Mae Ja Kim | 3 Articles |
PURPOSE
The objectives for this study were to identify the factors that correlate with appraisal of illness and to explore what variables are predictive of cancer patients primary caregivers' cognitive appraisal for stress. METHOD The subjects were selected by convenient sampling and 130 caregivers who completed a questionnaire. Measures used in this study included the Family Inventory of Resources for Management, Social Support Index, Family Crisis Oriented Personal Evaluation Scales and Family Coping Coherence Index. Pearson correlation was used to identify the relationship among factors and multiple regression was used to determine the individual and cumulative effect of potential predictors on the caregivers' appraisal. RESULTS Patient's level of activity, severity of the disease, quality of relation between patient and caregiver, caregiver's subjective health status, economic status, family resources and coping were significantly correlated. Among the variables, coping, family resources, economic status and quality of relation between caregiver and patient predicted 49.2 percent of the variance in appraisal of caregivers' stress condition. CONCLUSION These findings suggest that coping mechanisms and family resources are important for positive appraisal. Nurses should provide adequate nursing care for the primary caregiver about professional care information and supportive counseling.
The purpose of the study was to explore the effect of 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hour on the frequency of "red man syndrome", phlebitis and length of peripheral catheter placement of infected patients, in order to provide safe infusion method for reducing vancomycin-induced RMS and phlebitis. The subjects of the study consisted of 16 hospitalized patients; 3 oncology and gastro-intestinal patients, 1 neurological patient, 6 thoracic surgical patients and 6 orthopedic patients, who had received vancomycin from July to October in 1999 at S-hospital. The dependent variables were the incidence of RMS, phlebitis and the length of peripheral catheter placement. The incidence of RMS was checked by an inspector at the first night whenever the infusion method of vancomycin was changed. RMS was observed every 15 minutes during an hour for symptoms of RMS such as itching, erythema, chest pain and systolic blood pressure. Incidence of phlebitis was assessed by inspector twice a day from the insertion of peripheral catheter to the removal of the catheter. The data were analyzed by percentage, mean, X2-test, t-test, repeated ANOVA, and logistic regression analysis using the SPSSWIN program. The results are summarized as follows; 1. No significant difference was identified in frequency of RMS between the experimental group and control group. 2. There was no significant difference in the change of systolic blood pressure as the time goes on between the experimental group and control group. 3. The incidence of phlebitis was significantly lower in the experimental group than in the control group. 4. The length of peripheral catheter placement was significantly longer in the experimental group than in the control group. 5. Other drugs administrated with vancomycin didn't influence the occurrence of phlebitis. However, the infusion method of vancomycin influenced the occurrence of phlebitis. The results suggest that 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hours may decrease the incidence of phlebitis and increase the length of peripheral catheter placement compared to 1 hour infusion of vancomycin(1g) in 100ml of isotonic saline every 12 hours. However, it does not reduce the incidence of RMS.
The current patient management system has several limitations. To develop the critical pathway (CP) as a cost-effective method via continuous patient management, we investigated the medical records of 77 patients who underwent FP chemotherapy in Seoul National University Hospital from Feb, 1 to 28, 1999. And the pilot study was done to 12 patients admitted to undergo the FP chemotherapy. 1. The vertical contents in the CP consisted of 7 items; assessment, activity, diet, IV therapy, medication, education and evaluation. The duration of the horizontal axis was 6 days from admission to discharge. 2. The medical performance according to the vertical axis in the preliminary CP, consisted of 72 , and modified to 74 items in the final form of CP. 3. The nursing record consisted of a vertical axis of 4 items; assessment, IV therapy, medication and education. The duration of the horizontal axis was 6 days from admission to discharge of hospital days.
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