PURPOSE: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. METHOD: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characte-ristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. RESULTS: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was 36.76 55.7 hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. CONCLUSION: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.
Child ; Ethics ; Humans ; Intensive Care Units ; Nursing ; Nursing Care ; Patient Rights ; Restraint, Physical* ; Surveys and Questionnaires

This study was carried out to analyze the effect of a diet program for adult women on weight loss, BMI, eating habits, sleeping habits, health related indices. The subjects was 415 participants of the 10 weeks (20 time participation program). The data was collected by basic somatometry and HRV (Heart Rate Variability) / APG (Accelerated Plethysmograph) Analyzer. The average age, height, weight and BMI were 28.6 years, 162.1 cm, 62.8 kg and 23.9 kg/m2, respectively. Their body types by BMI were under weight (1.2%), normal (45.8%), overweight (24.8%), mild obesity (22.7%) and obesity (5.5%). There were significant reductions of average weight (4.6 kg) and average BMI (1.75 kg/m2) on the 10th week. There were positive changes in vascular age (50.4%), stress index (44.6%), fatigue index (43.9%), health index (54.5%) of the subjects during the program. There was a meaningful difference of the average variation for the vascular age, stress index, fatigue index, and health index between two groups; one improving the eating habit and the other did not (p < 0.05), and also there was a meaningful difference of the average variation for the fatigue index in both groups improving the sleeping habit (p < 0.05), but was not a meaningful difference of the average variation for the vascular age, stress index, and health index between two groups. There was a meaningful difference of the average variation for the vascular age, stress index, fatigue index, and health index between two groups improving both eating and sleeping habit (p < 0.05). In conclusion, the weight loss program was effective on the weight loss and BMI reduction and health related indices.
Adult* ; Body Weight* ; Diet* ; Eating ; Fatigue ; Female ; Humans ; Obesity ; Overweight ; Somatotypes ; Weight Loss ; Weight Reduction Programs

Methods: In this study, five subjects with colorectal cancer undergoing adjuvant chemotherapy were interviewed in-depth using the Giorgi study method. The contents of the nutrition education visits and in-depth interviews were transcribed in the language of the subject after recording, and the appropriateness of the data was improved by reflecting the subject’s actions and facial expressions. Results: After conducting the in-depth interviews for each subject, the experience of the subject’s diet and adjuvant chemotherapy was drawn into two domains, six elements, and 26 sub-elements. In the cognitive domain, the patients experienced physical and psychological changes, and the need for nutrition management was recognized by analyzing the dietary causes of the diseases. In the domain of practice, a knowing-doing gap was formed, unlike the patient’s will. Factors that inhibited compliance with nutritional management included digestive problems, sensory changes, loss of appetite, and social interaction stress. Conclusions Dietary management is very important for patients receiving periodic anticancer therapy, and step-by-step training and personal monitoring based on the chemotherapy order is necessary to maintain the patient’s will and social and environmental support.

Purpose: The aims of this systematic review were to identify the study protocol of Virtual Reality Therapy (VRT) and review the effect of VRT among patients with Post-Traumatic Stress Disorder (PTSD). Methods: This review followed the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic literature search was conducted using 12 electronic databases including gray literature with no limit of publication year. Search terms included relevant terms regarding “PTSD”, “trauma”, and “VRT”. Among 265 studies extracted through PRISMA, 20 studies were selected and evaluated for quality assessment using the Risk of Bias tool of Cochrane’s collaboration. Results: The majority of the literature focused on combat veterans and war situations (95%).Usually, each session usually took 60~120 minutes of VRT in 10~20 sessions for 5~10 weeks. The VRT equipment and contents were individually designed considering patients’ traumatic experiences. Most of the studies reported the positive effects associated to reduced levels of PTSD (80%) and related symptoms, such as, depression (45%) and anxiety (25%). Conclusion Based on our findings, further studies are required to evaluate VRT in people with PTSD, after improving study design and standardizing protocols.

