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Influencing factors for Sleep Disturbance in the Intensive Care Unit Patients: A Systematic Review (중환자실 환자의 수면에 영향을 미치는 요인: 체계적 고찰)

  • Cho, Young Shin;Joung, Sunae
    • Journal of Korean Critical Care Nursing
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    • v.16 no.2
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    • pp.1-14
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    • 2023
  • Purpose : Sleep disturbances in patients in the intensive care unit (ICU) are related to health problems after discharge. Therefore, active prevention and management are required. Hence, identification of the factors that affect sleep in patients who are critically ill is necessary. Methods : The PubMed, Cochrane Library, CINAHL, EMBASE, and Web of Science databases were searched. Selection criteria were observational and experimental studies that assessed sleep as an outcome, included adult patients admitted to the ICU, and published between November 2015 and April 2022. Results : A total of 21,136 articles were identified through search engines and manual searches, and 42 articles were selected. From these, 22 influencing factors and 11 interventions were identified. Individual factors included disease severity, age, pain, delirium, comorbidities, alcohol consumption, sex, sleep disturbance before hospitalization, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and high diastolic blood pressure (DBP), low hemoglobin (Hb), and low respiratory rate (RR). Environmental factors included light level, noise level, and temperature. Furthermore, treatment-related factors included use of sedatives, melatonin administration, sleep management guidelines, ventilator application, nursing treatment, and length of ICU stay. Regarding sleep interventions, massage, eye mask and earplugs, quiet time and multicomponent protocols, aromatherapy, acupressure, sounds of the sea, adaptive intervention, circulation lighting, and single occupation in a room were identified. Conclusion : Based on these results, we propose the development and application of various interventions to improve sleep quality in patients who are critically ill.

Risk Factors and Clinical Outcomes of Brain Reperfusion Injury after Mechanical Thrombectomy for Ischemic Stroke (기계적 혈전제거술을 시행한 허혈성 뇌졸중 환자의 뇌재관류 손상 위험요인과 임상결과)

  • Moon, Ji Hyun;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.23 no.3
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    • pp.217-226
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    • 2021
  • Purpose: The aim of this study was to investigate the risk factors for brain reperfusion injury in ischemic stroke patients and to analyze the clinical outcomes. Methods: A retrospective study was conducted in 168 patients who underwent mechanical thrombectomy. The data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, Chi-Square test, Fisher's exact test, and logistic regression with IBM SPSS/WIN 24.0. Results: Brain reperfusion injury occurred in 67 patients (39.9%) with a low favored outcome (𝛘2=6.01, p=.014). On multivariable analysis, blood urea nitrogen (Odds ratio [OR]=1.14, 95% Confidence interval [CI]=1.06-1.23), aphasia (OR=6.16, CI=1.62-23.40), anosognosia (OR=4.84, CI=1.13-20.79), presence of both aphasia and anosognosia (OR=7.33, CI=1.20-44.60), and time required to achieve targeted blood pressure (OR=1.00, CI=1.00-1.00) were identified as risk factors for brain reperfusion injury. A statistically significant difference was detected in clinical outcomes, including hemorrhagic transformation (𝛘2=6.32, p=.012), intensive care unit length of stay (Z=-2.08, p=.038), National Institute of Health Stroke scale score at discharge (Z=-3.14, p=.002), and modified Rankin Scale score at discharge (Z=-2.93, p=.003). Conclusion: This study identified the risk factors and presented the clinical outcomes of brain reperfusion injury. It is necessary to consider these risk factors for evaluating the patients and to establish nursing interventions and strategies.

