소동맥 폐쇄증에서의 급성 반응성 단백

성영희 대한뇌졸중학회 2006 Journal of stroke Vol.8 No.2

Background:Inflammatory processes are implied in the pathogenesis of atherosclerosis and are a risk factor for myocardial infarction, stroke, and peripheral arterial disease. We assessed whether acute reactive protein such as C-reactive protein (CRP) and fibrinogen levels are related to small-vessel occlusion. Methods:Six hundred twelve patients with acute ischemic stroke and one hundred thirteen control subjects who visited Gil Medical Center between March 2004 and February 2005 were enrolled in this study. Acute ischemic stroke was classified by TOAST classification. Among these patients, large artery disease (LAD), small vessel occlusion (SVO) patients uncomplicated by infection were included, and cardioembolic (CE), stoke of others determined cause (SOD) and stoke of undetermined etiology (SUE) were excluded. CRP and fibrinogen were measured during the first 48 hours after stroke onset. We analyzed the risk factor and acute reactive protein in each group. Results:Among the 612 patients with acute ischemic stroke patients, 235 had LAA and 213 had SVO. There was no significant difference in clinical characteristics between groups. LAA group had higher CRP and fibrinogen levels than SVO or control group. The CRP level was higher in SVO group than control group (p=0.041), but the fibrinogen showed no significant difference between two groups (p=0.302). Conclusion:The CRP may be involved in the pathophysiology of small-vessel occlusion as well as large-artery atherosclerosis. (Korean Journal of Stroke 2006;8:187-190)

병원감염관리에 관한 간호대학생의 지식 및 실천에 관한 연구

성영희,남혜경 한국직업건강간호학회 2006 한국직업건강간호학회지 Vol.15 No.1

급성뇌경색 환자에서 국내 신경과 전문의의 정맥내 헤파린 투여 사용 실태

성영희 대한뇌졸중학회 2003 Journal of stroke Vol.5 No.2

Department of Neurology Hallym University College of MedicineBackground and Purpose: The use of intravenous(IV) heparin in acute ischemic stroke has been an area of great controversy. We sought to get the current practice patterns of Korean board certificated neurologists(KBCN) with regard to heparin use in acute ischemic stroke. Methods: A survey was taken of 657 KBCNs. The e-mail address and subspecialty were obtained from both the History of Korean Neurological Association(1982-2002) and the directory of Korean Stroke Society. Brief vignettes were presented via electronic mailing system for the following five scenarios: progressive stroke, cardiogenic embolism, posterior circulation, external carotid artery stenosis, repetitive TIA. For each vignette respondents were asked whether they would use IV heparin with response choice such as 'yes', may be’and ‘no’. Results: Two hundred and thirty three (46.5%) KBCNs returned a completed survey. In progressive stroke, 157 respondents (67.4%) replied ‘yes’, 48 (20.6%) replied ‘maybe’, and 28(12.0%) would not use I.V. heparin. In cardiogenic embolism, 169 respondents (72.5%) replied that they would use, 46 (19.7%) replied maybe, and 18(7.7%) would not use I.V. heparin. In posterior circulation stroke, 122 respondents (52.4%) would use I.V. heparin, 60 (25.8%) maybe use, 51(21.9%) would not use I.V. heparin. In ECA stenosis, 104 respondents (44.6%) would use, 70 (30.0%) maybe use, and 59 (25.3%) would not use I.V. heparin. In repetitive TIA, 173 respondents (74.2%) would use, 29 (12.4%) maybe use, and 31 (13.3%) would not use I.V. heparin. The usage pattern of I.V. heparin in each vignette was not affected by age, current teaching status and subspecialty of stroke. Compared to results found in American study in 2001, KCBNs were significantly more likely to use IV heparin in four clinical scenarios, except in cardiogenic embolism. Conclusion: Although most therapeutic guidelines for anticoagulants in acute ischemic stroke do not recommend IV heparin for any specific group of acute ischemic stroke that is based on any presumed stroke mechanism or location, Neurologists in Korea would use intravenous heparin in large numbers for these conditions.