Purpose: Adequate nutrition is to be provided for normal growth and development during early childhood. Currently, childcare teachers provide lunch to most children in Korea. The purpose of this study was to investigate the portion size provided by teachers and examine the effect of education on food serving size. Methods: The subjects were childcare teachers (n = 120) in charge of children aged 3–5 years at a daycare center in Hanam-si. The survey was conducted through questionnaires which included questions on the general characteristics of the teachers, their nutritional education status, and the source of nutrition information. In addition, the portion sizes of items on the menu currently provided to children were measured and the data were analyzed. To assess the effectiveness of education in determining serving size, the subjects were randomly equally divided into two groups. In the first group (n = 60) theoretical education on nutrition and serving sizes was given, whereas in the second (n = 60), practical education on these topics was provided. Results: The difference between the actual portion size of rice and the serving size announced on the menu was observed to decrease along with the increase in the experience of the teacher, although the differences in the main dish and kimchi were higher. The gap between the serving size mentioned in the menu and the portion size distributed widened as the age of the teachers increased. Notably, the difference between the portion size and the serving size of food decreased after both practical and theoretical education. Furthermore, the effect of education on the serving size of the main dishes (p < 0.001), side dishes (p < 0.01), and kimchi (p < 0.01) was observed to be greater in the practical education group than in the theoretical education group. Conclusion Regular education should be provided to teachers on the serving sizes mentioned in the menu, as the quantity of food served depends on the experience and age of teachers. In the case of rice, theoretical education alone sufficed to ensure a proper serving size. However, hands-on training on the main and side dishes, and kimchi would be much more helpful.

Purpose: The aims of this systematic review were to identify the study protocol of Virtual Reality Therapy (VRT) and review the effect of VRT among patients with Post-Traumatic Stress Disorder (PTSD). Methods: This review followed the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A systematic literature search was conducted using 12 electronic databases including gray literature with no limit of publication year. Search terms included relevant terms regarding “PTSD”, “trauma”, and “VRT”. Among 265 studies extracted through PRISMA, 20 studies were selected and evaluated for quality assessment using the Risk of Bias tool of Cochrane’s collaboration. Results: The majority of the literature focused on combat veterans and war situations (95%).Usually, each session usually took 60~120 minutes of VRT in 10~20 sessions for 5~10 weeks. The VRT equipment and contents were individually designed considering patients’ traumatic experiences. Most of the studies reported the positive effects associated to reduced levels of PTSD (80%) and related symptoms, such as, depression (45%) and anxiety (25%). Conclusion Based on our findings, further studies are required to evaluate VRT in people with PTSD, after improving study design and standardizing protocols.

PURPOSE: To report a case of pituitary apoplexy presenting as isolated bilateral oculomotor nerve palsy. CASE SUMMARY: A 46-year-old male presented with bilateral ptosis and acute severe headaches for 6 days. He underwent head surgery and bilateral vitrectomy 12 years prior to his visit because of ocular and head trauma. He mentioned that previous visual acuities in both eyes were not good. The initial corrected visual acuity was finger counting in the right eye and 20/500 in the left eye. Ocular motility testing revealed the limitation of adduction, supraduction, and infraduction with complete bilateral ptosis in both eyes, and his left pupil was dilated. He was diagnosed with an isolated bilateral oculomotor nerve palsy. Magnetic resonance imaging indicated pituitary gland hemorrhage with a tumor, which was suspicious of pituitary apoplexy. The patient was treated intravenous with 1.0 g methylprednisolone to prevent the corticotropic deficiency. In addition, he underwent surgical decompression using a navigation-guided transsphenoidal approach and aspiration biopsy. He was confirmed with pituitary adenoma using a pathological examination. The patient's ocular movements began to dramatically improve by the third day postoperatively. At 4 months postoperative follow-up, his ocular movement and double vision were completely recovered. CONCLUSIONS: This was a rare case of pituitary apoplexy with bilateral isolated oculomotor nerve palsy, which was the first report in the Republic of Korea. A full recovery was achieved after early surgical treatment.
Biopsy, Needle ; Cranial Nerve Diseases ; Craniocerebral Trauma ; Decompression, Surgical ; Diplopia ; Fingers ; Follow-Up Studies ; Head ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Male ; Methylprednisolone ; Middle Aged ; Oculomotor Nerve Diseases ; Oculomotor Nerve ; Pituitary Apoplexy ; Pituitary Gland ; Pituitary Neoplasms ; Pupil ; Republic of Korea ; Visual Acuity ; Vitrectomy

Sudden sensorineural hearing loss (SNHL) is rarely presented in patients with several immune-mediated inflammatory diseases. We report a case of sudden SNHL in a patient with axial spondyloarthritis (aSpA). A 29-year-old male with aSpA was admitted for sudden unilateral hearing loss. His aSpA symptom was stable; however, pure tone audiometry revealed that he had SNHL in the left ear at low frequency. His hearing was fully recovered with systemic and local steroid therapy. This case suggests that sudden SNHL may be an extra-articular manifestation of aSpA and thus need prompt steroid therapy in order to restore hearing.
Audiometry ; Ear ; Hearing ; Hearing Loss, Sensorineural ; Hearing Loss, Unilateral ; Humans ; Male ; Spondylitis, Ankylosing