy pain control. Methods: We studied 60 patients, aged 5~12 yrs, undergoing tonsillectomy with or without adenoidectomy under general anesthesia using $N_2O-O_2$-enflurane. Patients were randomly assigned to receive fentanyl $250\;{\mu}g$ (Group 1: n=30) or butorphanol 5 mg (Group 2: n=30) mixed with ketorolac 90 mg and ondansetron 4 mg diluting 100 ml of 5% D/W solutions intravenously via PCA pump after operation. PCA pump were programmed to deliver a 0.05 ml/kg loading dose, 0.01 ml/kg/hr basal infusion, 0.01 ml/kg on demand bolus, 6 min lockout intervals between doses and 4 bolus hourly limit. Total infusion dosage of PCA drug, VAS pain scores, side effects and satisfaction score of both groups were monitored for 48 hrs. Results: Total infusion dosages were fentanyl $170.6\;{\mu}g$ with ketorolac 61.4 mg (Group 1) and butorphanol 2.8 mg with ketorolac 50.4 mg (Group 2). Total infusion dosage, quality of analgesia, side effects and overall satisfaction didn't differ between two groups. Conclusions: Both fentanyl and butorphanol mixed with ketorolac were effective for post-tonsillectomy pain control using PCA pump in children as young as 5 years old.

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Comparison of PHP Indexes According To Smoking, Drinking And Eating Habits (흡연, 음주, 식이행태에 따른 PHP index 비교)

  • Kim, Ye-Hwang;Lee, Jung-Hwa
    • Journal of Korean Clinical Health Science
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    • v.5 no.3
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    • pp.880-887
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    • 2017
  • Purpose. This study was conducted from the period of April 12th, 2017 to April 26th, 2017. The questionnaires were distributed among a group of 76 adults aged 20 years or older, who participated in the prevention program of the department of dental hygiene at Busan Metropolitan City. The negative questionnaire was finally analyzed. Methods. The SPSS program was used for analysis of this study. The general characteristics of the subjects were t-test and one-way, ANOVA(by Scheffe post-test) for a PHP index (Patient Hygiene Performance index) according to frequency analysis, general characteristics, smoking and drinking behavior, and dietary behavior. Results. As a result of an examination of the PHP index(Patient Hygiene Performance index) ac- cording to smoking and drinking behavior, the amount of alcohol drunk was statistically higher than that of 'soju that was not drunk'(P<0.05). As a result of the PHP index (Patient Hygiene Performance index) according to dietary behavior, 'vegetarians' were statistically higher than 'Carnivorous oriented' individuals (P<0.05). Moreover, individuals who regularly 'drank almost no water' were statistically significantly higher than those who 'drank water steadily'.(P<0.05). Conclusion. As a result, appropriate management is required for oral health of the patient, Oral health education is needed to systematically consider smoking, drinking, and eating habits when taking into consideration the individual oral environment.

The Effect of the Patient's Characteristics on Nursing Outcomes in Gastrointestinal Surgery Patients (간호결과에 대한 환자 특성의 영향 - 위장관계 수술 환자를 중심으로 -)

  • Lee, Byoung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.3
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    • pp.249-259
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    • 2008
  • Purpose: This study was performed to identify the patient characteristics significantly affecting nursing outcomes and their predictability in gastrointestinal surgery patients. Method: The subjects were 149 abdominal surgery patients from 3 general surgical nursing units of 3 general hospitals. Two instruments were used to measure nursing outcomes and acuity of the subjects. The nursing outcomes were measured at post-operation 4 and 7days using review of patients' records, observation of patients, and interviews with patients by a trained nurse. For data analysis, T-test or ANOVA, Pearson Correlation and Stepwise Multiple Regression were done. Result: Age, severity score, diagnosis, cancer or not, operation site were the subjects' characteristics that were significantly related to the nursing outcomes in both post-operation 4 and 7days. Cancer or not, age, diagnosis and severity score were the significant predictors for the scores of nursing outcome in post-operation 4days and the predictability was 34.9%. The predictability of cancer or not was highest, 22.6%. Age, diagnosis and cancer or not were the significant predictors for the scores of nursing outcome in post-operation 7days and the predictability was 27.8%. The predictability of age was highest, 17.3%. Conclusions: The patient characteristics affecting nursing outcomes should be considered when nursing care is planned and provided. Especially, careful attention should be given to the patients with cancer and older age. And, these patient characteristics should be adjusted for correct estimation of the effectiveness of nursing interventions on nursing outcomes.

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Performance-based User Testing of a Patient Drug Leaflet in the Elderly (노인 인구에 있어 환자용 의약품 안전사용 설명서의 활용성 평가)

  • Son, Mi-jung;Lee, Iyn-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.6-12
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    • 2016
  • Objective: This study aimed to explore the readability and comprehensibility of the drug information on a patient leaflet for the senior by employing performance-based user-testing. Methods: We included 36 elderly (65 years old or older) as the senior group (intervention group) and 36 adults (40~59 years old) as the adult group (control). We developed a questionnaire to test if participants could access to drug information. After completing a questionnaire, the participant was interviewed about their understanding over the patient leaflet. We performed t-test, ${\chi}^2$-test or Fisher's exact test to examine differences between two groups in primary outcomes. Results: The senior were less likely able to find information (78%) than the adult (91%); they were much less likely able to understand information (42%) than the adult (69%). While we found differences between the ability of finding and understanding drug information in both groups, the senior group had greater difficulties in understanding all kinds of drug information. They had significant difficulties to remember information after reading the patient leaflet and frequently failed to find proper information even though they were allowed to access freely to the leaflet during interviewing. Conclusion: To secure safe and effective use of drugs for the senior, it is necessary to develop drug leaflets for the senior.