암 환자의 증상경험과 가정간호항목별 가정간호 인식도 및 가정간호 요구도

성영희,황문숙,임수진,Sung, Young-Hee,Hwang, Moon-Sook,Lim, Su-Jin 한국가정간호학회 2010 가정간호학회지 Vol.17 No.1

Purpose: This study sought to provide basic information for the establishment of home care nursing system in cancer patients. Methods: Data were collected by the descriptive questionnaires consisting of 42 articles from five fields of nursing services. Patient's symptoms were investigated by the Korean version of EORTC QLQ-C30. Data were analysed using SPSS-PC 12.0. Results: Among the cancer patients (n=182), 40.1% had serious limitations on their usual lives. 74.7% had serious economic burdens. 79.7% agreed strongly with the necessity of home care nursing system, 74.2% were willing to use home care nursing, and 91.2% felt that home care nursing should be mandatory in cancer centers. There was no correlation between the frequency of symptoms or nursing items and the degree of home care nursing requirements. Digestive symptoms, symptoms requiring procedures, and symptoms to meet educational help displayed a high degree of requirement. Conclusion: Home care nursing should be activated for cancer patients as a bridge between hospital-based acute care and community-based chronic care which could increase the quality of care and reduce insurance related payments.

2주기 의료기관 평가를 돌아보며......

성영희 한국의료QA학회 2008 한국의료질향상학회지 Vol.14 No.1

응급실의 환자분류체계 확립을 위한 결정지표 개발 연구

성영희,성일순,이승자,이지향,김정하,문유정,최영미 대한간호행정학회 2006 간호행정학회지 Vol.12 No.3

Purpose: The purpose of the study was to identify critical indicators for the development of efficient patient classification system in a emergency room. Method: This study involved following five steps. Step 1. Selection of the lists direct nursing services in the ER. Step 2. Measurement of the time of direct nursing services from Aug. 31st to Nov. 30th, 2005. Step 3. Classification of the patients according to the nursing care time. Step 4. The determination the critical indicators for different patient classes. Result: Determinate indicators were as follow: 3 items in the first group (vital sign checking, Ⅳ route starting, blood sampling), 3 items in the second group (vital sign checking, fluid infusion, blood sampling), 9 items in the third group (I/O checking, O₂ inhalation, suction, fluid infusion, Ⅳ bolus, Central catheter preparation & management, blood sampling, intubation preparation & management, postmortem management), 7 items in the fourth group (EKG monitoring, BP monitoring, O₂ inhalation, fluid infusion, using the specific drugs, CPR, postmortem management). Conclusion: This study can help future studies which measure nursing services standard time or assigns value to emergency nursing services.

일 병원 간호서비스 질에 대한 소비자와 제공자의 지각차이 비교

성영희,권인각,김미경 병원간호사회 2006 임상간호연구 Vol.12 No.1

Purpose: The purpose of this study was to examine the expectation, performance, and perceived clinical nursing service quality on the basis of the model of SERVQUAL at one of the tertiary hospitals, where the ratio of inpatients to nurses is 2:1, located in Seoul. Method: This study was cross-sectional survey. A convenience sample of 274 customers and 295 providers was obtained. Data were collected through self-reporting questionnaire in 2005. The questionnaire, 5 Likert scale, consists of 20 statements divided into 5 dimensions. The values of Cronbach's α appeared to be 0.98 at the both group. Result: Consumers' expectation of the nursing service was not met in most of service factors except empathy. But the differences between expectation and performances were not statistically significant. Consumers' perception on nursing service quality was significantly higher than that of the nurses. Reliability was perceived the most important dimension of nursing service by customers but tangibles was perceived less important than others. And the item of 'to provide nursing care promptly however busy nurses may be' was pointed as the most urgent item to be improved. Conclusion: To improve the quality of patient-centered nursing service, outstanding nursing service focused on reliability and assurance should be stressed.

정주형 항생제치료에 대한 병원중심 가정간호서비스 효과분석 : 신장이식 후 CMV감염환자 대상으로

성영희,황문숙,류성숙,김성주 병원간호사회 2005 임상간호연구 Vol.10 No.2

Purpose: This study investigated the effect of hospital based home care nursing antibiotic treatment on the adequacy of treatments, amount of patient payment, patients' satisfaction and length of hospital stay. Method: A total of 22 patients(5 hospitalized, 6 home care nursing, and 11 mixed care) who were treated with only Ganciclovir for CMV infection following kidney transplant were analyzed in a comparative way. These subjects underwent kidney transplant at S. General Hospital in the year of 2003. The number of serum CMV antigen, "payment investigation table", and LOPSS to measure the adequacy of treatment, amount of patient payment and patient satisfaction. Data were analyzed with SPSS program by using descriptive statistics and Kruscal-wallis test. Result: Serum CMV antigen for all patients in 3 groups was negative and there was no significant difference among 3 groups in terms of complication(p=.592). The amount of patient payment in 3 groups was statistically different(p<.05). The patient in the home care nursing group paid significantly less amount than the others. There turned out to be no significant difference in patient satisfaction among 3 groups(p=.250). 4. Since the estimated revenue by reducing 165 days of LOS was approximately 51,092,085 won, there was a possibility to increase 106,828,905 won of revenue by expanding home care nursing to all inpatients who were admitted to the hospital by their own choices. Conclusion: This study proves the positive effect of hospital based home care nursing antibiotic treatment on the adequacy of treatment, amount of payment and satisfaction for CMV infected patients following kidney transplant. It is also proven to have a beneficial effect on the revenue of the institute.

