PURPOSE: The purpose of this study was to identify the factors associated with the discontinuation of patient controlled analgesia (PCA) after surgery. METHODS: The data of 1,092 adult patients that were over 20 years of age and underwent PCA after surgery in the Gachon University Hospital from May 1 to June 30, 2017, were collected through the patients' Electronic Medical Record (EMR). The collected data was analyzed via the use of the Chi-test, t-test and multivariate logistic regression analysis using SPSS 18.0 program. RESULTS: The postoperative PCA discontinuation rate was 26.1%. It was associated with various symptoms, such as those of nausea, dizziness, and headache. The PCA discontinuation was also related with female (odds ratio, OR=1.75; confidence interval, CI=1.09–2.82), nausea (OR=105.27; CI=61.03–181.58), total intravenous anesthesia (TIVA) of the thyroidectomy (OR=10.43; CI=5.01–21.70). CONCLUSION: It is necessary to provide additional medication and nursing interventions to reduce nausea, which is the symptom associated with PCA discontinuation, especially in the operation of female subjects and thyroidectomy under TIVA. That is, those who are at a high risk for PCA discontinuation should be able to administer additional antiemetics or reduce non medication nursing interventions.
Adult ; Analgesia, Patient-Controlled ; Anesthesia, Intravenous ; Antiemetics ; Dizziness ; Electronic Health Records ; Female ; Headache ; Humans ; Logistic Models ; Nausea ; Nursing ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Thyroidectomy

PURPOSE: The purpose of this integrative review was to synthesize the available research on educational programs for the management of childhood atopic dermatitis. METHODS: Articles were retrieved from the following databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PubMed, and SCOPUS. Inclusion criteria were publication in the English or Korean language prior to March 2013, as a peer-reviewed empirical study focused on educational programs for childhood atopic dermatitis. RESULTS: Fifteen papers met the inclusion criteria. Four themes were derived from the data: (a) children of all ages and symptom severity, and their families as learners; (b) well-trained and family-preferred health professionals as educators; (c) long-term follow-up with diverse interventions as educational methods; and (d) quality of life for the child and family as educational goals. CONCLUSIONS: This review indicates the challenges that health professionals face in improving symptoms of atopic dermatitis. The identified strategies can be used in the development of more effective evidencebased programs. Future studies should focus on the development and evaluation of educational programs that include these themes.
Adolescent ; Caregivers ; Child ; Child, Preschool ; Dermatitis, Atopic/*therapy ; Empirical Research ; Humans ; Infant ; Infant, Newborn ; Parents ; *Patient Education as Topic

PURPOSE: The purpose of this study was to investigate the incidence of osteoporosis and falls and their consequences, and to identify predictors of fracture risk in the postmenopausal women. METHODS: A total of 687 postmenopausal women were recruited through a stratified convenience sampling. A structured questionnaire was used to obtain osteoporosis and fall history and details of their most recent fall. To predict fracture risk factors, we collected demographic and physical health variables related osteoporosis and fall. Fracture risk was measured by FRAX(R) to calculate 10-year probability of major osteoporotic and hip fracture. RESULTS: The prevalence of osteoporosis was 22.1%, and 66.4% of them had treatments for osteoporosis. The incidence of falls during the past year was 19.2% and 38.6% of those who fell suffered consequent fractures. Women with history of osteoporosis and falls were significant predictors of 10-year probability of major osteoporotic and hip fracture. Other significant predictors were history of fracture, chronic disease, surgical menopause, lower BMI, poorer perceived health and no job. CONCLUSION: It appears that history of osteoporosis and falls are main predictors of fracture risk. Nursing assessment should be performed by detail history taking for osteoporosis, fall, chronic disease, and fracture to screen fracture risk group among postmenopausal women.
Chronic Disease ; Female ; Hip ; Humans ; Incidence ; Menopause ; Nursing Assessment ; Osteoporosis ; Prevalence ; Surveys and Questionnaires ; Risk Factors

PURPOSE: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. METHODS: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. RESULTS: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. CONCLUSION: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.
Activities of Daily Living ; Dementia/physiopathology ; Humans ; Inpatients/*psychology ; Long-Term Care ; National Health Programs ; Nursing Staff, Hospital/psychology/*statistics & numerical data ; Personnel Turnover ; Pressure Ulcer/etiology ; *Quality Indicators, Health Care ; Risk Factors

Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data. Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on the bed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x 2 test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission. Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00). Conclusion To reduce the patient mortality, it is necessary to ensure a sufficient number of nurses by improving the nursing fee system according to the nurse staffing level.

