This study was undertaken to identify optimal head elevation and position in the care of the neurosurgical patient with a cerebral aneurysm. The effects of 0degree, 15degrees and 30degrees head elevation and three positions(supine, side lying position opposite to the operation site, and side lying position on the same side as the operation site) on ICP was studied in fourteen neurosurgical patients with cerebral aneurysms. The results are as follows : 1. The mean intracranial pressure was significantly lower when the patient's head was elevated at 30degrees as compared to 0degree and 15degrees. 2. The mean intracranial pressure was significantly lower when the patient was positioned in the supine as compared to side lying positioned in the supine as compared to side lying position opposite to the operation site and side lying position on the same side as the operation site. The data indicate the head elevation to 30degrees and the supine position reduce ICP in neurosurgical patients with cerebral aneurysm.
BACKGROUND: Blood pressure measurement are used by medical purposes. Most clinical staffs assume that its values are accurate and reliable irrespective of the measured position. In order to measure blood pressure exactly the cuffed upper arm and the heart should be kept at the same level. However, sometimes the blood pressure must be taken with the patient lying on his/her side. In this lateral position it is difficult to set the cuff at the heart's level.
PURPOSE: This study aims at applying exact measurements of blood pressure to practical use. Blood pressure measurements taken from the four extremities (right arm, left arm, right leg and left leg) in the lateral position are compared to those taken in the right arm in the supine position.
METHODS
Thirty-one female and Thirty-two male subjects were sampled among fit students and the data were collected from May 7th, 2001 through June 7th, 2001. To begin with, the blood pressure of right arm in the supine position was measured. Then the blood pressure was measured again after 3 minutes in the subject's right lateral position.
RESULTS
The blood pressure in the left arm in the right lateral position was lower than the right arm's blood pressure in the supine position (systolic difference=15.57 mmHg, diastolic difference=10.86 mmHg).
DISCUSSION
Hydrostatic effects are the most likely cause of the drop in blood pressure of left arm in right lateral position. When blood pressure is measured in the left arm in the right lateral position, the position and site should be noted as well as the pressure may be 10mmHg or more lower than the precise blood pressure.
Recently, the hospitals in Korea has positively changed one way or another. Therefore hospital managers must focus on the nurses' role in terms of consumers' perception of overall image of hospitals and the degree of satisfaction of the consumers To achieve the purposes, the questionnaire was developed and distributed to 280 people who had a direct experience with nursing services subjected hospitals in Seoul at the time of screening. among them, 229 responses were turned out to be useful and used for final analysis. The measurement instrument for hospital nursing service quality evaluation was modified from the SERVQUAL model originated from Parasuraman, Zeithaml, and Berry(1988). For data analysis, SPSS/ PC and PC-MDS program were used. The results were as follows : 1) The perception map showed that the seven subjected hospitals were divided into three groups. It could be interpreted that the hospitals in the same group had a strong competitive relationships. Because the nursing services' scores of hospitals C and E were higher than those of other hospitals, they could be served as a benchmark for the other hospitals. 2) The marketing place of hospital nursing services was divided by four. Since service generally had a strong point in nearby service market segment, Aiming an nearby hospital nursing services market segment by the hospital nursing services department was regarded as a good repositioning strategy. 3) When consumers evaluated the quality of hospital nursing services, they were greatly affected by the hospitals' overall image or other characteristics. Therefore, for improving hospital's nursing services, hospital nursing services department requires a great deal of labor to improve hospitals' overall image or other characteristics.
The study was done to investigate the effects of an exercise program on body composition, cardiopulmonary function and physical fitness in obese children.
Thirty nine children in grades 4, 5, and 6 in elementary school were employed: experimental group(20) and control group(19). The subjects in the experimental group participated in an exercise program for 8weeks, thirty five minutes per session, four times per week. This data was analyzed by ANCOVA and paired t-test.
