Noise Experience Status and Response to Noise of Patients and Nursing Staff in the ICU / 기본간호학회지

Purpose@#The purpose of this study was to analyze noise experience and response to noise by patients and nursing staff in intensive care units (ICU). @*Methods@#This study was a cross-sectional survey based on questionnaires administered to patients and staff in ICU to analyze the perceived noise level in the ICU environment, frequency of noise experience and noise level emitted by different sources, noise induced discomfort, response to noise, and the quality of sleep. The data were analyzed using descriptive statistics, independent t-test, ANOVA, and Pearson's correlation coefficient. @*Results@#Regarding the frequency of experience and noise levels emitted by various sources, patients carried the maximum number of human factors, and staff carried the highest number of medical devices or medical supplies. The quality of sleep caused by noise in patients was lower. Based on the correlation between the various variables, the higher the perceived noise level in the ICU environment, the higher the response to the noise (positive correlation) and the lower the quality of sleep (negative correlation). @*Conclusion@#Based on the results of this study, a follow-up study is suggested to compare perceived noise levels of patients and staff. Practical strategies are needed to reduce noise based on noise levels and sources of noise experienced by ICU patients and staff.

Effects of Delirium Prevention Interventions for Neurocritical Patients / 기본간호학회지

PURPOSE: The purpose of this study was to investigate the effects of a delirium prevention intervention for patients in neurology and neurosurgery intensive care units (ICUs). METHODS: This study was a quasi-experimental study. Participants were 87 patients. The experimental group was provided with nonpharmacologic and multicomponent delirium prevention interventions, consisting of regular delirium assessment, improvement in orientation, early therapeutic intervention, and environmental interventions. The control group was provided with routine intensive care. Data were analyzed using χ² test, Fisher's exact test, and t-test. RESULTS: Both groups were homogeneous. The incidence of delirium and length of hospitalization were significantly lower in the experimental group compared to the control group. ICU stay, mortality and unplanned extubation were lower in the experimental group compared to the control group, but there was no significant difference. CONCLUSION: Findings indicate that the delirium prevention intervention is effective in reducing incidence of delirium and length of hospitalization. Therefore, this intervention should be helpful in preventing delirium in neurology and neurosurgery ICUs and can be used as a guide in the prevention of delirium in neurological diseases's patients.

Serological Detection of Borrelia burgdorferi among Horses in Korea

Lyme disease is a tick-borne zoonotic infectious disease caused by Borrelia burgdorferi. The present study assessed the infection status of B. burgdorferi among horses reared in Korea using ELISA and PCR. Between 2009 and 2013, blood samples were collected from 727 horses throughout Korea. Data for each animal including age, gender, breed, and region of sample collection were used for epidemiological analysis. Overall, 38 (5.2%; true prevalence: 5.5%) of 727 horses were seropositive by ELISA. There were statistically significant differences according to breed and region (P<0.001) whose differences might be attributed to the ecology of vector ticks and climate conditions. Using 2 nested PCR, none of the samples tested positive for B. burgdorferi. Thus, a positive ELISA result can indicate only that the tested horse was previously exposed to B. burgdorferi, with no certainty over the time of exposure. Since global warming is likely to increase the abundance of ticks in Korea, continuous monitoring of tick-borne diseases in Korean horses is needed.

Process of Overcoming Turnover Intention in Career Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to identify the process of overcoming the intention toward turnover experienced by career nurses. METHODS: Data were collected from 10 career nurses though in-depth interviews about their experiences. The main question was "How do you describe your experience of the process of overcoming intention to turnover as a career nurse?" Qualitative data from field and transcribed notes were analyzed using Strauss & Corbin's grounded theory methodology. RESULTS: From the participants' statement, 127 concepts, 34 subcategories and 13 categories were extracted through the open coding process. The core category was discovered to be 'back to the original place'. Phenomenon was identified as 'reached the threshold that cannot be withstood' and this series of process was categorized as having four stages: 'conflict', 'meditation', 'discovery' and 'conquest'. There were three types of overcoming turnover intention in career nurses, 'adjustment', 'compromise', 'self-led'. CONCLUSION: The results of this study produced useful information about the needs of career nurses during the process of overcoming turnover intention based on their stage and overcoming types of turnover intension. Ultimately this study may help decrease the turnover intention of career nurses.