PURPOSE: To determine feasibility of RapidArc in sequential or simultaneous integrated tumor boost in whole brain radiation therapy (WBRT) for poor prognostic patients with four or more brain metastases. MATERIALS AND METHODS: Nine patients with multiple (> or =4) brain metastases were analyzed. Three patients were classified as class II in recursive partitioning analysis and 6 were class III. The class III patients presented with hemiparesis, cognitive deficit, or apraxia. The ratio of tumor to whole brain volume was 0.8-7.9%. Six patients received 2-dimensional bilateral WBRT, (30 Gy/10-12 fractions), followed by sequential RapidArc tumor boost (15-30 Gy/4-10 fractions). Three patients received RapidArc WBRT with simultaneous integrated boost to tumors (48-50 Gy) in 10-20 fractions. RESULTS: The median biologically effective dose to metastatic tumors was 68.1 Gy10 and 67.2 Gy10 and the median brain volume irradiated more than 100 Gy3 were 1.9% (24 cm3) and 0.8% (13 cm3) for each group. With less than 3 minutes of treatment time, RapidArc was easily applied to the patients with poor performance status. The follow-up period was 0.3-16.5 months. Tumor responses among the 6 patients who underwent follow-up magnetic resonance imaging were partial and stable in 3 and 3, respectively. Overall survival at 6 and 12 months were 66.7% and 41.7%, respectively. The local progression-free survival at 6 and 12 months were 100% and 62.5%, respectively. CONCLUSION: RapidArc as a component in whole brain radiation therapy for poor prognostic, multiple brain metastases is an effective and safe modality with easy application.
Apraxias ; Brain ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Paresis ; Radiotherapy, Intensity-Modulated

PURPOSE: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. METHODS: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient’s pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. RESULTS: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). CONCLUSION: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.
Analgesics* ; Drug Therapy ; Education ; Hand* ; Hospice Care ; Hospices ; Humans ; Massage* ; Non-Randomized Controlled Trials as Topic

Purpose: This study aimed to analyze the tasks of midwives who lead natural childbirth in hospitals using the DACUM technique. Methods: Data were collected from 42 hospital midwives between August 23 to October 12, 2022, and the importance, frequency, and professional difficulty of hospital midwives' tasks were assessed. The collected data were analysed using the IBM SPSS Statistics ver. 22.0 program as the average and standard deviation for the importance, difficulty, and frequency of performance the analyzed tasks. The importance, difficulty, and frequency of performance each task were indicated as high, medium, or low,; furthermore, the importance and difficulty were multiplied and analyzed using the coefficient of determination.Result: Midwives’ tasks in natural childbirth in hospitals were classified into 8 duties, 138 tasks, and 49 task elements. Duties were classified into ‘before childbirth,’ ‘during childbirth,’ ‘after childbirth,’ ‘management of high-risk pregnant women,’ ‘goods management,’ ‘administrative work,’ ‘self-development,’ and ‘newborn care.’ The most important and difficult tasks with the highest coefficient of determination were performing neonatal resuscitation if necessary (11.25), transporting and managing emergency patients (10.46), requesting hospitals to transfer patients in case of emergency (10.43), and transferring patients to a tertiary hospital in case of maternal of neonatal emergency (10.30). Conclusion In this novel study in Korea, the role of a midwife in a hospital for natural childbirth were defined, and task according to duties were analyzed.

No abstract available.
Animals ; Busulfan* ; Fetal Blood* ; Humans* ; Infant, Newborn* ; Liver* ; Mice* ; Umbilical Cord*

PURPOSE: Increase in the use of diagnostic imaging or occupational exposure to radiation have brought upon concerns on the safety and biological effects of low- or moderate-dose radiation. However, limited information is available on the effects of low or moderate dose radiation on human health. METHODS: Using C57BL/6 mice, we aimed to evaluate the biological effects of low- and moderate-dose radiation on the immune system. X-rays was chosen as a radiation source and we analyzed complete blood counts, various lymphocyte subsets and various cytokine levels after single fraction x-ray exposure (0.1 Gy, 1 Gy). RESULTS: No significant changes in the immunologic parameter of C57BL/6 mice were observed after radiation, except LIX (a cytokine equivalent to human CXCL5), that showed higher level after 0.1 Gy radiation compared to the control. CONCLUSION: We observed that a single fraction of low or moderate dose of X-ray radiation does not cause significant changes in the immune system of C57BL/6 mice. Further studies are necessary to elucidate the mechanism underlying our results.
Animals ; Blood Cell Count ; Diagnostic Imaging ; Humans ; Immune System* ; Lymphocyte Subsets ; Mice* ; Occupational Exposure ; Radiation Dosage