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등받이 의자와 좌변기에서 스마트폰 사용 시 목세움근, 위등세모근, 척추세움근의 근활성도 비교
김준혁 ( Jun-hyeok Kim ),강슬기 ( Seul-gi Kang ),김민주 ( Min-joo Kim ),민유진 ( Yu-jin Min ),백숙향 ( Suk-hyang Baek ),장윤호 ( Yoon-ho Jang ),주미정 ( Mi-jung Ju ),최가람 ( Ga-ram Choi ),홍성화 ( Sung-hwa Hong ),권혁규 ( Hyeok-g 대한신경치료학회 2018 신경치료 Vol.22 No.2
Purpose The usage of a smartphone in the life have been increased because of the convenience of a smartphone. In addition, the usage of a smartphone is increased in the restroom. The use of smartphone in the toilets have affected on large intestine such as constipation and hemorrhoids. However, little is known about musculoskeletal system. Therefore, the Purpose of this study was to examine the effect of using smarphone in the restroom on muscle activity of cervical erector spineae, upper trapezius, and lumbar erector spinae in the able-bodied people. Methods 28 healthy subjects were recruited for this study. Electromyographic signals of both cervical erector spinae, upper trapezius and lumbar erector spinae were acquired during sitting on the general chair and toilet with using a smartphone. Paired t-test was used for determination of differences in the muscle activation between general chair and toilet. The significant level of the p value was set at 0.05. Results In cervical erector spinae and upper trapezius, no significant difference was observed between the general chair and toilet (p>.05). In contrast, regarding lumbar erector spinae, using a smartphone on the toilet showed significant difference compared to on the general chair (p<.05). Conclusion We found that the sitting on the toilet during using a smartphone showed higher muscle activation of lumbar erector spinae than the sitting on the general chair. Therefore, using a smartphone on the toilet could affect the musculoskeletal of the lower back.
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중환자의 욕창 예방 연구 : 욕창 예방 QI팀을 중심으로
강소영,최은경,김진주,주미정 한국의료QA학회 1997 한국의료질향상학회지 Vol.4 No.1
Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14%. United states were reported the incident rate of pressure sores in patients rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulders. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol.called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention, After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that there was significant difference of incidence rate of pressure sores between patients at high risk( control group) who received care implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p< .05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was deceased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be appleed to patients at moderate, or low risk throughout continuous CQI team activities based on Bed sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimation cost of poor quality. like workload(full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.
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