The Height(F=2.615, p=0.027) of the experimental group was significantly different from the control group. Also, in the experimental group, there were significant differences of height(t=4.79, p=0.000), cardiac rate(t=-6.461, p=0.000), body mass index(t=-2.13 p=0.046), muscle strength(t=3.48, p=0.003), and muscle endurance(t=3.20, p=0.005). Otherwise, in the control group, there were significant differences of weight(t=2.27, p=0.036), waist-hip ratio(t=3.16, p=0.005), and muscle endurance(t=-2.38, p=0.030).
Jumping rope improved the body composition, cardiopulmonary function, and physical fitness for obese children.
This study was done to investigate the effects of backrest elevation of 0 degree and 30 degrees that minimize the risk of increasing ICP when CVP is measured.
Subjects were sixty-four patients who stayed in the neurosurgical intensive care unit after brain surgery at two university-based hospitals. CVP, blood pressure, heart rate and ICP were measured along with position changes in order of backrest position with primary 30 degrees backrest position, 0 degree backrest position and secondary 30 degrees backrest position. For data analysis, one-group, repeated-measures analysis of variance design was used in SAS program.
Backrest elevations from 0 degree to 30 degrees did not alter the CVP without increasing the ICP. Therefore, 30 degrees backrest position is a preventive position without increasing ICP.
30 degrees backrest position might be appropriate for brain injury patients when CVP is measured.
This study was to examine the effects of an exercise program for middle-aged obese women.
The exercise program combined folk dance and resistance training. The subjects group consisted of 85 middle-aged obese women between 40 and 60 years of age. Three 8 week sessions consisted of a 55-80% maximum heart rate (MHR) exercise for 60-90 minutes a day and 3 times a week from March to November, 2004. Data was collected through a pre- and post-exercise test before and after each session. Data was collected with Inbody, dynamometer and blood. This data was analyzed by descriptive statistics, and a paired t-test with an SPSS/PC(10.0 version) program.
There were significant positive changes in body weight, body fat mass, body mass index, percent body fat, muscle strength, muscle endurance, flexibility, and balance quality, but no significant positive changes in skeletal mass, fat free mass, percent abdominal fat(waist-hip ratio), visceral fat area, agility, total cholesterol, high density lipoprotein cholesterol, or triglycerides.
This study showed that an exercise program has partially positive effects for middle-aged obese women. The results of this study show that exercise at community health centers should continue for middle-aged obese women's health.
This study was done to determine the effects of walking exercise training(WET) on metabolic syndrome risk factors and body composition in obese middle school girls.
A non-equivalent pretest-posttest experimental design was used. Twenty seven subjects participated in this study from one women's middle school in Busan. The participants were purposely allocated to an experimental group (n=14) and a control group (n=13). The experimental group participated in 30-60 minutes of WET with 55 to 75% of a maximal heart rate six days a week for 12 weeks.
The prevalence of individual risk factors on metabolic syndrome were improved in the experimental group after the intervention. The high waist circumference(WC), high triglyceride(TG), low high density lipoprotein cholesterol(HDL-C), high blood pressure(BP) and high fasting glucose(FG) were 21.4, 21.4, 14.3, 28.6 and 7.2%, respectively. There were significant differences in WC (F=22.24, p<.001), TG (F=5.34, p=0.30), body weight(F=21.99, p<.001), fat mass(F=19.17, p<.001), and % body fat(F=17.93, p<.001) between the experimental and control group after the intervention. However, there were no significant differences in HDL-C, FG and BP between the experimental and control group after the intervention.
These results indicate that WET is effective in decreasing risk factors of the metabolic syndrome and body composition components in obese middle school girls. These findings suggest that WET can be useful as a nursing intervention in the prevention of obesity-related disorders in obese adolescents.
This study was to evaluate the effects of a short term comprehensive life style modification program on glycemic metabolism, lipid metabolism and body composition in type 2 diabetes mellitus patients.
