Purpose: Bariatric surgery is the gold standard for the treatment of morbid obesity, but postoperative pain impedes recovery. Currently available pain-recovery treatments have patient safety concerns. This led to a noninferiority study of Welpass (Genewel Co., Ltd.) vs. On-Q PainBuster (B. Braun), each used alongside a traditional method of continuous local anesthetic administration, in patients undergoing bariatric surgery. Methods: In this single-center prospective randomized clinical trial, patients were assigned in a 1:1 ratio to the treatment group (Welpass) and the control group (On-Q PainBuster), with ketorolac administered as needed after surgery according to the protocol. To assess efficacy, the total amount of ketorolac used up to 72 hours postoperatively was measured.Additionally, ketorolac usage and numerical rating scales (NRS) were recorded at 6, 24, 48, and 72 hours after operation. Results: The total amounts of ketorolac used in the 72 hours postoperatively were 188.0 ± 84.6 mg in the treatment group and 198.7 ± 50.0 mg in the control group. The efficacy of the treatment group was noninferior to that of the control group, since the lower limit (–29.9 mg) of the confidence interval for the difference with the control group was greater than the prespecified noninferiority margin (–35.0 mg). Furthermore, when the NRS was evaluated after bariatric surgery, there was no significant difference in scores between the 2 groups at each time point (P > 0.05). Conclusion We found no difference in effect on pain between the 2 groups, supporting the use of Welpass in clinical practice for pain management in patients undergoing bariatric surgery.

PURPOSE: This study aimed to examine influence of cognitive function, disease severity and disability on ability to perform activity of daily living (ADL) after ischemic stroke. METHODS: A total of 88 patients with ischemic stroke were recruited from January 1, 2008 to December 31, 2012 and assessed with the standardized cognitive test battery and self-reports about disease severity, disability, and ADL. To analyze the data, ANOVA, Pearson correlation coefficients and multiple regression were conducted using SPSS/WIN program. RESULTS: Significant correlations were found between ADL and visuospatial function, visual memory, executive function, and disability (r=.29~.38). Executive function and disability explained 17.3% of total variability in ADL performance after ischemic stroke. CONCLUSION: Executive function may be a promising target for cognitive rehabilitation after ischemic stroke. Thus, effective therapeutic interventions such as cognitive training for stroke patients should be considered to improve their ability to perform ADL.
Activities of Daily Living* ; Cognition ; Executive Function ; Humans ; Memory ; Rehabilitation ; Severity of Illness Index ; Stroke*

PURPOSE: The purpose of this study was to identify the effects of heating on the non-affected hand on blood flow velocity, wound healing, and pain for hand microsurgery patients. METHODS: This study was designed using the nonequivalent control group pretest-posttest design. Thirty-nine patients were assigned either to the experimental group (20 patients) or control group (19 patients). Data were analyzed with chi2-test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 17.0 program. RESULTS: After treatment in this program, blood flow velocity (F=5.13, p=.008) and wound healing (F=4.11, p=.020) improved significantly in the experimental group compared to the control group. But there was no significant improvement in pain in the experimental group compared to the control group (F=2.40, p=.097). CONCLUSION: Based upon these results, the non-affected side hand heating was recommended as an independent nursing intervention for the patients who need improvement in blood flow velocity and wound healing such as patients who have microsurgery. As the heating was effective even when applied on the non-affected side, it is the applicable to patients who cannot tolerate any therapy on affected side.
Adult ; Blood Flow Velocity/*physiology ; Female ; Hand Injuries/surgery/*therapy ; Humans ; Hyperthermia, Induced ; Male ; *Pain Measurement ; Time Factors ; Wound Healing/*physiology

PURPOSE: The purpose of this study was to identify from the International Classification of Functioning model, factors influencing quality of life in elderly persons and to describe the concrete pathway of influence and the power of each variable. METHODS: The sample included 334 elders who lived in 5 districts of D Metropolitan City. A structured questionnaire was used and the collected data were analyzed for fitness, using the AMOS 18.0 program. RESULTS: This model was concise and extensive in predicting the quality of life of elders. The research verified the factors influencing quality of life for elders as direct factors such as activity of daily living (ADL) (beta=.13, t=2.47), leisure activity (beta=.55, t=5.04), social disengagement (beta=-.25, t=-2.25), and depression (beta=-.62, t=-10.86). Indirect factors including economic status (gamma=.17, p=.009), type of residence (gamma=.19, p=.004), ADL (gamma=.12, p=.027) were important factors in predicting quality of life for elders. These variables explained 75.6% of variance in the prediction model. CONCLUSION: The findings indicate a need for the nursing scientific community to develop intervention programs considering these variables to improve the quality of life for elders.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Depression ; Female ; Humans ; Leisure Activities ; Male ; *Models, Psychological ; *Quality of Life ; Questionnaires ; Socioeconomic Factors

PURPOSE: The purpose of this study was to examine the effects of a day care rehabilitation program managed by nurses on physical and emotional function of patients with job-related injuries. METHOD: A one group pre-test and post-test quasi-experimental design was used. Thirty patients participated in a day care rehabilitation program and 9% of those were unable to complete the 16 weeks program due to absence. The physiotherapist, occupational therapist, and clinical psychologist offered the day care rehabilitation program, 5 times a week for 16 weeks. Outcome measures included physical and emotional function. RESULTS: The program participants had significantly greater motor function (t=-2.85, p=.008) and activity of daily living (t=-5.34, p<.001), and lower depression (t=5.20, p<.001), state anxiety (t=4.71, p<.001), and trait anxiety (t=4.40, p<.001). CONCLUSION: The nurse managed day care rehabilitation program significantly improved physical and emotional function in patients with job-related injuries. The program should be further tested in a larger sample to validate the findings.
Accidents, Occupational ; Anxiety ; Day Care, Medical ; Depression ; Humans ; Outcome Assessment (Health Care) ; Physical Therapists

