• Title/Summary/Keyword: surgical intervention

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Study on the Effects of the Supportive Nursing Intervention Program for Body Image and Self Esteem of the Child with Cancer (지지간호중재가 암환아의 신체상 및 자존감에 미치는 영향)

  • 오상은
    • Journal of Korean Academy of Nursing
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    • v.29 no.3
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    • pp.679-687
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    • 1999
  • The increased potential for the lifespan of a child with cancer is largely due to advances in drug treatment, radiation treatment, and surgical techniques. In this generation cancer has become associated with chronic illness. Therefore supportive nursing intervention for children with cancer is needed to promote normal growth and development. This study was designed to develop and test the supportive nursing intervention program for promoting body image and self-esteem of children with cancer The supportive nursing intervention program involved emotional, physical, informational, and social support. The subjects were 41 children with cancer(20 in intervention group, 21 in control group) in K city. Measurements were taken concerning body image and self-esteem from both groups during pre and post test The data were analyzed using Cronbach's alpha, x$^2$-test, paired t-test and t-test. The results were as follows : The intervention group had a more positive body image as measured by the Body Cathexis Scale (t=2.436, p=.020) and a more self esteem as measured by the Cpopersmith self-inventory (t=2.768, p=.009) than the control group at post test. According to this study, the supportive nursing intervention program was effective for promoting the body image and self-esteem of children with cancer. Repeated research is needed to develop a refined supportive nursing intervention program for children with chronic illness.

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The Short-term Outcomes of Physiotherapy for Patients with Acetabular Labral Tears: An Analysis according to Severity of Injury in Magnetic Resonance Imaging

  • Makoto Kawai;Kenji Tateda;Yuma Ikeda;Ima Kosukegawa;Satoshi Nagoya;Masaki Katayose
    • Hip & pelvis
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    • v.34 no.1
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    • pp.45-55
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    • 2022
  • Purpose: The aim of this study was to evaluate the short-term outcome of physiotherapy in patients with acetabular labral tears and to assess the effectiveness of physiotherapy according to the severity of the labral tear. Materials and Methods: Thirty-five patients who underwent physiotherapy for treatment of symptomatic acetabular labral tears were enrolled. We evaluated the severity of the acetabular labral tears, which were classified based on the Czerny classification system using 3-T MRI. Clinical findings of microinstability and extra-articular pathologies of the hip joint were also examined. The International Hip Outcome Tool 12 (iHOT12) was use for evaluation of outcome scores pre- and post-intervention. Results: The mean iHOT12 score showed significant improvement from 44.0 to 73.6 in 4.7 months. Compared with pre-intervention scores, significantly higher post-intervention iHOT12 scores were observed for Czerny stages I and II tears (all P<0.01). However, no significant difference was observed between pre-intervention and post-intervention iHOT12 scores for stage III tears (P=0.061). In addition, seven patients (20.0%) had positive microinstability findings and 22 patients (62.9%) had findings of extra-articular pathologies. Of the 35 patients, eight patients (22.9%) underwent surgical treatment after failure of conservative management; four of these patients had Czerny stage III tears. Conclusion: The iHOT12 score of patients with acetabular labral tears was significantly improved by physiotherapy in the short-term period. Improvement of the clinical score by physiotherapy may be poor in patients with severe acetabular labral tears. Determining the severity of acetabular labral tears can be useful in determining treatment strategies.

The Effect of Warming Patients Before or During the Surgical Operations on the Patients' Body Temperature and Shivering (수술전 가온과 수술중 가온이 수술환자의 체온과 전율에 미치는 영향)

  • Lee, Ji-Yeon;Lee, Hyang-Yeon
    • Korean Journal of Adult Nursing
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    • v.14 no.3
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    • pp.428-437
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    • 2002
  • Purpose: The purpose of this study is to examine the changes of surgical patients' body temperature in applying warming to patients. The study of an effective nursing intervention, which aims to prevent hypothermia during surgical operations, use of anesthesia, and to remove dermal discomforts. The nonequivalent control group pre-test/post-test design was used for this quasi-experimental study. Method: The study subjects were adult patients who would take a surgical operation under general anesthesia in C Hospital; the surgical operations done were, total abdominal hysterectomy or Myomectomy; 20 patients were included in experimental group I, 20 patients were included in experimental group II, and 20 patients were in the comparative group. The total number of study subjects was 60. The data was collected from September the 1st, 2001 to October the 20th, 2001. The data was analyzed by SPSS program, F-test and Repeated measures of ANOVA. Multi-comparison method of DUNCAN was used for the sections that show the significant differences at the level of p<.05, which was a posterior examination. Result: 1) "The body temperatures of the three groups of patients will be respectively different at the end of the operations; experimental group I to which warming was applied before the operations, experimental group II to which warming was applied during the operations, and the comparative group with no warming being given," showed (F=12.609, p=.000). 2) "Degrees of shivering symptoms for the three groups will be respectively different at the end of the operations; experimental group I which applied warming before operations, experimental group II which applied warming during operations and the comparative group with no warming." Showed assumed (F=6.626, p=.000). Conclusion: Summing up the above study, the warming assumed during operations was a more effective nursing intervention for preventing patients' hypothermia than the warming assumed before operations.

