Development and Effect of a Fall Prevention Program Based on the King's Goal Attainment Theory for Fall High-Risk Elderly Patients in Long-Term Care Hospital / 간호학회지

PURPOSE: The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects. METHODS: This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ2-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software. RESULTS: For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368). CONCLUSION: These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

Development and Effect of a Fall Prevention Program Based on the King's Goal Attainment Theory for Fall High-Risk Elderly Patients in Long-Term Care Hospital

PURPOSE@#The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects.@*METHODS@#This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an χ2-test, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software.@*RESULTS@#For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368).@*CONCLUSION@#These resultsindicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

A case of Churg-Strauss syndrome presenting with acute respiratory failure due to diffuse pulmonary hemorrhage / 천식및알레르기

Churg-Strauss syndrome is a rare subset of the group of systemic necrotizing vasculitis. Acute respiratory failure is an extremely rare presentation of Churg-Strauss syndrome. The authors report a case of Churg-Strauss syndrome presenting with acute respiratory failure due to diffuse pulmonary hemorrhage. A 28-year-old male suffering from not-well responding bronchial asthma developed erythematous maculopapulous skin lesion and progressive infiltrative pulmonary consolidation on chest X-ray but initially there was no eosinophilia in the peripheral blood. One week later, acute respiratory failure developed with peripheral eosinophilia. Chest X-ray showed bilateral multiple consolidations and patchy densities. The patient was supported on mechanical ventilator and we performed skin biopsy and bronchoscopic examination immediately. The lung biopsy specimens demonstrated capillaritis and prominent interstitial and alveolar eosinophil infiltrates. Grossly bloody bronchoalveolar lavage fluid showed predominant increase in eosinophilic increase and many hemosiderin laden macrophages. Therefore the patients was diagnosed with Churg-Strauss syndrome presenting with pulmonary hemorrhage. Treatment with intravenous methylprednisolone produced symptomatic improvement and normalized peripheral eosinophilia. This case emphasizes that Churg-Strauss syndrome should be considered in the differential diagnosis of acute respiratory failure, and early intervention or diagnostic approach is needed.