Comparison of Prescription Patterns and Clinical Features according to Clinical Departments in Sedative-hypnotic Intoxication (진정수면제 중독 환자의 처방과에 따른 처방 및 임상양상 비교)

  • Kim, Do Min;Park, Won Bin;Lim, Yong Su;Kim, Jin Joo;Jang, Jae Ho;Jang, Jee Yong;Yang, Hyuk Jun;Lee, Geun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.54-62
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    • 2014
  • Purpose: The purpose of this study was to compare prescription patterns and clinical features according to clinical departments in sedative-hypnotic intoxication. Methods: This was a retrospective study of histories, substances of poisoning, acquisition routes, clinical courses, and outcomes of patients treated for acute intoxication in a single emergency medical center from January, 2011 to December, 2013. Results: A total of 769 patients were treated for acute intoxication, 281 patients ingested sedative hypnotics during the study period. Among 281 patients, 155 patients were prescribed by psychiatric department and 80 patients were prescribed by non-psychiatric department. Benzodiazepines were more likely to be prescribed by psychiatrists, and zolpidem was preferred by non-psychiatrists (p<0.001). Non-psychiatrists were more likely to prescribe short acting benzodiazepines than psychiatrists (p<0.001). However, there was no statistically significant difference in the clinical outcomes, including prevalence of admission to ICU, ventilator care, and length of stay in ICU. In patients prescribed by non-psychiatrists, there were more patients prescribed without psychiatric diagnosis and diagnosed as major depression disorder after hospitalization. Conclusion: To promote rational prescribing of sedative hypnotics, proper psychiatric evaluation should be performed before prescribing, and educational programs including the contents of interactions and side effects of sedative hypnotics are needed.

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SB-MAC : Energy efficient Sink node Based MAC protocol for Wireless Sensor Networks (무선 센서 네트워크 에서 에너지 효율적인 싱크노드 기반 MAC 프로토콜)

  • Jeon, Jun-Heon;Kim, Seong-Cheol
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.18 no.1
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    • pp.177-182
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    • 2014
  • In this paper, we propose an energy efficient sink node based MAC protocol for Wireless Sensor Networks (WSNs). The proposed sink node-based MAC (SB-MAC) protocol uses a RB(rapid beacon) frame to save sender's energy consumption and to reduce transmission delay. The RB frame is a modified IEEE 802.15.4 beacon frame. The RB frame contains the length of the sender nodes data. Using this information other nodes except sender and receiver nodes can be stay sleep mode long time to reduce energy consumption. Results have shown that the SB-MAC protocol outperformed other protocols like X-MAC and RI-MAC in terms of packet delivery delay and energy consumption. The SB-MAC protocol is especially energy efficient for the networks with one sink node and many senders.

Procedural outcomes of laparoscopic caudate lobe resection: A systematic review and meta-analysis

  • Shahab Hajibandeh;Ahmed Kotb;Louis Evans;Emily Sams;Andrew Naguib;Shahin Hajibandeh;Thomas Satyadas
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.1
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    • pp.6-19
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    • 2023
  • A systematic review was conducted in compliance with PRISMA statement standards to identify all studies reporting outcomes of laparoscopic resection of benign or malignant lesions located in caudate lobe of liver. Pooled outcome data were calculated using random-effects models. A total of 196 patients from 12 studies were included. Mean operative time, volume of intraoperative blood loss, and length of hospital stay were 225 minutes (95% confidence interval [CI], 181-269 minutes), 134 mL (95% CI, 85-184 mL), and 7 days (95% CI, 5-9 days), respectively. The pooled risk of need for intraoperative transfusion was 2% (95% CI, 0%-5%). It was 3% (95% CI, 1%-6%) for conversion to open surgery, 6% (95% CI, 0%-19%) for need for intra-abdominal drain, 1% (95% CI, 0%-3%) for postoperative mortality, 2% (95% CI, 0%-4%) for biliary leakage, 2% (95% CI, 0%-4%) for intra-abdominal abscess, 1% (95% CI, 0%-4%) for biliary stenosis, 1% (95% CI, 0%-3%) for postoperative bleeding, 1% (95% CI, 0%-4%) for pancreatic fistula, 2% (95% CI, 1%-5%) for pulmonary complications, 1% (95% CI, 0%-4%) for paralytic ileus, and 1% (95% CI, 0%-4%) for need for reoperation. Although the available evidence is limited, the findings of the current study might be utilized for hypothesis synthesis in future studies. They can be used to inform surgeons and patients about estimated risks of perioperative complications until a higher level of evidence is available.

