Résumé
Purpose@#The purpose of this study was to identify factors influencing job satisfaction among ambulatory care nurses. @*Methods@#Data were collected through a self-evaluation survey of 129 nurses in one tertiary hospital. Data were analyzed using paired t-test, independent t-test, one-way ANOVA, Importance-Performance Analysis, Pearson correlation coefficients, and multiple regression analysis. @*Results@#The mean scores were: for importance, 3.18 out of 4, for performance, 2.24 out of 4, for professional self-concept, 2.92 out of 4, and for job satisfaction 2.77 out of 5. There were statistically significant positive correlations between professional self-concept and job satisfaction (r=.37, p<.001). Stepwise multiple regression analysis showed that satisfaction with professional self-concept, clinical career, and age explained 47.0% of the job satisfaction of ambulatory care nurses (F=37.51, p<.001). Satisfaction with professional self-concept, clinical career, and age were statistically significant predictors of job satisfaction. @*Conclusion@#Findings indicate motivation programs according to clinical career would be useful to improve job satisfaction of ambulatory care nurses. Additionally, continuous education should be provided to strengthen the professional self-concept of nursing professionals in both undergraduate curricula and clinical fields.
Résumé
BACKGROUND: Selective transforaminal epidural block has come to the for as a targetspecific modality in the treatment and diagnosis of spinal pain. Thoracic transforaminal epidural block (TTFEB) has the associated risk of pneumothorax. This article describes a retrospective study conducted using computed tomography (CT) imaging to investigate the TTFEB angle and depth appropriate to minimize the risk of pneumothorax in Koreans. METHODS: The subjects of the present study were 100 randomly selected patients between 50 and 70 years of age found be free of thoracic disease according to chest CT performed in the present hospital. On the chest CT, the superior, middle, and inferior thoracic vertebrae were observed at the T2, T7, and T11 levels, respectively. RESULTS: The average distance and the needle insertion angle from the skin point at which the needle may be inserted without piercing the lung to the intervertebral foramen were 117.8 ± 12.1 mm and 58.1 ± 6.1° at the T2 level, 85.6 ± 10.0 mm and 61.7 ± 4.3° at the T7 level, and 94.3 ± 8.7 mm and 64.4 ± 7.0° at the T11 level, respectively. CONCLUSIONS: The needle insertion at the point further than 40 mm, on the upper, middle thorax, if the needle pass from the inner vertebral body to lamina, it could be safer. However, on the lower thorax, needle could pierce the lung though the needle start from the inner vertebral body. Thus, it can be safer if the needle pass toward the exterior margin of lamina.
Sujets)
Humains , Diagnostic , Poumon , Aiguilles , Pneumothorax , Études rétrospectives , Peau , Maladies du thorax , Vertèbres thoraciques , Thorax , TomodensitométrieRésumé
Vagal mononeuropathy is very rare. Diabetes mellitus is one of the causes of this rare disease condition. Here we report a 44-year-old woman who presented with an idiopathic vagal mononeuropathy and was finally diagnosed with diabetic vagal mononeuropathy. She presented with isolated dysphagia without hoarseness or other symptoms related with vagal dysfunction. Except for diabetes mellitus, no abnormalities were found by routine and specific checkups including brain imaging, gastroscopy, electromyography, and laryngoscopy. Finally, 12 days later, she abruptly developed hoarseness without other cranial nerve dysfunction.We suggest that her neurological symptoms originated from diabetes affecting the vagus nerve in isolation. Clinicians should pay attention to this association, especially when they encounter a patient with diabetes mellitus with sudden idiopathic dysphagia even without problems of vocalization.
Sujets)
DiabèteRésumé
Hirayama disease usually selectively involves lower cervical myotomes (C8, T1). Thus, patients usually manifest with atrophy and weakness of small hand muscle. Predominant isolated involvement of proximal arm is rarely reported in Hirayama disease. Here, we report a case of Hirayama disease who had focal weakness and wasting, mainly confined to right biceps brachii muscle, with prominent shifting of dural sac in C4-5 segment by dynamic flexion magnetic resonance imaging (dfMRI), which may explain this unusual distribution of the disease.
Résumé
No abstract available.
Sujets)
Dermatomyosite , Pneumopathies interstitielles , Pneumopathie infectieuseRésumé
No abstract available.
Sujets)
Maladie de Creutzfeldt-Jakob , Parésie , Accident vasculaire cérébralRésumé
Iatrogenic vascular injury during lumbar disc surgery is a rare but serious complication. This paper reports a patient who sustained an injury to the iliac artery while undergoing intervertebral disc surgery at the lumbar region. He suffered from massive bleeding and shock. An urgent laparatomy was performed under cardiopulmonary bypass, and the vascular injuries were repaired successfully. This case shows that a rapid diagnosis and immediate intervention can result in a favorable outcome.
Sujets)
Humains , Pontage cardiopulmonaire , Discectomie , Hémorragie , Artère iliaque , Disque intervertébral , Région lombosacrale , Rupture , Choc , Lésions du système vasculaireRésumé
We present a patient who developed a psoas muscle hematoma after spinal anesthesia. He had received hemodialysis with heparin every two days because of end stage renal disease. Under the jack-knife position, he underwent spinal anesthesia and a paramedian approach was used for incision and drainage of an anal abscess. The coagulation tests were normal throughout the surgery. Eleven days after the operation, he complained of sudden onset of right buttock pain and a psoas muscle hematoma was diagnosed by CT. Although heparin is recommended after regional anesthesia, it is a major cause of delayed hematoma. Because of this potential complication, anesthesiologists and clinicians should carefully monitor the usage of anticoagulants after spinal anesthesia, and it is necessary to use active diagnostic tools such as CT for early diagnosis when hematoma formation is suspected in patients receiving anticoagulants.
Sujets)
Humains , Abcès , Anesthésie de conduction , Rachianesthésie , Anticoagulants , Fesses , Drainage , Diagnostic précoce , Hématome , Héparine , Défaillance rénale chronique , Composés organothiophosphorés , Muscle iliopsoas , Dialyse rénaleRésumé
BACKGROUND: Many women have experienced artificial abortion, but artificial abortion itself may take a life away from a fetus and also influence serious effect on operated womens health condition. So this study was attempted to offer basic information for improving maternity health condition by knowing womens artificial abortion performance status and recognition about its complication. METHODS: The 215 married women who visited in OPD of certain hospital in Pusan from november 1994 to January 1995, answered the question about experience of artifial abortion the recognition about its complication, and artificial abortioned group answered the reason of artificial abortion and the experience of complication. RESULTS: The number of women who experienced artificial abortion was 107 persons(49.8%). More educated women have experienced less artificial abortion. The causes of artificial abortion were birth control as of 40.6%, continuation of occupation or study as of 20.6%, for preserving health condition as of 14.2%, impossible marriage as of 14.2%. 115 persons out of 215 persons (53.4% ) answered they heard about, its complicatons. In relation to health, 66 persons(30.7% ) answered that the abortion had no relation with health condition or they answered they have no idea about the issue, 68 persons(31.6%) answered that the abortion had relation with but its complication would be soon recovered. Higher understanding was obtained in higher educated group(P<0.05). If unwanted pregnancy occur to them in the future, 32 persons(27.8%) in recognized group and 38 persons(38%) in unrecognized group answered they would perform artificial abortion. So understanding about complicaton of artificial abortion has little effect on their artificial abortion rate. CONCLUSIONS: Recognition of complications of married women is low, and recognition degree doesnt affect artificial abortion. So, not only education about complications of artificial abortion and contraception but also social performance of sharing womens responsibility for birth control or bringing up infants is necessary.