The Effect of an Internet Community on Knowledge, Self-efficacy and Self Care Behavior in Workers with Hypertension / 간호학회지

PURPOSE: This study was aimed to evaluate the effect of an internet community on knowledge, self-efficacy, and self-care behavior in workers with hypertension. METHOD: The research design used was a nonequivalent control group pre-test and post-test design. Sixty hypertensive workers participated in this study(Exp.=29, Cont.=31). The data was collected from the 3rd of November 2003 to the 27th of February 2004 using an interview with questionnaires. Information related to hypertension was provided on the internet community weekly and an e-mail newsletter was sent in order to increase participation in the internet community. We used a tool developed by Park Young-Im(1994) that measured knowledge related to hypertension and self-efficacy. A tool developed by Jung Mi-Young(2001) was used for self-care behavior. The collected data was analyzed with an chi2-test and t-test using the SPSS WIN 10.0 program. RESULT: The internet community helped workers with hypertension to increase their knowledge related to hypertension, as well as increasing their self-efficacy and self-care behavior. CONCLUSION: An internet community could be applied as hypertensive nursing intervention.

Usefulness of 99mTx Methoxyisobutylisonitrile Lung SPECT in Benign andMalignant Lesion of the Lungs / 결핵

BACKGROUND: 99mTc MIBI(Methoxyisobutylisonitrile complex), a member of the isonitrile class of coordination compounds, is a lipophilic cation presently under investigation for clinical use as myocardial perfusion imaging agent and is widely used to detect myocardial infarction. Preliminary reports indicate that T1-201 accumulate in human neoplasm and several authors reported 99mTc MIBI may also localized in primary malignant tumor and metastatic deposits from lung cancer. We evaluated the uptake of 99mTc MIBI in lung cancer and localization of mediastinal and other site metastasis, and compared the benign lesion of the lung. METHOD: Thirty four patients of lung cancer and ten patients of benign lung lesion were studied with chest CT and 99mTc MIBI Lung SPECT. 99mTc MIBI uptake ratio was assessed by TR/NL(Lung lesion/ Normal area), HT/NL (Heart/ Normal area) and HT/TR(Heart/Lung lesion). RESULTS: 1) All lung cancer patients showed increased uptakes of 99mTc MIBI in malignant lung lesion and Tc-99m MIBI uptake was also increased in mediastinal and lymph node metastasis except two cases. 2) There was significant different ratio of TR/NL between malignant and benign lesion, 3.79 +/- 1.82 and 1.67+/-0.63 on planar images, respectively(p <0.001). 3) There was no significant difference of 99mTc MIBI uptake ratio between squamous cell carcinoma, small cell carcinoma and adeno carcinoma(3.64+/- 1.66, 3.57+/-0.72, 4.31 +/-2.28 respectively). CONCLUSION: 99mTc MIBI lung SPECT was useful in the localization of tumor and mediastinal or other site metastatic lesion in lung cancer and also in the differential diagnosis between benign and malignant lesion.

The Effect of Nasal BiPAP Ventilation in Acute Exacerbation of Chronic Obstructive Airway Disease / 결핵

BACKGROUND: Mechanical ventilation constitutes the last therapeutic method for acute respiratory failure when oxygen therapy and medical treatment fail to improve the respiratory status of the patient. This invasive ventilation, classically administered by endotracheal intubation or by tracheostomy, is associated with significant mortality and morbidity. Consequently, any less invasive method able to avoid the use of endotracheal ventilation would appear to be useful in high risk patient. Over recent years, the efficacy of nasal mask ventilation has been demonstrated in the treatment of chronic restrictive respiratory failure, particularly in patients with neuromuscular diseases. More recently, this method has been successfully used in the treatment of acute respiratory failure due to parenchymal disease. METHOD: We assessed the efficacy of Bilevel positive airway pressure(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD). This study prospectively evaluated the clinical effectiveness of a treatment schedule with positive pressure ventilation via nasal mask(Respironics BiPAP device) in 22 patients with acute exacerbations of COPD. Eleven patients with acute exacerbations of COPD were treated with nasal pressure support ventilation delivered via a nasal ventilatory support system plus standard treatment for 3 consecutive days. An additional 11 control patients were treated only with standard treatment. The standard treatment consisted of medical and oxygen therapy. The nasal BiPAP was delivered by a pressure support ventilator in spontaneous timed mode and at an inspiratory positive airway pressure 6-8cmH2O and an expiratory positive airway pressure 3-4cmH2O. Patients were evaluated with physical examination(respiratory rate), modified Borg scale and arterial blood gas before and after the acute therapeutic intervention. RESULTS: Pretreatment and after 3 days of treatment, mean PaO2 was 56.3mmHg and 79.1mmHg (p<0.05) in BiPAP group and 56.9mmHg and 70.2mmHg (p<0.05) in conventional treatment (CT) group and PaCO2 was 63.9mmHg and 56.9mmHg (p<0.05) in BiPAP group and 53mmHg and 52.8mmHg in CT group respectively. pH was 7.36 and 7.41 (p<0.05) in BiPAP group and 7.37 and 7.38 in CT group respectively. Pretreatment and after treatment, mean respiratory rate was 28 and 23 beats/min in BiPAP group and 25 and 20 beats/min in CT group respectively. Borg scale was 7.6 and 4.7 in BiPAP group and 6.4 and 3.8 in CT group respectively. There were significant differences between the two groups in changes of mean PaO2, PaCO2 and pH respectively. CONCLUSION: We conclude that short-term nasal pressure-support ventilation delivered via nasal BiPAP in the treatment of acute exacerbation of COPE), is an efficient mode of assisted ventilation for improving blood gas values and dyspnea sensation and may reduce the need for endotracheal intubation with mechanical ventilation.