ABSTRACT
PURPOSE: This study was performed to systematically review the recently published nursing intervention studies. METHODS: The literature was identified through the Korean Education and Research Information Service (KERIS), the Korean Information Service System (KISS), and National Assembly Library websites. Key words such as breast cancer, nursing, and intervention were used. The factors analyzed are as follows: 1) the characteristics of studies and study populations, 2) the classification of interventions, 3) outcome indicators and their effects, and 4) effective interventions. RESULTS: Thirty two studies were included. Seventeen studies used a single intervention such as aerobic dance, TaiChi, foot massage, aromatherapy, or a stress-reduction method. Fifteen studies used combined interventions, including education, exercise, counseling, support, yoga or meditation. The data on 47 outcome indicators and their effects were segregated into psycho/spiritual outcomes, stress coping, physical outcomes, cardiorespiratory function, symptom management, arm and shoulder functions, fatigue, and quality of life. Some interventions had positive effects on stress, fatigue, and functions of shoulder. CONCLUSION: Various interventions are available for breast cancer patients, and some have had positive effects. However, more studies are required to develop evidence-based practice guidelines for nursing interventions.
Subject(s)
Humans , Arm , Aromatherapy , Breast , Breast Neoplasms , Counseling , Evidence-Based Practice , Fatigue , Foot , Information Services , Clinical Trial , Korea , Massage , Meditation , Quality of Life , Shoulder , YogaABSTRACT
PURPOSE: The purpose of this study was to examine the causal relationships among quality of health care service, service value, satisfaction and loyalty as perceived by hospital inpatients. METHODS: A survey using a structured questionnaire was conducted with 654 hospital inpatients. Analysis of the data was done with both SPSS Win 17.0 for descriptive statistics and AMOS 18.0 for the structural equation model. RESULTS: The modified model yielded Chi-square=7.96 (p=.019), df=2, chi2/df=3.98, GFI=.99, AGFI=.96, RMSEA=.07, NFI=.99, CFI=.99, TLI=.98 and showed good fit indices. Three dimensions of quality had significant direct effects on service value. Functional quality, technical quality and service value had significant direct effects on customer satisfaction. Technical quality, service value, and customer satisfaction had significant direct effects on customer loyalty. CONCLUSION: These results suggest that quality of health care is an important element in service value, and through both quality and service value, customer satisfaction and customer loyalty can be enhanced. Further study with a larger sample from various hospitals and a longitudinal design is necessary.
Subject(s)
Humans , Inpatients , Quality of Health Care , Surveys and QuestionnairesABSTRACT
BACKGROUND: Perioperative hypothermia is a common problem during both laparotomy and laparoscopic surgery. Hypothermia during laparoscopic surgery is related to the use of irrigation fluid and the large volume of CO2 for maintaining pneumoperitoneum. The aim of this study is to estimate whether the use of warm irrigation fluid can reduce the incidence of hypothermia and the decrease of body temperature. METHODS: Forty-two female patients undergoing elective laparoscopic surgery were randomly divided into 2 groups. Group 1 (n = 20) was given an ambient temperature irrigation fluid and group 2 (n = 22) a warm irrigation fluid. The core esophageal body temperatures of all the patients were measured every 10 minutes for 70 minutes. Body temperature 10 minutes after induction was a control value. The degree of body temperature decrease was measured, and the incidence of hypothermia was recorded. RESULTS: The incidences of hypothermia in group 2 were decreased significantly 60 and 70 minutes after induction, compared with those of group 1. The degree of body temperature decrease was revealed to be significantly different between the two groups starting 50 minutes after induction. CONCLUSIONS: The use of warm irrigation fluid during laparoscopic surgery can reduce the incidence of hypothermia and degree of body temperature decrease.
Subject(s)
Female , Humans , Body Temperature , Hypothermia , Incidence , Laparoscopy , Laparotomy , PneumoperitoneumABSTRACT
BACKGROUND: Perioperative hypothermia is a common problem during both laparotomy and laparoscopic surgery. Hypothermia during laparoscopic surgery is related to the use of irrigation fluid and the large volume of CO2 for maintaining pneumoperitoneum. The aim of this study is to estimate whether the use of warm irrigation fluid can reduce the incidence of hypothermia and the decrease of body temperature. METHODS: Forty-two female patients undergoing elective laparoscopic surgery were randomly divided into 2 groups. Group 1 (n = 20) was given an ambient temperature irrigation fluid and group 2 (n = 22) a warm irrigation fluid. The core esophageal body temperatures of all the patients were measured every 10 minutes for 70 minutes. Body temperature 10 minutes after induction was a control value. The degree of body temperature decrease was measured, and the incidence of hypothermia was recorded. RESULTS: The incidences of hypothermia in group 2 were decreased significantly 60 and 70 minutes after induction, compared with those of group 1. The degree of body temperature decrease was revealed to be significantly different between the two groups starting 50 minutes after induction. CONCLUSIONS: The use of warm irrigation fluid during laparoscopic surgery can reduce the incidence of hypothermia and degree of body temperature decrease.