Healthcare Professional's Knowledge, Perception and Performance on Early Enteral Nutrition for Critically Ill Patients / 대한구급학회지

BACKGROUND: Proper nutritional supplement is one of the fundamental management domains for critical ill patients. While it shows positive effect on processing and prognosis of critical ill patients, early enteral nutrition is overlooked. This study explored healthcare professional's level of knowledge perception and performance on early enteral nutrition for critically ill patients. Data was collected from a convenient sample of 319 registered doctors, nurses and nutritionists in ICU at seven university hospitals. METHODS: A cross-sectional survey design was used. The participants were assessed by questionnaires, specifically designed for the study and verified for the content validity by professional reviewers related with critical ill patients. RESULTS: While the level of the perception of early enteral nutrition is high, the level of knowledge and performance are relatively low. The nurses showed a statistically significant difference on the level of knowledge, by their educational backgrounds and clinical experiences. Regarding the hospital support system, the doctors showed a significant difference on the level of perception and performance, while the nurses only showed that difference on the level of performance. It was shown that with higher the level of knowledge regarding the early enteral nutrition, the higher the level of performance. Further, the higher the level of perception, the higher the level of performance was observed. The hospital support system and the perception of the healthcare professionals are two most influential factors to affect the performance of the healthcare professionals related with the early enteral nutrition for the critically ill patients. CONCLUSION: To perform the proper early enteral nutrition, the hospital support system and the level of the healthcare professionals' perception, are two most important factors. Therefore, the efforts to build the hospital support system along with the educational provisions are needed.

Effects of Aromatherapy on Depression, Anxiety and the Autonomic Nervous System in Breast Cancer Patients Undergoing Adjuvant Radiotherapy / 한국호스피스완화의료학회지

PURPOSE: The study was designed to verify effects of aromatherapy on depression, anxiety and the autonomic nervous system in breast cancer patients who are undergoing adjuvant radiotherapy. METHODS: Data were collected from November 2006 through March 2007 at the C university hospital in Seoul. The study included 33 patients and they were assigned to three groups. Group I had aroma oil inhalation for 2 minutes per time, three times a day for six weeks whereas Group II and a control group inhaled aroma oil for 2 minutes per time, once a day for six weeks. For Groups I and II, a mixture of lemon, lavender, rosewood and rose essential oils were used while control group inhaled tea tree oil. RESULTS: Depression was significantly decreased in patients in the experimental groups only. In Groups I and II patients, anxiety level was lower than that in control patients. Patients in Groups I and II also showed stronger physical resistance to stress than control group patients. CONCLUSION: Aromatherapy should be considered as a method that can significantly decrease depression in breast cancer patients who are undergoing adjuvant radiotherapy.

The Effects of Aroma Inhalation on Sleep and Fatigue in Night Shift Nurses / 성인간호학회지

PURPOSE: This study was conducted to describe the effects of aroma inhalation on sleep and fatigue in night shift nurses. METHODS: The research design was one group pre-posttest design. The subjects were 17 night shift nurses who work at neurosurgery intensive care unit of K hospital of C university in Seoul. During three consequent night shifts, the participants were worn the Actigraph to measure the sleep pattern on their wrist since their first night shift work. The quality of sleep and fatigue was measured by survey when they awoke at 6 pm after second night shift work. And these measures were repeated during the night shifts in second and third week. Aroma inhalation was applied before going to bed after finishing each night shift work during second and third week. SPSS 12.0 program was used for data analysis. RESULTS: There were no statistically significant differences in sleep latency and total sleeping time. However, significant differences were found in the sleep efficiency, awakening number, sleep quality, subjective symptom and intensity of fatigue. CONCLUSION: These results showed that aroma inhalation had positive effects on the pattern and quality of sleep and reducing fatigue in night shift nurses.

The Effects of Aroma Inhalation on Sleep and Fatigue in Night Shift Nurses / 성인간호학회지

PURPOSE: This study was conducted to describe the effects of aroma inhalation on sleep and fatigue in night shift nurses. METHODS: The research design was one group pre-posttest design. The subjects were 17 night shift nurses who work at neurosurgery intensive care unit of K hospital of C university in Seoul. During three consequent night shifts, the participants were worn the Actigraph to measure the sleep pattern on their wrist since their first night shift work. The quality of sleep and fatigue was measured by survey when they awoke at 6 pm after second night shift work. And these measures were repeated during the night shifts in second and third week. Aroma inhalation was applied before going to bed after finishing each night shift work during second and third week. SPSS 12.0 program was used for data analysis. RESULTS: There were no statistically significant differences in sleep latency and total sleeping time. However, significant differences were found in the sleep efficiency, awakening number, sleep quality, subjective symptom and intensity of fatigue. CONCLUSION: These results showed that aroma inhalation had positive effects on the pattern and quality of sleep and reducing fatigue in night shift nurses.