A Study on Aggressive Behavior Among Nursing Home Residents with Cognitive Impairment

  • Oh Heeyoung;Eom Miran;Kwon Yunjung
    • Journal of Korean Academy of Nursing
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    • v.34 no.8
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    • pp.1451-1459
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    • 2004
  • Purpose. With a sample of cognitively impaired nursing home residents and nursing staff, the following were examined 1) the proportion and nature of aggressive behavior, 2) the frequency and types of aggressive behavior, 3) the difference between the residents who demonstrate aggressive behavior and those who do not demonstrate aggressive behavior (age, mental status, functional status, and pain, length of nursing home stay), and 4) nursing staff responses to aggressive behavior by residents. Methods. A cross-sectional descriptive study design was used. Data were collected from cognitively impaired nursing home residents (N=205) and nursing staff (N=60) at two nursing homes using Ryden Aggression Scale I and II, Mini-Mental State Exam, Modified Barthel Index, Verbal Descriptor Scale, and aggressive behavior management questionnaire. Data were analyzed using descriptive statistics including t-test. Results. About $62.9\%$ residents were found to be aggressive and $38.5\%$ were both physically and verbally aggressive. Pushing, making threatening gestures, hitting, slapping, cursing/obscene/vulgar languages, making verbal threats were occurred frequently. Aggressive residents were significantly older, had more cognitive impairment, had more pain, and stayed longer in the nursing home when compared with non-aggressive residents. Considerable proportion of nursing staff responded to aggressive behaviors inadequately. Conclusion. Aggressive behavior among cognitively impaired nursing home residents is prevalent thus needs to be prevented and reduced. Along with environmental modification, educational programs for nursing staff and family caregivers need to be developed and implemented so that they can have extensive knowledge and skills to manage aggressive behaviors.

Patient Management Through Simulation Modeling in the Medical Center (시뮬레이션 기법을 이용한 검진센터의 환자관리방안)

  • Lim, Ji-Hye;Kang, Sung-Hong;Kim, Won-Joong
    • Journal of Digital Convergence
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    • v.10 no.4
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    • pp.287-295
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    • 2012
  • This study aims to develop the methods for effective patient flow in the medical center through simulation modeling. To achieve this, we developed three simulation scenarios based on max/min processing time and addition of X-ray by 15 patient tracks from real hospital data. The simulation software used in this study is Flexsim HC 2.7. According to the scenario 1 on 15 patient tracks' LOS by max processing time, there is a great difference between average length of stay(LOS) and max LOS. And average LOS increases greatly depending on the number of patients by the hours. There is no need to add extra X-ray because the addition of X-ray has not much influence in average LOS. It is possible to make good decisions on patient flow management and medical equipment purchasing through simulation modeling. The concrete simulation scenario as a tool for decision support will contribute to efficiency in hospital management.

Research on Actual Condition of Emergency Patients in Farming and Fishing Villages - In southwest coast district center - (농어촌지역 응급환자 실태조사 - 서남해안 지역을 중심으로 -)