Subject(s)
Female , Humans , Body Temperature , Hypothermia , Incidence , Laparoscopy , Laparotomy , PneumoperitoneumABSTRACT
BACKGROUND: Epidural pain control has been used extensively for postoperative pain management, but nausea, vomiting and pruritus associated with morphine and fentanyl administration remain intractable problems. The aim of this study is to find the optimal epidural droperidol dosage for reducing the side effects of epidural morphine and fentanyl. METHODS: 140 patients randomly sampled and undergoing vaginal total hysterectomy were divided into 7 groups. Groups I and IV, and groups II and V, and groups III and VI, received 5 mg, 3.75 mg, 2.5 mg of droperidol by 2-day infusion pump through the indwelling epidural catheter, respectively. Group IV, V, VI patients received 1.25 mg of bolus droperidol through the indwelling epidural catheter at the time of peritoneal closure. As group VII was the control group, these patients received only epidural analgesics (morphine 10 mg, fentanyl citrate 300 microgram and 0.05% bupivacaine 100 ml) by 2-day infusion pump. RESULTS: Droperidol significantly reduced the incidence and severity of postoperative nausea, vomiting and itching sensation compared with the control group but verbal rating scale (VRS) of sedation was increased with the dosage of droperidol. There was no significant difference in the intensity of analgesia between the there groups. CONCLUSIONS: An effective epidural droperidol dosage for reducing postoperative nausea, vomiting and pruritus due to epidural pain control is 2.5 mg by 2-day infusion pump.
Subject(s)
Humans , Analgesia , Analgesics , Bupivacaine , Catheters , Droperidol , Fentanyl , Hysterectomy , Incidence , Infusion Pumps , Morphine , Nausea , Pain Management , Pain, Postoperative , Postoperative Nausea and Vomiting , Pruritus , Sensation , VomitingABSTRACT
BACKGROUND: Epidural pain control has been used extensively for postoperative pain management, but nausea, vomiting and pruritus associated with morphine and fentanyl administration remain intractable problems. The aim of this study is to find the optimal epidural droperidol dosage for reducing the side effects of epidural morphine and fentanyl. METHODS: 140 patients randomly sampled and undergoing vaginal total hysterectomy were divided into 7 groups. Groups I and IV, and groups II and V, and groups III and VI, received 5 mg, 3.75 mg, 2.5 mg of droperidol by 2-day infusion pump through the indwelling epidural catheter, respectively. Group IV, V, VI patients received 1.25 mg of bolus droperidol through the indwelling epidural catheter at the time of peritoneal closure. As group VII was the control group, these patients received only epidural analgesics (morphine 10 mg, fentanyl citrate 300 microgram and 0.05% bupivacaine 100 ml) by 2-day infusion pump. RESULTS: Droperidol significantly reduced the incidence and severity of postoperative nausea, vomiting and itching sensation compared with the control group but verbal rating scale (VRS) of sedation was increased with the dosage of droperidol. There was no significant difference in the intensity of analgesia between the there groups. CONCLUSIONS: An effective epidural droperidol dosage for reducing postoperative nausea, vomiting and pruritus due to epidural pain control is 2.5 mg by 2-day infusion pump.
Subject(s)
Humans , Analgesia , Analgesics , Bupivacaine , Catheters , Droperidol , Fentanyl , Hysterectomy , Incidence , Infusion Pumps , Morphine , Nausea , Pain Management , Pain, Postoperative , Postoperative Nausea and Vomiting , Pruritus , Sensation , VomitingABSTRACT
Takayasu's arteritis is a chronic, idiopathic occlusive inflammation of the aorta and its major branches, affecting females in over 85% of the cases. The major clinical finding is loss of palpable pulses in the upper limbs and neck. Several authors have cautioned against the use of regional anesthesia in Takayasu's arteritis, because of the dangers of hypotension and subsequent vasopressor use. However, regional anesthesia, with an awake patient, is the easiest way to monitor cerebral function and is the preferred technique in the parturient. We report on a case of Takayasu's arteritis associating renovascular hypertension during pregnancy with successful cesarean delivery under epidural anesthesia.