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.
Absorptiometry, Photon ; American Heart Association ; Blood Pressure ; Body Mass Index ; Body Weight ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Exercise ; Female ; Femur ; Health Promotion ; Humans ; Lipoproteins ; Lumbar Vertebrae ; Menopause ; Obesity ; Osteoporosis ; Reference Values ; Risk Factors

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.
Absorptiometry, Photon ; American Heart Association ; Blood Pressure ; Body Mass Index ; Body Weight ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Exercise ; Female ; Femur ; Health Promotion ; Humans ; Lipoproteins ; Lumbar Vertebrae ; Menopause ; Obesity ; Osteoporosis ; Reference Values ; Risk Factors

PURPOSE: The purpose of this study was to examine the effects of Tai Chi exercise on flexibility, balance, walking ability, muscle strength, bone mineral density, and fracture risk in institutionalized elders. METHOD: A quasi-experimental pretest-posttest design with a nonequivalent comparison group was utilized, and 53 older adults living in one institution were recruited and assigned to one of two groups, experimental group (18) or comparison (20). Both groups completed posttest measures at 6 months. There was a 31% rate of dropouts. Tai Chi exercise was provided twice a week for 24 weeks. Outcome measurements were conducted by a physiotherapist at a university hospital health promotion center who did not know the group assignment. RESULTS: At 6 months, the experimental group had significantly greater grip strength(t=2.12, p=.04), back muscle strength (t=2.42, p=.02), balance (t=5.31, p<.001), and flexibility (t=3.57, p<.001). They also showed significantly greater bone mineral density of lumbar spine and femur, and reduced fracture risk. CONCLUSION: Tai Chi exercise was safely and effectively used with institutionalized elders for 6 months and significantly improved physical fitness, bone mineral density along with a reduction in fracture risk. Whether Tai Chi exercise would lead to prevention of fall episodes and fall related fractures in this population will require further study.
Adult ; Aged ; Bone Density ; Femur ; Fractures, Bone ; Hand Strength ; Health Promotion ; Humans ; Muscle Strength ; Patient Dropouts ; Physical Fitness ; Physical Therapists ; Pliability ; Postural Balance ; Spine ; Tai Ji ; Walking

PURPOSE: The purposes of this study were to explore changes in pain, mood and the level of posttrauma risk for 2 weeks after acute hand microsurgery and determine predictors of pain 2-week after microsurgery. METHOD: Using a sample of 84 patients with hand microsurgery, pain, mood, and posttrauma risk were measured by the Brief Pain Inventory-Korea, the modified Profile of mood states, and the Posttrauma risk checklist at 1-day, 1-week and 2-week post-microsurgery. Repeated measures ANOVA and Multiple regression analysis were conducted to evaluate changes in pain, mood, and posttrauma risk over time after the surgery and determine predictors of pain 2-week after the surgery. RESULTS: Pain significantly decreased (F=63.22, p<.001), mood significantly improved (F=41.04, p<.001) 2 weeks after microsurgery and interestingly, posttrauma risk significantly decreased from baseline to 1-week microsurgery but increased at 2-week after microsurgery (F=24.66, p<.001). Approximately 57% of the variance of pain 2-week post-microsurgery was explained by pain at 1-week post-microsurgery, mood and the numbers of injured fingers. CONCLUSION: The findings suggest the pain control for 1week after acute surgery being critical and posttrauma rehabilitation of injured finger being necessary. Developing nursing interventions is urgently needed to help individuals with impending hand microsurgery.
Checklist ; Fingers ; Hand ; Hand Injuries ; Humans ; Microsurgery

PURPOSE: Death is an important problem for physicians and parents in neonatal intensive care unit. This study was intended to evaluate the mortality rate, causes of death, and the change of mortality rate by year for infants admitted to the neonatal intensive care unit. METHODS: We retrospectively surveyed the medical records of the infants who were admitted to the neonatal intensive care unit at Asan Medical Center and who died before discharge between 1998 and 2007. Gestational age, birth weight, gender, time to death and the underlying diseases related to the causes of infant deaths and obtained from the medical records and analyzed according to year. RESULTS: A total of 6,289 infants were admitted and 264 infants died during the study period. The overall mortality rate was 4.2%. For very low and extremely low birth weight infants, the mortality rate was 10.6% and 21.4%, respectively. There was no significant change in the mortality rate during the study period. Prematurity related complications and congenital anomalies were the conditions most frequently associated with death in the neonatal intensive care unit. of the infant deaths 37.1% occurred within the first week of life. CONCLUSION: Even though a remarkable improvement in neonatal intensive care has been achieved in recent years, the overall mortality rate has not changed. To reduce the mortality rate, it is important to control sepsis and prevent premature births. The first postnatal week is a critical period for deaths in the neonatal intensive care unit.
Birth Weight ; Cause of Death ; Critical Period (Psychology) ; Gestational Age ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Medical Records ; Parents ; Premature Birth ; Retrospective Studies ; Sepsis