파킨슨병에서 안정시 진전의 도파민 치료에 대한 반응 예측 인자

성영희,정선주,김성렬,이명종 대한신경과학회 2007 대한신경과학회지 Vol.25 No.1

Background: The pathophysiology of resting tremor in Parkinsons disease (PD) remains unclear. Dopaminergic treatment provides variable effects on resting tremor in PD. We aimed to evaluate the predictable clinical factors for the levodopa responsiveness of resting tremor in patients with PD. Methods: Eighty-five PD patients with prominent resting tremor who visited Asan Medical Center between June 2004 and June 2005 were included. The prominent resting tremor was defined as tremor scoring more than 3 in at least one limb in the Unified Parkinsons Disease Rating Scale (UPDRS). Subjects were divided into the responsive group (RG) or non-responsive group (NRG) according to the responsiveness of resting tremor to dopaminergic treatment. Responsiveness was defined as a minimum 2 points reduction of UPDRS score for the resting tremor after dopaminergic treatment for more than 3 months. Results: Among the 85 patients, there were 35 men and 50 women ages 34-87 years (mean age, 67 years). Thirty-six patients (42.4%) were grouped into RG and 49 (57.6%) into NRG. Mean age of RG was significantly younger than that of NRG. RG showed significantly higher initial UPDRS part III subtotal score (p=0.015) and more severe Hoehn & Yahr stage (p=0.010) than those of NRG. UPDRS subscores for rigidity (p=0.012), bradykinesia (p=0.021) and postural impairment (p=0.018) were correlated with the responsiveness of dopaminergic treatment. Conclusions: Resting tremor in PD patients more favorably responded to dopaminergic treatment when it presented in combination with bradykinesia and rigidity suggesting dopaminergic role in the genesis of resting tremor in those PD patients.

Validation of the Korean Version of the Scales for Outcomes in Parkinson's Disease-Sleep

성영희,김희진,고성범,김중석,김상진,천상명,조진환,김윤중,마효일,박미영,백종삼,이필휴,정선주,김종민,송인욱,김한준,김지영,권도영,이재혁,이지영,김지선,윤지영,홍진용,김미정,윤진영,김지선,오응석,양희준,윤원태,유수연,권겸일,박형은,이수윤,김연수,김희태,안태범 대한의학회 2018 Journal of Korean medical science Vol.33 No.2

Background: Sleep problems commonly occur in patients with Parkinson's disease (PD), and are associated with a lower quality of life. The aim of the current study was to translate the English version of the Scales for Outcomes in Parkinson's Disease-Sleep (SCOPA-S) into the Korean version of SCOPA-S (K-SCOPA-S), and to evaluate its reliability and validity for use by Korean-speaking patients with PD. Methods: In total, 136 patients with PD from 27 movement disorder centres of university-affiliated hospitals in Korea were enrolled in this study. They were assessed using SCOPA, Hoehn and Yahr Scale (HYS), Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Sleep Scale 2nd version (PDSS-2), Non-motor Symptoms Scale (NMSS), Montgomery Asberg Depression Scale (MADS), 39-item Parkinson's Disease Questionnaire (PDQ39), Neurogenic Orthostatic Hypotension Questionnaire (NOHQ), and Rapid Eye Movement Sleep Behaviour Disorder Questionnaire (RBDQ). The test-retest reliability was assessed over a time interval of 10–14 days. Results: The internal consistency (Cronbach's α-coefficients) of K-SCOPA-S was 0.88 for nighttime sleep (NS) and 0.75 for daytime sleepiness (DS). Test-retest reliability was 0.88 and 0.85 for the NS and DS, respectively. There was a moderate correlation between the NS sub-score and PDSS-2 total score. The NS and DS sub-scores of K-SCOPA-S were correlated with motor scale such as HYS, and non-motor scales such as UPDRS I, UPDRS II, MADS, NMSS, PDQ39, and NOHQ while the DS sub-score was with RBDQ. Conclusion: The K-SCOPA-S exhibited good reliability and validity for the assessment of sleep problems in the Korean patients with PD.