Subject(s)
Female , Humans , Pregnancy , Anesthesia, Conduction , Anesthesia, Epidural , Aorta , Cesarean Section , Hypertension, Renovascular , Hypotension , Inflammation , Neck , Takayasu Arteritis , Upper ExtremityABSTRACT
BACKGROUND: Inhalation anesthetics have been known to be effective in lowering respiratory system resistance (Rrs); however the bronchodilation effects of sevoflurane has not been well defined. We administered same end-tidal concentration of halothane, isoflurane and sevoflurane and continuous thiopental infusion to compare bronchodilation effects between these groups. METHODS: After institutional reviewed board approve and written informed consent, 59 patients (smoker 47, non-smoker 12) were randomized to receive either 1.1 end-tidal concentration of inhalation anesthetics (Halothane, Isoflurane, Sevoflurane) in 100% O2 or continuous thiopental infusion (15 mg/kg/hr) in 50% N2O/50% O2. Patients were anesthetized with 2 microgram/kg fentanyl and 5 mg/kg thiopental. Tracheal intubation was done with 1 mg/kg succinylcholine and paralyzed patient with vecuronium (0.1 mg/kg IV). Just after intubation baseline Rrs, blood pressure, heart rate were measured with Datex Capnomac (Capnomac Ultima, Datex, Finland). Just after baseline measurement we administered anesthetics and measured same variables repeatedly at 5 min, 10 min following given anesthetics. Data were analyzed using analysis of variance and t-test to determine bronchodilation effects of Rrs between groups. RESULTS: Rrs at 5 min, halothane and sevoflurane decreased more significantly than isoflurane (33.4%, 38.5%, 23.2%) but increased in thiopental infusion (10.6%). Rrs at 10 min, halothane and sevoflurane decreased (39.1%, 41.6%) and less decreased in isoflurane (26.5%), but more increased in thiopental infusion (13.1%) (Table 2, Fig. 2). CONCLUSIONS: In lowering respiratory system resistance, sevoflurane decreases resistance as much as halothane and is more potent than isoflurane and thiopental which was induced by tracheal intubation.
Subject(s)
Humans , Anesthetics , Anesthetics, Inhalation , Blood Pressure , Fentanyl , Halothane , Heart Rate , Informed Consent , Intubation , Isoflurane , Respiratory System , Succinylcholine , Thiopental , Vecuronium BromideABSTRACT
BACKGROUND: Immobile vocal fold or folds result from neuromuscular pathology and/or mechanical fixation of cricoarytenoid joint. Electrophysiological investigation is indispensible in the diagnosis and treatment of laryngeal mobility disorders. However, laryngeal electrodiagnosis has been rarely performed clinically, not to mention nerve conduction study (NCS). It is well understood that needle EMG and NCS are complementary, and they should be performed together for reliable evaluation of neuromuscular system. OBJECTIVES: The author intended to present the methods and clinical application of laryngeal electrodiagnosis. MATERIALS AND METHODS: Laryngeal electrodiagnosis including needle EMG and NCS was performed in the patient with bilaterally immobile vocal folds. CONCLUSION: Electrodiagnosis is inevitable in the diagnosis and treatment of larygeal mobility disorders;the differentiation of neurogenic lesion from mechanical fixation, the diagnosis of the site of nerve lesion, and the estimation of the degrees of injuries. Furthermore by performing NCS, we can have the objective prognosticator, and therefore can take the best timing and choice of surgical intervention in the management of laryngeal mobility disorders.
Subject(s)
Humans , Diagnosis , Electrodiagnosis , Joints , Needles , Neural Conduction , Pathology , Vocal CordsABSTRACT
Cricoarytenoid joint dislocation is not an uncommon complication resulting from intubation trauma or blunt trauma to the neck, yet it has been poorly documented. Hoarseness is the most prevalent symptom, and poor mobility of the vocal fold is the most common sign. It is best evaluated by stroboscopic examination combined with laryngeal electromyography(EMG). Early diagnosis is important for appropriate surgical management and better prognosis. Closed reduction of dislocated joint is the treatment of choice. A case of cricoarytenoid joint dislocation after blunt trauma to the anterior neck is presented with a brief review of literature.