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Factors Influencing the Nursing Performance of Delirium in Elderly Patients among Ward Nurses at a University Hospital (대학병원 병동간호사의 노인섬망 간호수행에 영향을 미치는 요인)

  • Park, Sung Suk;Song, Min Sun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.29 no.2
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    • pp.183-193
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    • 2022
  • Purpose: This research aims to identify the relationship between the knowledge of delirium in elderly patients, nursing stress of delirium in elderly patients, emotional intelligence, and nursing performance of delirium in elderly patients among word nurses at a university hospital. Method: Data were collected from September 28 to October 13, 2020, by distributing questionnaires to 185 ward nurses at a university hospital located in city D. A data analysis was performed using descriptive statistics, a t-test, one-way ANOVA, and Pearson correlation coefficients, and a multiple regression analysis. Results: Nursing performance of delirium in elderly patients showed statistically significant differences according to nursing experience with these patients. Nurses' knowledge of delirium in elderly patients had a statistically significant positive correlation with emotional intelligence and nursing performance of delirium in elderly patients. Also, nurses' emotional intelligence had a statistically positive correlation with nursing performance of delirium in elderly patients. The factors that significantly affected nursing performance delirium in elderly patients were emotional intelligence and knowledge of delirium in elderly patients. The total explanatory power of the regression model was 12.5%. Conclusion: For nursing performance of delirium in elderly patients by ward nurses, it is necessary to develop a geriatric delirium nursing education program that can improve the knowledge of delirium in elderly patients. In addition, guidelines in consideration of the emotional intelligence of nurses should be included in the development of educational programs.

Prediction of pathogen positive-culture results in acute poisoning patients with suspected aspiration (흡인이 의심되는 급성 중독환자에서 병원균 양성 배양 결과의 예측)

  • Baek Sungha;Park Sungwook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.20 no.2
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    • pp.75-81
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    • 2022
  • Purpose: This study sought to compare the characteristics of patients with pathogen-positive and negative cultures, and to investigate factors predicting pathogen-positive culture results in patients of acute poisoning with suspected aspiration. Methods: Consecutive patients with acute poisoning admitted to an intensive care unit between January 2016 and December 2018 were retrospectively studied. Respiratory specimens were collected from the enrolled patients at the time of the suspected aspiration. We compared the characteristics of patients with pathogen-positive and negative culture results and analyzed the causative pathogens. Results: Among the 526 patients, 325 showed no clinical features that could be attributed to aspiration, and 201 patients had clinical features suggestive of aspiration. Of these, 113 patients had pathogen-positive culture, 61 were negative, and the specimens of 27 patients contained poor-quality sputum. In univariate analysis, patients with a positive culture showed a longer time to culture from ingestion (p=0.01), faster heart rate (p=0.01), and higher partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) (p=0.02) than patients with negative culture. Multivariate analysis demonstrated that PaO2/FiO2 (adjusted odd ratio, 1.005; 95% confidence interval [CI], 1.002-1.008; p=0.005) was a significant risk factor for pathogen-positive culture. The area under the receiver operating characteristic curve of PaO2/FiO2 was 0.591 (95% CI, 0.510-0.669, p=0.05). Gram-negative pathogens (GNPs) were predominant and at least one GNP was observed in 84 (73.3%) patients among those with pathogen positive culture. Conclusion: We failed to find any clinical factors associated with positive culture results. Antibiotics that cover GNPs could be considered when deciding the initial antibiotic regimen at the time of suspected aspiration.

Decision and Practice of End-of-Life Care in Lung Disease Patients with Physicians Orders for Life Sustaining Treatment

  • Yu Mi Oh;Yoon Na Kang;Soo Jung Han;Jeong Hye Kim
    • Journal of Hospice and Palliative Care
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    • v.26 no.1
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    • pp.7-17
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    • 2023
  • Purpose: The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs). Methods: We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021. Results: Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. Conclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a non-malignant lung disease, because the characteristics of the respective diseases differ, end-of-life care practices and hospice approaches must be considered differently.

Clinical Features of Fracture versus Concussion of the Temporal Bone after Head Trauma

  • Kong, Tae Hoon;Lee, Jae Woo;Park, Yoon Ah;Seo, Young Joon
    • Journal of Audiology & Otology
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    • v.23 no.2
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    • pp.96-102
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    • 2019
  • Background and Objectives: Temporal bone fracture (TBF) is a common occurrence in cases of head trauma. Although the incidence of temporal bone concussion (TBC) has increased in cases of head trauma, it has not been extensively studied. We assessed the characteristics of TBF and TBC in patients with head trauma. Subjects and Methods: We conducted a retrospective review of 432 patients with head injury who visited our hospital between January 2011 and April 2016. Of these patients, 211 who met the inclusion criteria were included in the study. Their clinical characteristics, causes of injury, and hearing function were analyzed. Results: Among the 211 patients, 157 had TBFs and 54 had TBCs. Ear symptoms were more common among patients with TBF than among those with TBC. Car accidents were the most common cause of both TBF and TBC, but assault and sports injuries were more common among patients with TBC than among those with TBF. The occurrence of facial palsy in both cases of TBF and TBC. Hearing loss was observed among 35 patients with TBF and 11 patients with TBC. However, patients with TBF showed conductive hearing loss with an air-bone gap. Hearing function of these patients with TBF recovered with a reduced air-bone gap, but the patients with TBC showed little recovery. Conclusions: Emergency physicians should focus more on temporal bone injury in patients with head trauma. Therefore, an early complete diagnostic battery, which includes high-resolution computed tomography, audiometric tests, neurologic examination, and vestibular tests, be performed in patients with head trauma.