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SURGICAL TREATMENT OF AIRWAY OBSTRUCTION IN INFANTS WITH PIERRE ROBIN SEQUENCE (Pierre Robin sequence 환자에서 기도 폐색의 외과적 치료)

  • Ryu, Sun-Youl;Lee, Young-Uk;Seo, Il-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.3
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    • pp.237-245
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    • 2004
  • The deformities of micrognathia and glossoptosis in the newborn are frequently associated with a cleft palate, which is known as Pierre Robin sequence. Upper airway obstruction is the most serious problem in these patients. Treatment of Pierre Robin sequence includes either positional or surgical intervention. Mild cases are often managed in the prone position. However, when the patient fails to thrive due to chronic upper airway obstruction, or severe respiratory distress ensures despite positional treatment, surgical intervention is mandatory to relieve the obstruction. We experienced three infants with Pierre Robin sequence who showed a symptom triad of micrognathia, glossoptosis, and cleft palate. Intermittent cyanosis, depression of the chest, respiratory difficulty and feeding problems were also observed. To relieve severe upper airway obstruction caused by micrognathia and glossoptosis, we simultaneously performed modified tongue lip adhesion (TLA) and a subperiosteal release of the floor of the mouth (SRFM). Respiratory and feeding difficulties were relieved, the tongue positioned anteriorly, body weight increased, and mandibular growth improved. Simultaneous TLA and SRFM may constitute a simple and reliable method for surgical treatment of airway obstruction in patients with Pierre Robin sequence.

The Effects of Pre-operative Visual Information and Parental Presence Intervention on Anxiety, Delirium, and Pain of Post-Operative Pediatric Patients in PACU (회복실에 대한 사전 정보제공과 보호자 상주 중재가 수술 직후 각성 시 소아 청소년 환아의 불안, 섬망 및 통증에 미치는 효과)

  • Yoo, Je-Bog;Kim, Min-Jung;Cho, Soo-Hyun;Shin, Yoo-Jung;Kim, Nam-Cho
    • Journal of Korean Academy of Nursing
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    • v.42 no.3
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    • pp.333-341
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    • 2012
  • Purpose: The purpose of this study was to test whether pre-operative visual information and parental presence had positive effects on anxiety, delirium, and pain in pediatric patients who awoke from general anesthesia in a post-surgical stage. Methods: This study used a non equivalent control-group post test design (n=76). Independent variables were provision of pre-operative visual information and parental presence for post-surgical pediatric patients in PACU (post anesthesia care unit). Dependent variables were anxiety, delirium, and pain in the pediatric patients measured three times at 10 minute intervals after extubation in the PACU. Measurements included Numerical Rating Scale for assessing state anxiety, Pediatric Anesthesia Emergence Delirium Scale by Sikich & Lerman (2004) for delirium, and Objective Pain Scale by Broadman, Rice & Hannallah (1988) for pain. Results: Experimental group showed significantly decreased state anxiety at time points-10, 20, and 30 minutes after extubation. Delirium was significantly lower at 10 minutes and 30 minutes after extubation in the experimental group. Pain was significantly lower at 10 minutes after extubation in the experimental group. Conclusion: The results of this study suggest that this intervention can be a safe pre-operative nursing intervention for post-surgical pediatric patients at PACU.

Is Routine Repeated Head CT Necessary for All Pediatric Traumatic Brain Injury?

  • Kim, Won-Hyung;Lim, Dong-Jun;Kim, Se-Hoon;Ha, Sung-Kon;Choi, Jong-Il;Kim, Sang-Dae
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.125-130
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    • 2015
  • Objective : Repeated computed tomography (CT) follow up for traumatic brain injury (TBI) patients is often performed. But there is debate the indication for repeated CT scans, especially in pediatric patients. Purpose of our study is to find risk factors of progression on repeated CT and delayed surgical intervention based on the repeated head CT. Methods : Between March, 2007 and December, 2013, 269 pediatric patients (age 0-18 years) had admitted to our hospital for head trauma. Patients were classified into 8 subgroups according to mechanisms of injury. Types, amount of hemorrhage and amount changes on repeated CT were analyzed as well as initial Glasgow Coma Scale (GCS) scores. Results : Within our cohort of 269 patients, 174 patients received repeat CT. There were progression in the amount of hemorrhage in 48 (27.6%) patients. Among various hemorrhage types, epidural hemorrhage (EDH) more than 10 cc measured in initial CT was found to be at risk of delayed surgical intervention significantly after routine repeated CT with or without neurological deterioration than other types of hemorrhage. Based on initial GCS, severe head trauma group (GCS 3-8) was at risk of delayed surgical intervention after routine repeated CT without change of clinical neurologic status. Conclusion : We suggest that the patients with EDH more than 10 cc or GCS below 9 should receive repeated head CT even though absence of significant clinical deterioration.

