전신마취 수술환자의 수술전후 경험

양기우,이미라 중앙대학교 의과대학 간호학과 간호과학연구소 1997 간호과학연구 Vol.1 No.1

This study was to understand the experience of patients before and after operation with General Anesthesia. and find specific nursing intervention unique to each patient. So that they could keep peaceful mind and recover sooner. Subjects were 20 adult patients who were operated under general anesthesia in a university hospital in Seoul. They did not have any complication, were alert enough to be interviewed and agreed willingly to participate in this study. Data were gathered through in-depth interview using some open and unstructured questions from June to July, 1995. Author interviewed each objective once before operation and twice after operation. Interview tooks from 20 minutes to 40 minutes. Interviews were tape recorded and transcribed by author later. Transcription tooks from 2 to 3 hours. Data were analyzed by Giorgi's phenomenological analysis method. Similar data were grouped into higher categories and named. Results were as follows. Preoperative experiences were categorized into "anxiety", "self-comfort", "transcendental attitude", "discomfort", "sleep dissatisfaction". Postoperative experiences were categorized into "discomfort", "wound pain", "satisfaction", "dissatisfaction". Before operation, most patients felt anxiety on the possibilities of postoperative pain, complication or failure of awakening from anesthesia before operation, Which caused sleep disturbance. And preoperative tests or interventions and noisy ward environment added burden. But patients tried to keep peaceful mind expecting good results or relying on medical teams. Some patients who had religion relied on God to overcome anxiety. Exposure to other's eyes and careless handing of stretcher car on which preoperative patients were lying on the way to operating room made most patient have low self esteem. After operation, patients suffered mostly from wound pain, nausea, vomiting, powerlessness, and immobilization etc. A special treatment to reduce wound pain gave patients much satisfaction. Late response of medical teams to patients's need made them unsatisfied. Patients thanked much for nurse's visit for pre-and post-operative education and nurse's concern on them Suggestions for further studies were as follows. 1) Based on this results, pro- and post-nursing interventions were to be developed. 2) Repeated studies were needed on different subjectives. 3) A suggestion of pre- and post-operative visit to surgical patients.

입원환자의 수술경험

황윤영,양기우,채정선,이필호,장미,강미경,서효신,박성희,최경숙 중앙대학교 의과대학 간호학과 간호과학연구소 2000 중앙간호논문집 Vol.4 No.2

This study was to understan the experience of patients before and after operation with general anesthesia, and find specific nursing intervention unique to each patients so that they could keep peaceful mind and recover sooner. Patients in front of operation would experience anxiety and even emotional crisis in almost of them even though individual variation. To provide effective nursing care to them, it is essential to estimate nd understand the experiences of subjects. So this study is aimed to estimate the experience of patients in perioperative period in view of them. Subjects were 25 adult patient over 20 years who had been operated under general anesthesia in one university hospital in seoul. They did not have any special complication or psychological problem or change consciousness in perioperative period and agree this study. Data were gathered through in - depth interview using open and unstructive questions. Interview was done twice per one patients before and after 3 days of opeartion in their room and each interview tooks 30 - 40 minutes. Data analysis tool was Giorgi's phenomenological analysis method. Result were as follows ; 1) preoperative experiences of the patients were categorized into "Anxiety" "Hoping·Wishing" and "Transcendental Attitue" 2) postoperative experiences of the patients were categorized nto "Comfortability" "Hoping·Wishing" and "Dissatisfaction" Before operton most patients felt anxiety on the possibilities of operative pain, complication of failure of awakening from anesthesia. But patients tried to keep peaceful mind expecting good results or relying on medical teams. After opearton most patients felt comfortability and dissatisfaction a special treatment to reduce patients dissatisfaction. For satisfaction that perioperative nursing needs of the patients in admission is above all nurse's supporting and thinking patient's situation and specific nursing care to unique patients. Specially, patient's satisfaction that important role of operation room nurse to provide information and emotional support in opeartion waiting room and operation room. Therefore nursing intervention developed in properly operation waiting room and operation room and then performed by operation room nurse. Suggestions for further studies as follows ; 1) various approach for supportive nursing intervention methods by that perioperative patients in admission could be opearted and recovered in more comfortable state. 2) further study about perioperative nursing needs of the patients in same operation would be needed.