Clinical Outcomes Associated with Degree of Hypernatremia in Neurocritically Ill Patients

  • Yun Im, Lee;Joonghyun, Ahn;Jeong-Am, Ryu
    • Journal of Korean Neurosurgical Society
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    • v.66 no.1
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    • pp.95-104
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    • 2023
  • Objective : Hypernatremia is a common complication encountered during the treatment of neurocritically ill patients. However, it is unclear whether clinical outcomes correlate with the severity of hypernatremia in such patients. Therefore, we investigated the impact of hypernatremia on mortality of these patients, depending on the degree of hypernatremia. Methods : Among neurosurgical patients admitted to the intensive care unit (ICU) in a tertiary hospital from January 2013 to December 2019, patients who were hospitalized in the ICU for more than 5 days and whose serum sodium levels were obtained during ICU admission were included. Hypernatremia was defined as the highest serum sodium level exceeding 150 mEq/L observed. We classified the patients into four subgroups according to the severity of hypernatremia and performed propensity score matching analysis. Results : Among 1146 patients, 353 patients (30.8%) showed hypernatremia. Based on propensity score matching, 290 pairs were included in the analysis. The hypernatremia group had higher rates of in-hospital mortality and 28-day mortality in both overall and matched population (both p<0.001 and p=0.001, respectively). In multivariable analysis of propensity score-matched population, moderate and severe hypernatremia were significantly associated with in-hospital mortality (adjusted odds ratio [OR], 4.58; 95% confidence interval [CI], 2.15-9.75 and adjusted OR, 6.93; 95% CI, 3.46-13.90, respectively) and 28-day mortality (adjusted OR, 3.51; 95% CI, 1.54-7.98 and adjusted OR, 10.60; 95% CI, 5.10-21.90, respectively) compared with the absence of hypernatremia. However, clinical outcomes, including in-hospital mortality and 28-day mortality, were not significantly different between the group without hypernatremia and the group with mild hypernatremia (p=0.720 and p=0.690, respectively). The mortality rates of patients with moderate and severe hypernatremia were significantly higher in both overall and matched population. Interestingly, the mild hypernatremia group of matched population showed the best survival rate. Conclusion : Moderate and severe hypernatremia were associated with poor clinical outcomes in neurocritically ill patients. However, the prognosis of patients with mild hypernatremia was similar with that of patients without hypernatremia. Therefore, mild hypernatremia may be allowed during treatment of intracranial hypertension using hyperosmolar therapy.

Clinical Features of Fracture versus Concussion of the Temporal Bone after Head Trauma

  • Kong, Tae Hoon;Lee, Jae Woo;Park, Yoon Ah;Seo, Young Joon
    • Korean Journal of Audiology
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    • v.23 no.2
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    • pp.96-102
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    • 2019
  • Background and Objectives: Temporal bone fracture (TBF) is a common occurrence in cases of head trauma. Although the incidence of temporal bone concussion (TBC) has increased in cases of head trauma, it has not been extensively studied. We assessed the characteristics of TBF and TBC in patients with head trauma. Subjects and Methods: We conducted a retrospective review of 432 patients with head injury who visited our hospital between January 2011 and April 2016. Of these patients, 211 who met the inclusion criteria were included in the study. Their clinical characteristics, causes of injury, and hearing function were analyzed. Results: Among the 211 patients, 157 had TBFs and 54 had TBCs. Ear symptoms were more common among patients with TBF than among those with TBC. Car accidents were the most common cause of both TBF and TBC, but assault and sports injuries were more common among patients with TBC than among those with TBF. The occurrence of facial palsy in both cases of TBF and TBC. Hearing loss was observed among 35 patients with TBF and 11 patients with TBC. However, patients with TBF showed conductive hearing loss with an air-bone gap. Hearing function of these patients with TBF recovered with a reduced air-bone gap, but the patients with TBC showed little recovery. Conclusions: Emergency physicians should focus more on temporal bone injury in patients with head trauma. Therefore, an early complete diagnostic battery, which includes high-resolution computed tomography, audiometric tests, neurologic examination, and vestibular tests, be performed in patients with head trauma.

