체온조절과 수술후 저체온 : A review

손정태 김천과학대학 1993 김천과학대학 논문집 Vol.19 No.-

The human body needs to maintain a core temperature between 36℃ to 38℃(96.8℉to 100.4℉) to carry on cellular metabolism essential for life: below 36℃(96.8℉) hypothermia occurs. General anesthesia decreases core body temperature by depressing hypothalamic thermoregulating centers. Skeletal muscle relaxants and CNS depressants also abolish shivering and eliminate motor activity: thus the body lose its natural ability to increase heat production and become poikilothermic. Ulnder spinal anesthesia patients lose heat distal to the level of block because of vasodilatation of blocked segments. Other contributors of intraoperative heat loss are cold stress of the OR, exposed sedated patients, unwarmed fluid therapy, cold surgical preparation solutions, open body cavities and blood loss during operation. All of these combined to make inadvertent intraoperative hypothermia, one of the most complication of modern surgical practice under anesthesia. The adverse effects of the hypothermia are cardiac arrhythmia, decreased oxygen availability, metabolic acidosis, hyperglycemia, depressed CNS and coma so on. Because of little can be done to increase heat production in the anesthetized patient, most efforts to prevent hypothermia should be directed at reducing heat loss. Keeping the patient covered as much as possible while in the OR should considered routine. If the large volume of Ⅳ fluids are predicted, a fluid warmer should be used. During transfusion blood warmer should be used. Warming blanket(fluid filled circulating blanket) or electric blanket can be placed under the patient on the operating table. However its placement and efficacy is limited by the patients, patient's operative position. Heated and humidified anesthetic gases also help to maintain the body temperature. Radiant heat devices (Radiant heat lamp, heat cradle and Infrared lamp) are useful for patients who experinced post operative shivering. Radiant heat control shivering by increasing cutaneous thermal input to the hypothalamic temperature regulating center. Vigorous skin surface warming prevents shivering and provides a feeling of thermal comfort even when the patient remains markedly hypothermic. The OR nurse should establish protocols and be instrumental in maintaining the body temperatures within the normal range.

개심술후 전율에 대한 간호중재

손정태 김천과학대학 1995 김천과학대학 논문집 Vol.21 No.-

This article reviews within nursing context what is known about postoperative shivering after cardiac surgery Physiologic concepts and principles related to cold induced shivering are included. Research findings are discussed as they related to specific nursing intervention goals. After cardiac surgery, the patient is particularly vulnerable to the candiorespiratory demands and the metabolic consequences of shivering. Myocardial oxygen consumption increases during shivering and reflects increases in heart rate and mean arterial pressure. And also, carbon dioxide production increases with intensity of shivering. But the efficiency of shivering in rewarming the hypothermic patient has been estimated at only 11%. Abbey provided a conceptual approach to nursing interention for shivering in clinical situation. Her approach can be used to plan interventions for shivering in the patient undergoing cardiac surgery. Abbey suggested five goals for nursing intervention and action related to shivering based on physiologic principles of heat loss and shivering stimulus: (1) reporting the phenomenon, (2) restoring lost heat, (3) modifying the rate of heat loss, (4) altering the physiologic determination of heat loss and, (5) preventing the response by drug administration. The perception of physiologic response to shivering are another dimension relatively untouched by research. There is need for researches that explored emotional distress of patient awareness of uncontrolled shivering during emergence from anesthesia. In the futrue researches, with new information about shivering mechanism may possibly find effective nonpharmacologic measures for halting this complication. Specific actions to accomplish intervention goals must continually be developed, tested, and shared with professional collegues.

익산 경주마 육성목장 건설 - 갈등과 반목에서 추진하기까지

손정태 열린전북 2000 열린전북 Vol.13 No.-

一部 病院 首看護員의 業務 分析

孫貞台 김천과학대학 1981 김천과학대학 논문집 Vol.9 No.-

A study on the nursing activities of head nureses was carried out during the peried of July, 20-August,21. 1981. in in-patient units of hospitals located in Daegu. The purpose of this study was to determine the specific areas of nursing activities performed by head nurses, especially to find out, amount of time spent for paper work and find out its kind. For this study total 12 head nurses were engaged in the 12 wards of 2Hospitals, Each head nurse wars observed for 5days from Monday to Friday. For a continous time study employed in this study 12 nursing students worked as the observer after the special training prior to the study The results were as followes. 1. Self - movement activies occupied 57.1% of the total observation time. 2. Paper works occupied 28.2% of the total observation time. 3. Among the direct nursing care, "Ward rounding" occupied 25.8% with the proportion 4. Anong the indirect, nursing care performed by head nurses "Listening to or giving the morning, afternoon, evening report" occupied 42.8% with the highest proportion. 5. Head nurse of the N.S. & ENT.unit of K.Hospital. was carried out "Nursing education" for students for 159min.(51.9%). 6. K.Hospital accesed on the management of equipment and supplies, on the contrary F.hospital accessed on the management of hospital environment. 7. Among the patient centered paper work, "Order check" occupied 46.7% (K. Hospital), and 64.6 % (F.Hospital) with the highest proportion.

