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외래 및 퇴원환아 부모의 전화상담요구와 간호중재에 대한 조사연구
강화자,한경자,최명애,박승현,김영미,권원경,김선구,안혜영,허미영,Kang Hwa Ja,Han Kyung Ja,Choe Myoung Ae,Park Seung Hyun,Kim Young Mi,Kwon Won Kyoung,Kim Sun Gu,Ahn Hye Young,Heo Mi Young 한국아동간호학회 1996 Child Health Nursing Research Vol.2 No.1
The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.
거대 자궁 근종의 복식 전 자궁 절제술 후 발생한 폐색전증
이립 ( Rippy Lee ),정미화 ( Young Ryong Choi ),최영룡 ( Mi Hwa Chung ),최은미 ( Eun Mi Choi ),강화자 ( Wha Ja Kang ) 경희대학교 경희의료원 2011 慶熙醫學 Vol.27 No.1
We report a case of pulmonary embolism on 2nd postoperative day of total abdominal hysterectomy under general anesthesia. Patient was transfused preoperatively because of severe anemia, but she did not undergo any diagnostic test for pulmonary embolism and prophylactic trial because there was no symptom and sign that can predict pulmonary embolism. On the morning of 2nd postoperative day, with first ambulation, patient showed abrupt symptom and sign such as dyspnea, tachypnea, drowsy mental status, hypotension and hypoxemia. Under suspecting pulmonary embolism, patient was sent to intensive care unit and cardiopulmonary resuscitation was done. After 2 hours from first symptom and sign patient died. Pulmonary embolism was diagnosed on autopsy and the cause of death was cardiac arrest by pulmonary embolism.
임상연구 : 폐쇄성 수면 모호흡 환자의 기관내 삽관 난이도 예측
장지혜 ( Ji Hye Jang ),신옥영 ( Ok Young Shin ),강화자 ( Hwa Ja Kang ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.4
Background: Patients with obstructive sleep apnea (OSA) may exhibit difficult endotracheal intubation and mask ventilation because of anatomical abnormalities of their upper airway. Many anesthesiologists try to predict difficult endotracheal intubation using simple bedside screening tests. Among these tests, modified Mallampati test (MMT) is the most popular one, but a newer method, called upper lip bite test (ULBT) has been investigated. We compared the clinical accuracy of modified Mallampati test and upper lip bite test for patients with OSA. Methods: 65 patients with OSA were included in the study. Preoperatively, anestheiologist not involved in endotracheal intubation evaluated patient`s airway with MMT and ULBT. Another anesthesiologist assessed the direct laryngoscopic grade. Using Fisher`s exact test, we analyzed the correlation of MMT and ULBT with direct laryngoscopic grade and calculated the sensitivity, specificity, positive predictive value and negative predictive value. Furthermore, AUC of ROC (area under a receiver operating characteristic) curve were used to estimate the predictive accuracy of each tests. Results: MMT grade III, IV and ULBT class III was significantly correlated with Cormack-Lehane grade III, IV (P < 0.05). The ULBT showed higher specificity and positive predictive value, but sensitivity and negative predictive value were higher in MMT. AUC of ROC curve was poor for MMT (0.656) and ULBT (0.617). Conclusions: These results suggest that MMT and ULBT has a poor diagnostic accuracy for predicting difficult intubation in OSA patients as a single bedside screening test. (Korean J Anesthesiol 2006; 50: 367~72)