  • Choi, Gil-Soon;Kwon, Hay-Rran
    • The Korean Journal of Emergency Medical Services
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    • v.10 no.1
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    • pp.13-21
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    • 2006
  • Purpose: This study aims to examine characteristics and actual conditions of patients using emergency room at farming and fishing villages, solve overcrowding of emergency room at the tertiary hospital and activate local emergency clinics. Methods: It examines department of diagnosis and treatment, vehicles used, sex, age, residential area, visit hour, length of stay, presence or absence of trauma, measures after first aid and degree of severity based on medical records of 6,740 patients using emergency room at farming and fishing villages from Jan. 1 to Dec. 31, 2005. Conclusion : 1. Sex distribution of patients of emergency room was male 54.9% and female 45.1% and age distribution between over 40 and below 50 was most as 15.9%. 2. Transport means to emergency room were 91.4 of private car and others (public transport and going on foot), 7.5 of 119, 129 and police car and 1.0% of ambulance. 3. According to distribution of residential areas of emergency patients, 38.9% were Eup area, 42.1% Myeon area, 11.4% distant area and 7.5% adjacent area. 4. According to distribution of emergency patients by department of diagnosis and treatment, internal medicine was most as 35.8% and 55% of patients visited emergency room from 3:31 p.m. to 11:30 p.m.. 5. According to total hours of diagnosis and treatment of subjects, 51.2% were within 30min. and cases of non-trauma disease were 68.2%. 6. According to degree of emergency of emergency patients, non-emergency cases were 65.3%, urgent cases 27.7% and emergency cases 7.0% and 74.2% of patients returned home after first aid and 20.6% of them hospitalized. In conclusion, characteristics and diversification of patients should be examined and efforts by government and local medical institutions which must organize emergency system and facility and personnel levels suitable to regional conditions are needed in order to prevent overcrowding of emergency center of the tertiary hospital and activate local emergency center.

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Health in Optimal Fitness and its Related Factors in Young Korean Children Born Prematurely

  • Lee, Sangmi;Sohn, Min;Kim, Shinjeong;Choi, Sunha;Jun, Yonghoon;Ahn, Youngmee
    • Child Health Nursing Research
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    • v.22 no.4
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    • pp.336-345
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    • 2016
  • Purpose: This study was conducted to describe health in optimal fitness (HOF) in young children born prematurely and to analyze factors affecting HOF in health status, investment resources, and anthropological values, based on HOF theory. Methods: A case-control study of 76 children with preterm births (PTB) was conducted at 24 to 42 months of corrected age. Their HOF status was evaluated based on height, weight, head circumference, and the Korean-Bayley Scale of Infant Development-II and classified as either HOF-achieved or HOF-uncertain in the domain of growth, development, and all together. Results: For growth, development, and all, 26.3%, 27.6%, and 47.4% of children, respectively, belonged to the HOF-uncertain group. Logistic regression analysis showed that longer length of hospital stay (${\geq}21days$; OR=7.8; 95% CI [1.5, 40.5]), worse scores on the Home Observation for Measurement of the Environment (HOME) (${\geq}38$; OR=0.1; 95% CI [0.0, 0.4]), having a working mother, (OR=5.7; 95% CI [1.2, 27.6]), and an older mother (${\geq}35years$; OR=8.8; 95% CI [2.1, 37.3]) were statistically significant contributors of HOF-uncertain in the domain of all. Conclusion: Findings show that young children born prematurely with prolonged stays in a neonatal intensive care unit and insufficient socioeconomic resources at home are more likely to exhibit delayed growth and development.

Determinants of Tourist Expenditure on 2013 Gangneung Dano Festival (2013 강릉단오제 관광객의 소비지출 결정요인에 관한 연구)

  • Jeong, Ug-Yeong;Han, Jin-Young
    • Journal of Digital Convergence
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    • v.11 no.12
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    • pp.93-100
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    • 2013
  • This paper analyzes determinants of tourist consumption in the case of 2013 Gangneung Dano Festival, based on the multiple regression model. We set 12 determinants of consumption such as income as explanatory variables and consumption expenditure as a dependent variable. Also Five kinds of categorical consumptions are estimated. Main results are the followings. First, income is the most important factor and shows positive effect in tourist consumption. Second, age and metropolitan area influence consumption positively. Third number of participating day and length of stay also influence consumption positively. Fourth, number of accompanying person shows negative effect on consumption. Fifth, male, married person, and lodge with own expense influence consumption positively. Finally, categorical consumption has its specific determinants distinct from common factors This paper can be applied to invent and implement efficient strategies for development in regional economies and tour industries.