Factors affecting the number of emergency room visits in a public hospital in Korea (일개 공공병원 응급실 방문건수 관련 요인)

  • Byung-Keun Yang;Jae-Hwan Oh;Kwang-Soo Lee
    • Korea Journal of Hospital Management
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    • v.28 no.3
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    • pp.39-46
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    • 2023
  • Purpose: Korean medical services are not balanced across regions and social classes. To prevent mortality gaps, Korea must distribute its medical resources more efficiently. Patient factors affecting emergency room visits serve as basic data for determining best practices for public healthcare distribution. Methods: The data included 18 473 visits by 14 949 de-identified patients who visited a public emergency room over one year. The dependent variable was the number of emergency room visits. A Poisson regression was conducted with the independent variables, comprising sociodemographic, socioeconomic, and spatial accessibility factors and patient characteristics. Results: Older men with higher Korean Triage and Acuity Scale scores visited more frequently. Greater patient-hospital distance decreased visits; however, the presence of a hospital within 1 km of a patient's residence did not affect the number of visits. The use of 119 services was negatively correlated with the number of visits. Visits increased with more medical benefits. Conclusions: Patient age, distance to hospital, use of 119 services, and medical benefits should be considered when planning or managing public hospitals in Korea.

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The Effect of Operating Room Nurse's Patient Safety Competency and Perception of Teamwork on Safety Management Activities (수술실 간호사의 환자안전역량과 팀워크 인식이 환자안전관리활동에 미치는 영향)

  • Park, Mi-Ma;Kim, Seon-Ha
    • Journal of Digital Convergence
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    • v.16 no.6
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    • pp.271-281
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    • 2018
  • The purpose of this study was to investigate the effect of patient safety competence and teamwork on patient safety management activities in operating room nurse. The survey was 110 nurses with in the operating room of the general hospital, using self-report questionnaire. Stepwise regression analysis were used. Older group and those with higher levels of education status were significantly associated with high scores on patient safety competence. Patient safety competence and safety management activities showed a significant positive correlation, and teamwork and safety management activities showed a significant positive correlation. Regression analysis showed that patient safety competence and awareness of teamwork had a significant impact on patient safety management activities and the explanatory power of these variables was 15.7%. In conclusion, efforts are needed to improve patient safety competence and teamwork in order to improve patient safety management activities in operating room nurse, and further studies on other variables affecting patient safety management activities are needed.

An Analysis of Factors Affecting Satisfaction of Physical Therapy Patients (물리치료 내원환자의 만족도에 영향을 미치는 요인 분석)

  • Sohn, Ae-Ree;Kim, Mi-Won
    • Journal of Korean Physical Therapy Science
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    • v.9 no.4
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    • pp.63-72
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    • 2002
  • Patient satisfaction is an important factor in evaluating the quality of care. Patient satisfaction may be used to evaluate provider services and facilities, and used to predict the patient returns to a facility. The patients d whether the patient returns to a facility or whether the patient recommends the facility to other people may be affected by a variety of factors of patient satisfaction. Low satisfaction may result in poor compliance with the potential of waste of resources and suboptimal clinical outcome. This study is to identify factors of patient satisfaction that will affect patients decision whether the patient returns or not. A self-administered questionnaire survey was conducted in Seoul, Chung-Joo and Bu-Cheon cities, Survey data was obtained from 743 patients who visited the physical therapy practice at university hospitals, general hospitals and clinics. Response rate was 94.4%. The instrument developed by Goldstein et al. (2000) was used and translated into Korean. Several items were added to the instrument. Patient's opinions of service in each domain measured using 5-point Likert-type scales that ranged from strongly disagree to strongly agree. A multiple-regression analytic approach was used to predict overall satisfaction of physical therapy. Age, kindness, scheduling, convenience of parking, privacy, and waiting time predicted the overall satisfaction of physical therapy. The older patients had higher level of satisfaction with physical therapy compared with the younger patients. Patient satisfaction were more affected by access (scheduling and waiting time), administrative technical management (convenience of parking), and interpersonal management (kindness of physical therapists and other staffs) than clinical technical management (physical therapists' skills).

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An Exploratory Study on the Meaning of 'the Patient Trusts the Doctor' (의사-환자 관계에서 '환자가 의사를 신뢰한다'의 의미 고찰)

  • Kim, Min-Jeong
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.415-423
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    • 2017
  • Patient's trust in their physician is crucial for relationship between patients and their doctors, treatment outcomes such as satisfaction and adherence or revisits. The purpose of this study is to investigate the meaning of trusting the doctor in the doctor - patient relationship and to examine it through the multidimensional measurement tools. Using the convenience sampling method, 328 respondents in their 20s or older who had visited the hospital within 6 months were used as the analysis data. As a result of the research, it is difficult to define the meaning of the patient's trust in the doctor, but it can be summarized as having at least four meanings. First, the doctor should listen carefully to the patient's story and show communication behaviors expressing interest and forming an atmosphere of dialogue. Second, the patient's health should be considered first to understand the patient and empathize with the patient. Third, it should be honest in the examination and procedures related to the treatment as well as the technical ability. Finally, we should try to cooperate with patients.