CLINICAL STUDY OF CHRONIC OSTEOMYELITIS (만성 골수염 환자의 임상적 연구)

  • Kim, Moon-Soo;Kim, Su-Gwan;Yeo, Hwan-Ho;Kim, So-Young;Kim, Soo-Min;Lee, Jun-Gil;Cho, Gyeong-An;Park, In-Soon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.514-518
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    • 2000
  • Chronic osteomyelitis is often considered difficult to treat and may lead to refratory condition in oral and maxillofacial region. Clinical features of chronic osteomyelitis includes pain, swelling, pus discharge, and radiographic change. There are many kinds of treatment of chronic osteomyelitis. One of the most important factors in treating osteomyelitis are removal of infectious foci and administration of massive antibiotics. Recently we reviewed 29 patients with chronic osteomyelitis who visited in our department and treated successfully with our treatment protocols, consisting of surgical intervention and intravenous antibiotics for 2 weeks, and followed by oral antibiotics for 6 weeks. It is concluded that combination of surgical intervention and antibiotic therapy are sufficient to treat the chronic osteomyelitis in oral and maxillofacial region.

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Effect of Tailored Music Intervention on Intra-operative Anxiety among Those Undergoing Regional Anesthesia (환자의 선호도를 고려한 음악중재가 부분마취 환자의 수술 중 불안에 미치는 효과)

  • Kim, Joo Hee;Baek, Seol Hyang
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.1
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    • pp.187-198
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    • 2008
  • Purpose: Music intervention has long been used in research of patients undergoing surgical operation in reducing anxiety level and improve surgical outcome. However, there are few studies that have considered a patient's music preference. We investigated the effect of the tailored music intervention which chose music according to the patient's preference on anxiety level and vital signs. Method: The subjects were 50 patients who received regional anesthesia for surgical operation at D hospital in Pohang city from April, 2006 to November, 2006. All of the subjects were randomly assigned either music group (30 subjects) or non-music group (20 subjects). As the patients arrived in the operating room, vital signs were monitored until the subjects were transferred to the recovery room, while Spielberger's STAI-KYZ questionnaires were applied twice to measure preoperative and intra-operative anxiety. The data were analyzed by 2-test, t-test, one-way ANCOVA and repeated measures ANOVA using SPSS 12.0/PC+. Results: There were no significant differences between the two groups on vital signs. All of the vital signs increased when the subjects arrived in the operating room, but decreased quickly once the operation began, regardless of the groups. However, the music group reported significantly less intra-operative anxiety, compared to the non-music group (F=15.208, p<.000), when preoperative anxiety was treated as a covariance. Conclusion: The findings support that the use of music which was chosen by patients during the surgery significantly reduced patient's intra-operative anxiety during regional anesthesia.

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Analysis of Core Interventions of Operating Room using Nursing Intervention Classification (NIC간호중재분류체계를 이용한 수술실 핵심간호중재분석)

  • Lee, Yoon-Young;Park, Kwang-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.3
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    • pp.361-372
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    • 2002
  • Purpose : The purpose of study was to identify to analysis of core nursing interventions performed by Operating Room nurses. Method : The subjects of the study were arbitrarily selected nurses(n=104) working in Operating Room. The period for data collection was 15 days from July, 15, 2002 to July, 30. 2002. The instrument for study was 486 Nursing Interventions Classification developed by McClosky & Bulechek(2000) and was translated into Korean. In 486 nursing interventions, 57 nursing interventions were selected by more than half of 47 professional nurses group of Operating Room. 57 nursing interventions were used as a secondary questionnaire. In the secondary questionnaire, labels and definitions of all 57 interventions were listed. The collected data were self reported by Operating Room nurses. The data were analysed with SPSS program. Result : In 57 nursing interventions, the 'Behavior' domain was the most frequently used. Core interventions of Operating Room were performed several times a day by more than 50% of Operating Room nurses. Core interventions of Operating Room were 16 Core interventions, 7 classes, 5 domains. In the core interventions, the 'Physiological:Complex' domain was the most frequently used. Core interventions of Operating Room were Surgical Preperation, Infection Control:Intraoperative, Surgical Precautions, Fall Prevention, Documentation, Surgical Assistance, Environmental Management:Safety, Skin Surveillance, Physical Restraint, Pressure Ulcer Prevention, Environmental Management:Comfort, Infection Protection, Presence, Emotional Support, Specimen Management, Shift Report. Conclusion : Core interventions of Operating Room have implications for nursing care practice, nursing education, nursing research, and nursing information system in Operating Room.

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Endoscopic versus surgical management for colonic volvulus hospitalizations in the United States

  • Dushyant Singh Dahiya;Abhilash Perisetti;Hemant Goyal;Sumant Inamdar;Amandeep Singh;Rajat Garg;Chin-I Cheng;Mohammad Al-Haddad;Madhusudhan R. Sanaka;Neil Sharma
    • Clinical Endoscopy
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    • v.56 no.3
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    • pp.340-352
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    • 2023
  • Background/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States. Methods: We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared. Results: From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p<0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management. Conclusions: Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.