한탄바이러스 감염 제대정맥내피세포에 대한 단핵구 매개성 손상

정상인,김기우,문언수,강응택,유석희,최철순,양용태 중앙대학교 의과대학 의과학연구소 1992 中央醫大誌 Vol.17 No.4

Studies on the pathogenesis of hemorrhagic fever with syndrome(HFRS) in patients have been seriously hindered by the abscence of appropriate animal model. The major pathologic findings in patient with HFRS are generalized vasculopathy. However, the pathogenesis of disseminated intravascular coagulation (DIC) and bleeding tendency in patients with HFRS are not well understood. It has been reported that the specific viral antigens are usually demonstrated in the endothelium of glomerular capillaries, and resulted in application of primary cultured human umbilical vein endothelial of glomerular capillaries, and resulted in application of primary cultured human umbilical vein endothelial cells (HUVEC) to study on the pathogenesis of HFRS. In this study, HUVEC were infected with Hantaan virus. The outcome Hantaan virus infection of HUVEC were assessed by flurescence activated cell scanning(FACS). The result of FACS assay indicated that 11% of the cells contained veiral antigens on 3 days postinfection. The proportion of virus-containing cells increased to 85% by the fifth days, adn 96% by the seventh, respectively. These observed no CPE development in the HUVEC cells infected with Hantaan virus and observed up to 13 days. The sensitivity of immunohistochemical method used for the viral antigens appeared similar to that of indirect immunofluorescent antibody technique. The monocyte adherence rate of infected HUVEC was much higher that than that of uninfected HUVEC, The monocyte adherence rate of infected HUVEC was increased by addition of convalescent serum of patient with HFRS. Infection with Hantaan virus HUVEC stimulated the production of superoxide radical.

가정간호 수혜자의 가정간호에 대한 인식조사 연구 : Q-방법론적 접근

김미숙,정연강,양갑필,원삼순,은미자,김복순,박현옥,양기우,윤정인 중앙대학교 의과대학 간호학과 간호과학연구소 1998 중앙간호논문집 Vol.2 No.2

The purpose of this study was to understand the pattern of the client's recognition on home nursing care system, individually, and then to provide some basic information that needed for establishment home nursing care system. The research had been proceeded as follows : 1. Delineation of the Q-population : the statements of Q-population had been derived from review of the related literature and open-ended questionare filled by Nurses, Doctors, general public, and outpatient. 2. Selection of the Q-sample : Among 452 concourse, those which was obscure or overlapped were deleted. 30 concourse were selected finally. 3. selection of the P-sample 27 subjects had been determined among the person who were provided home health nursing care after discharged from inpatient service in 1 university hospital. We visited at their home and collected data from 20th, Oct. to 5th, Nov. 1998. 4. Q-sorting : based on 1 to 9 point scale(forced normal distribution), the selected P-sample rated their operant definition of home health nursing care 5. Determination of Q-type : with Q-sorts, PC-QUANL program identified the three Q-types 6. Analysis of Q-type : the characteristics of three different recognition had been analyzed based on the typal array, extreme comments, and subject's demographic information The results revealed that there are three different pattern of recognition on home health nursing care system: certain type(recognition of effectiveness), deficiency of recognition type, uncertain type. As a view of summerized results the recognition of the home health nursing system had characteristics of 3 types with similarity but independency Accordingly, the means of this study was the facts discovered the characteristic 3 types that home health nursing subjects had thought. Because this 3 types are not fixed but changeable through each reaction and by their being conditions, we think that to build a practical and concrete home health nursing system and to utilize will be necessary.