Effects of Perineal Care with Aroma Essential Oil on the Decrease of Urinary Tract Infection in Patients with Indwelling Urinary Catheter / 성인간호학회지

PURPOSE: This study was designed to verify effects of perineal care with aroma essential oil on urinary tract infection(UTI) in patients with indwelling urinary catheter. METHOD: The research design was non equivalent control group pretest-post test design. The data were collected from March to August, 2005 at C university hospital in Seoul. The subjects were 43 patients who had a indwelling catheter in neurosurgery intensive care unit(NSICU). They were assigned to two groups, 21 subjects to the experimental group and 22 subjects to the control group. The experimental group received perineal care with 3% blending essential oil for 4 days. RESULTS: In the experimental group, white blood cells and bacteria in urine were significantly lower than control group. Bacteria in urine culture was lower in the experimental group at post test. CONCLUSION: Perineal care with aroma essential oil could be an effective intervention to reduce the UTI of patients in NSICU.

The Effects of Artificial Dead Space on the Pulmonary Ventilation of Intubated Children with Mechanical Ventilation / 간호학회지

This study was done to evaluate the effect reducing artificial dead space on intubated children. Data were collected from July 1st, 1998 to August 31st, 1999. The subjects were selected from a pediatric intensive care unit of 'S' hospital and intubated with 3.5 mm or 4.5 mm endotracheal tube after open heart surgery. They were composed of 34 patients : 17 patients were assigned to the experimental group and the rest of them were placed in the control group. The artificial airway volume was minimized in the experimental group, and the control group maintained the artificial airway volume. ETCO2, PaCO2, SPO2 were measured as indicators of pulmonary ventilation. The tools of this study were GEM-Premier and Space-Lab patient monitors. The data were analyzed using the SPSS/PC+ program. The Chi2 -test was used to find general characteristics. The t-test was used to test the homogenety of the pulmonary ventilation status and mechanical ventilation setting before intervention between the two groups. Also, the paired t-test was used to examine the hypothesis. The results can be summerized as : 1. CO2 can be expelled effectively from the body in case artificial dead space was decreased. 2. As the artificial dead space was reduced, the difference between ETCO2 and PaCO2 was decreased, in other words pulmonary ventilation was improved. 3. If the artificial dead space occupied above 15 percent of tidal volume, the effect of CO2 was retention revealed in the body. 4. If the artificial dead space occupied below 1.5 percent of tidal volume, there was no dead space effect. Based on the results, the following is suggested to be applied practically : 1. A kind of the ventilator circuit acting artificial dead space should be removed from the intubated children with mechanical ventilaion. 2. The endotracheal tube should not be cut because extra-body space of the endotracheal tube did not have an effect on the dead space of the intubated children. Since the researcher could not cover this aspect in the study, they recommend the following. 1. The study should be extended to the other pulmonary disease patients for the effect of improving pulmonary ventilation. 2. Also, further studying with a more narrow interval in the extra-body space of the artificial airway will be able to explain the point of artificial dead space with proper ventilation.

A Case of Acute Pancreatitis as a Complication of Systemic Lupus Erythematosus / 대한신장학회잡지

Systemic lupus erythematosus, an autoimmune disease with multisystem involvement, has been reported to be associated with a number of gastrointestinal complications and symptoms such as nausea, vomiting, and abdominal pain. However, acute pancreatitis only rarely has been reported as a complication of SLE. We report a case of SLE presenting drug unrelated acute pancreatitis as a initial manifestation.

A Case of Anti-Glomerular Basement Membrane Antibody Associated Crescentic Glomerulonephritis with Positive Antineutrophilic Cytoplasmic Antibody / 대한신장학회잡지

A 63-year-old woman presented to the hospital with gross hematuria and acute renal failure. Kidney function deteriorated rapidly and progressively. A renal biopsy revealed segmental or circumferential crescents associated with linear deposits of immunoglobulin G, typical of anti-glomerular basement membrane disease. Both c-ANCA and anti-GBM antibody were detected in serum. She was treated with hemodialysis, plasmapheresis, high dose steroid and cyclophosphamide. However, she died 7 weeks after treatment because of pneumonia, without recovery of renal function. Serologic positivity of both ANCA and anti-GBM antibody are becoming more frequently recognized in rapidly progressive glomerulonephritis. The influence of c-ANCA on the clinical course of anti-GBM glomerulonephritis remains to be determined.