Change of Symptoms after Total Hip Arthroplasty in Patients with Hip-Spine Syndrome

  • Sung-Hyun Yoon;Ju Hyun Kim;Hyung Jun Lee;Ki-Choul Kim
    • Hip & pelvis
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    • v.35 no.4
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    • pp.238-245
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    • 2023
  • Purpose: Elderly patients with degenerative diseases undergo treatment for the hip and spine; these patients present with various symptoms. This study focused on patients with residual symptoms, predominantly pain, even after receiving treatment for their spinal lesions. Materials and Methods: Patients who underwent total hip arthroplasty (THA) between 2016 and 2022 at a single tertiary hospital were included in the study. Of the 417 patients who underwent primary THA, a retrospective review of 40 patients with previous lesions of the spine was conducted. Patients were stratified to two cohorts: Patients with symptoms related to the spine (Group A), and those with hip-related symptoms (Group B). Preand postoperative comparisons of groups A and B were performed. Results: Improvements in patients' symptoms were observed in groups A and B after THA. In Group A, the mean preoperative visual analog scale (VAS) score was 5.10±0.876, which showed a postoperative decrease to 2.70±1.767. In Group B, the mean preoperative VAS score was 5.10±1.539, which showed a postoperative decrease to 2.67±1.493. Conclusion: According to the findings, promising results were achieved with THA in treatment of debilitating diseases of the hip for both the prognosis of the disease, as well as the patients' symptoms. In addition, in some cases elderly patients with dual pathologies underwent treatment for spinal lesions without performance of any evaluation related to the hip. Thus, evaluation of a patient's hip must be performed and performance of THA in patients with symptoms even after treatment of spinal lesions is recommended.

Perception on Hospice, Attitudes toward Death and Needs of Hospice Care between the Patients with Cancer and Family (암 환자와 가족의 호스피스 인식, 죽음에 대한 태도 및 호스피스 간호 요구도)

  • Son, Youn-Jung;Park, Youngrye
    • The Korean Journal of Rehabilitation Nursing
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    • v.18 no.1
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    • pp.11-19
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    • 2015
  • Purpose: The purpose of this study was to identify the perception on hospice, attitudes toward death and needs of hospice care between the patients with cancer and family. Methods: This study used descriptive research design. The participants were 118 patients with cancer hospitalized and 118 family caregivers of patients with cancer. The data collected by questionnaires from October to December, 2013. Results: There was significant difference in perception on hospice (recognition of hospice term and definition of hospice) and needs of hospice care between patients and family. Among the categories of the needs, 'medical needs' was the highest in patients and 'emotional care' was the highest in family. But there was no significant difference in attitudes toward death. There correlation between attitudes toward death and needs of hospice care was significant only in patients. Conclusion: Hospice care must be provided considering the death attitudes and needs of patients with cancer and family based on the understanding of perception on hospice, attitudes toward death of the patients with cancer and family.

Sexual Behavior and Sexual Satisfaction according to Gender in Korean Patients with Cancer (암 환자의 성별에 따른 성행동과 성만족 변화)

  • Kim, Jung-Hee;Kim, Hyun-Kyoung
    • Women's Health Nursing
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    • v.20 no.2
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    • pp.137-147
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    • 2014
  • Purpose: This study was done to investigate sexual behavior and sexual satisfaction according to gender difference in Korean patients with cancer Methods: In this study, a convenience sample of Korean patients with cancer who visited hospitals in J City was used. Data were collected between September and December 2012using structured questionnaires: Sexual frequency scale and General sexual satisfaction index (GSSI). Results: Over half of the patients reported loss of sexual desire and changes in sexual behaviors. There was a significant decrease in sexual satisfaction among the male patients, compared to the female patients (t=2.34, p=.020). There were significant correlations between sexual satisfaction and sexual behaviors (male patients r=.45, p<.001; female patients r=.59, p<.001). Conclusion: The results of this study demonstrate the need to take gender into account in developing interventions for patients with cancer. These results will also contribute to the development of improved interventions for sexual health care.

Oral Microbiota Comparison between Healthy volunteers, Periodontitis patients and Oral cancer patients

  • Na, Hee Sam;Kim, Seyeon;Choi, Yoon Hee;Lee, Ju-Yeon;Chung, Jin
    • International Journal of Oral Biology
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    • v.38 no.4
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    • pp.181-188
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    • 2013
  • The presence of distinct bacterial species is found to be dependent on age, diet, and disease. We compared the detection rate of several oral bacterial strains in a cohort of 36 subjects including healthy volunteers, periodontal patients, and oral cancer patients. Gargling samples were obtained from these subjects from which DNA was then extracted. Specific primers for 29 bacterial species were used for PCR detection. In the oral cancer patients, Capnocytophaga ochracea, Gemella morbillorum, and Streptococcus salivarius were detected more frequently compared with the healthy volunteers and periodontitis patients. Fusobacterium nucleatum/ polymorphym and Prevotella nigrescens were significantly less prevalent in oral cancer patients than the other groups. In periodontitis patients, Porphyromonas gingivalis and Treponema denticola were more frequently found compared with the healthy volunteers. In the healthy volunteer group, Peptostreptococcus anaerobius was more frequently found than the other groups. The detection rate of several oral bacterial species was thus found to differ between healthy volunteers, periodontitis patients and oral cancer patients.