Comparison of an intraoperative infusion of dexmedetomidine or remifentanil on perioperative haemodynamics, hypnosis and sedation, and postoperative pain control.

This prospective, randomized, double-blind study compared the effects of dexmedetomidine and remifentanil on haemodynamic stability, sedation and postoperative pain control in the postanaesthetic care unit (PACU). Fifty consecutive patients scheduled for total laparoscopic hysterectomy were randomly assigned to receive infusions of either dexmedetomidine (1 µg/kg) i.v. over 10 min followed by 0.2 - 0.7 µg/kg per h continuous i.v. infusion or remifentanil (0.8 - 1.2 µg/kg) i.v. over 1 min followed by 0.05 - 0.1 µg/kg i.v. per min, starting at the end of surgery to the time in the PACU. Modified observer's assessment of alertness scores were significantly lower in the dexmedetomidine group than in the remifentanil group at 0, 5 and 10 min after arrival in the PACU. Blood pressure and heart rate in the dexmedetomidine group were significantly lower than that recorded in the remifentanil group in the PACU. Dexmedetomidine, at the doses used in this study, had a significant advantage over remifentanil in terms of postoperative haemodynamic stability.

[A study of the effects of health contracts on the performance level for activities of daily living in the hemiplegic patients].

The purpose of this study was to test the effects of health contract on the performance level for activity of daily living (ADL) in the hemiplegic patients. A quasi-experimental research for health contract, which was approved as an effective method of nursing intervention, was attempted to increase the performance of the hemiplegic patients' ADL. As a purpose sample, 69 hemiplegic patients hospitalized at Oriental medicine hospital of K university were taken and divided into the experimental group and the control group by means of random assignment. After Contracting with the experimental group, they were reinforced everyday for 20 minutes. The experimental group and the control group were observed and interviewed for five times at the interval of 3-4 days by the trained nurses for this research. The data Collected through above mentioned methods were compute analyzed by t-test and ANOVA according to the purpose of this study. The data collected through above mentioned methods were computer analyzed by t-test and ANOVA according to the purpose of this study. Strate increased the performance level for ADL than the Control group" was supported (t = 2.96, df = 52.76, p = .004). Sub Hypothesis 1,2,4,5: "The hypothesis that the experimental group with health contract will demonstrate increased the performance level for eating (t = 2.29, df = 42.70, p = .027), personal hygiene and grooming (t = 4.04, df = 43.10, p = .000), dressing (t = 3.32, df = 67, p = .001) and undressing (t = 3.47, df = 48.44, p = .001) than the control group" was supported. Sub Hypothesis 3.6: "The hypothesis that the experimental group with health contract will demonstrate increased the performance level for toiletting (t = .19, df = 67, p = .849) and mobilization (t = .30, df = 67, p = .765) than the control group" was not supported. The conclusion can be that the positive relationship between the nurse and the patient results in the desired performance level for ADL in the hemiplegic patients.

[The use of nursing diagnosis in practice].

This study was conducted to investigate the present situation and problems related to the use of nursing diagnosis in practice. The data were obtained from 332 subjects (27 director of nursing service, 302 staff nurses) who worked in university hospitals in Korea from July through August 1988 using a mailed questionnaire. Data were analyzed by frequency, X2 test and t-test. The findings were as follows: 1. Clinical use of nursing diagnosis by directors of nursing service and staff nurses. 1) The majority of the nursing departments (88.9%) conducted group education on nursing diagnosis during the last 5 years and 81.5% of them kept a record format for nursing diagnosis; 88.9% of them had had prior experience with the nursing diagnosis. 2) Most of nurses (97.0%) had received education on nursing diagnosis. 2. Factors related to the clinical use of nursing diagnosis in nursing service departments and by staff nurses. 1) The one factor related to the use of nursing diagnosis in the nursing service department was the existence of a record. 2) Factors related to the use of nursing diagnosis by the staff nurses were the organization style of the nursing service department, group education during the last 5 years, existence of a record, the attitude of the director of nursing service, and prior experience of the use of the nursing diagnosis as characteristics of nursing service department and educational experience of nursing diagnosis as a character of nurse. 3. Problems with the use of nursing diagnosis. 1) The primary problem was the lack of time and personnel (mean:3.757); the second problem was the lack of knowledge and will to use nursing diagnosis in practice by the staff nurses (mean:3.546). 2) There was no significant difference in problems expressed by the director of nursing services and the nurses. The majority of nurses who worked in the university hospitals expressed interest in and concern about the use of nursing diagnosis. Most of the nurses had had education about on nursing diagnosis but use in practice was limited. The primary problem was lack of time and manpower.(ABSTRACT TRUNCATED AT 400 WORDS)

[The effects of clinical application of a nursing diagnosis protocol].

This study was conducted to measure the effects of clinical application of a Nursing Diagnosis Protocol. The dependent variables were the degree of patient's satisfaction and the degree of nurse's satisfaction with the nursing activity. Analysis of the effect of the use of the nursing diagnosis protocol was based on the nursing record. The subjects for this study were 61 nurses (experimental group 31, control group 30) and 155 patients (experimental group 55, control group 100) on four internal medicine wards in K University Hospital in Seoul.