경북도내 일부 초ㆍ중학교의 양호실 실태조사

孫貞台,金玉蘭 김천과학대학 1982 김천과학대학 논문집 Vol.10 No.-

In order to find out the situation of nursing room of primary and middle schools in kyung Sang Boog Do, this study examined, opened for two weeks from June 26, to August 6, 1982, in seminar of teacher with an additianal position of nurse of primary and middle schools. Study population was 58 teachers presently engaged in primary and middle schools. An analysis of the data collected showed the following findings: 1. General composition of teachers with an additional position of nurse : In sex deference women(85.5%) was more than men(15.5%) There was the highest in age group of 20-24. Unmarried teacher(43.1%) was more than married(43.1%) and a class teacher was 98.3%. In the experiences of teacher, under 5 years(62.1%) was the highest. An academic background in primary schools, there was the most college of teaching(55.6%), in middle, university (90.9%) In a subject of special study in middle, the most domestic economics(50.0%). 2. The size of their schools In number of schools, the primary schools was 62.1% the middle 37.9%. In class, the primary was 98.2% under 18 class, the middle 63.6% under 9, and in number of pupil the primary was the most the number of 100-199(47.2%), in the middle was 400-499(31.8%) 3. The whole of school health nursing The place of activities for school nursing room : the instruction department used the most(60.3%) health record card : was 89.7% the teaching hour of health : to get accomplished in class study was 51.7% and was 84.5% by the class teacher health examination :used class was the most(89.7%) the instrument of psysical examination was the average 59.5% the utilization rate appealed 77.1%. medical emergency drugs was the average 91.2% the utilization rate appealed 100%. the commen equipment of nursing room was the average 29.6%, the utilization rate appealed 55.3%. the audiovisual teaching material was the average 50.9% the utilization rate appealed 54.0%.

태극권 운동이 류마티스관절염 환자의 주관적 증상, 체력, 우울 및 자기효능감에 미치는 효과: 3개년 자료를 바탕으로

손정태,황혜영 대한근관절건강학회 2018 근관절건강학회지 Vol.25 No.3

Purpose: The purpose of this study was to evaluate whether subjective symptoms, physical fitness, and emotional variables were improved after participating in a 6-week Tai Chi program in patients with rheumatoid arthritis. Methods: 23 rheumatoid arthritis patients participated in the Yang style Tai Chi for arthritis patients 90 minutes session conducted twice a week at the Arthritis Center of D University Hospital. The main outcome of current studies included self-reported scores of subjective symptoms(pain, sleep satisfaction, and fatigue), physical fitness tests, and depression (PHQ-9) and self-efficacy investigated with questionnaire before and after participating in Tai Chi. Results: After participating in Tai Chi, participants perceived lesser pain (t=2.61, p=.016) and fatigue (Z=-2.32, p=.020), and reported improved sleep satisfaction (t=-3.56, p=.002). In the physical fitness test, there were significant improvement in muscle strength (upper limb: t=-7.19, p<.001, lower limb: t=-4.86, p<.001), and balance (right t=-3.70, p=.001; left t=-2.30, p=.031). Depression (t=3.87, p=.001) and self-efficacy (Z=-3.44, p=.001) improved significantly after participating in Tai Chi. Conclusion: Tai Chi had beneficial effects on subjective symptoms and emotional variables as well as physical fitness. Therefore, the program could be recommended in the patients with rheumatoid arthritis.

기관내흡인 간호에 대한 일 조사연구

손정태 김천과학대학 1996 김천과학대학 논문집 Vol.22 No.-

수술후 전율 경험에 대한 조사연구 : Incidences and thermal discomfart

손정태,노명희 김천과학대학 1993 김천과학대학 논문집 Vol.19 No.-

Frequency of postoperative shivering and thermal discomfort of 62 patients who were admitted in recovery room were determined by interview and review of patients' charts. In addition, the influence of age, operative procedure, type of anesthesia, duration of operation and amount of infused fluid were assessed. Results were as follows. Postoperative body temperaure of the subjects, 36.1±0.7℃, was significantly higher than the preoperative body temperature, 36.7±0.3℃. 50% of the subjects experienced postoperative shivering. 70.4% of the hypothermic subjects(postoperative temperature<36.0℃) experienced postoperative shivering. There was no significant differences in frequency of shivering according to age, sex, operative procedure and intraoperative fluids but spinal anesthesia and operation time were significantly related with incidence of shivering. Most of the subjects who experienced shivering complained severe thermal discomfort and no specific nursing intervention for the subjects was done.

하천의 어제, 오늘 그리고 내일 1 - 밀양 청도천(淸道川:일명, 내진천)의 어제

손정태,Son, Jeong-Tae 한국하천협회 2011 하천과 문화 Vol.7 No.3

병원 간호역할 중 의사소통에 관한 일 조사연구

손정태,김정남,석태옥 간호사 1979 월간 看護 Vol.1979 No.1