A nonequivalent control group with a pre post test was designed. Data collection was done from October 2003 to June, 2004 at a hospital. Glycemic metabolism was measured by a.c., p.c. and HbA1c, and lipid metabolism was measured by cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Body Composition was measured by body weight, body mass index, waist, measurement waist per hip ratio, body fat, muscle weight and abdominal fat tissue(intra abdominal distance). The Experimental group, which was composed of 29 participants, was educated based on a life style modification protocol at a weekly meeting for 12 weeks and carried out exercise, diet along individual parameters and self monitoring, while 24 participants in the control group received only diet education.
1.The experimental group showed a significant lower a.c.(t=2.11, p=.04) and HbA1c(t=2.65, p=.01) compared to those of the control group. 2. The experimental group showed a significant lower LDL than the results of the control group(t=2.42, p=.02). 3. The experimental group showed a significant lower weight(t=3.09, p=.00), BMI(t=3.01, p=.00), body fat(t=2.94, p=.01) and abdominal fat tissue(t=3.05, p=.01) than those of the control group.
The results provided evidence for the effectiveness of a short term comprehensive life style modification program composed of exercise, diet, support, self efficacy elevation and self monitoring in type 2 diabetes mellitus.
This research was conducted to provide basic information about the effects of aerobic exercise on physiological change in middle-aged obese women according to differences of β3-adrenergic receptor polymorphisms.
Twenty-nine middle aged obese women with over 30%BMI were divided into three groups according to β3-adrenergic receptor gene polymorphism[Variable Group(VG):9, Normal Group(NG):10, Control Group(CG):10]. The VG and NG groups performed walking at 50% exercise intensity for 30 minutes a day, 4 days a week, for 12 weeks. The data was analyzed using the SPSS program.
The level of leptin, insulin and % body fat in the VG and NG groups was significantly lower than those of the CG after 12 weeks. In addition, the level of HDL-C in the VG and NG was significantly higher than that of the CG after 12 weeks. However, TC, TG and body weight between groups didn't appear significant at the end of 12 weeks.
Aerobic exercise didn't cause differences in persons with differing β3-adrenergic receptor gene polymorphisms, but aerobic exercise affected the physiological change in middle-aged obese women. The findings suggest that aerobic exercise is a desirable nursing intervention for obesity control in middle-aged obese women.
To examine the effects of body position and time after feeding on gastric residuals in low birth weight infants(LBW).
A repeated measures design was conducted. Twenty LBW infants being fed via indwelling nasogastric tubes were randomly assigned to one of 5 different position orderings. In each position, gastric residuals were measured at 30, 60, 90, 120, 150, and 180 minutes after feeding.
In comparisons of gastric residuals with position and time, the main effects of position and time were statistically significant (F = 5.038,
The body position after feeding has a significant affect on gastric residuals over time in LBW infants. The right anterior oblique or prone position is recommended rather than left lateral position after feeding. Knowledge of the proper position and the pattern of gastric emptying over time after feeding may lead to the development of evidence-based nursing care.
To investigate body compositons and bone mineral density(BMD) in college women and to find the relationship between them.
From January to March of 2001, BMD at four parts(forearm, lumbar, femur and whole body), body mass index(BMI), body fat mass(BFM), lean body mass(LBM) and body fat percentage(%Fat) were measured with the Dual Energy X-ray Absorptiometry. Other physical characteristics were measured with a scale, a height measurer, and questionnaires.
Grouping by the BMI, 43.2% showed low weight, and 5% over weight. When applying the percent Fat, 43.8 % was diagnosed as obesity group. The fact indicate that a majority of college women have unbalanced body composition with high percent Fat, compared to their body weight. Assessing the BMD with the WHO standards, 91.4~95.7% of the BMD of forearm and whole body was normal. But, 40.3% and 33.1~43.9% showed osteopenia at lumbar and femur, and 1.4 %, 0.7~7.2% showed osteoporosis. The BMD at all parts showed significant correlation each other(r=.29~.89, p=.001~.000). Body weight and BMI showed correlations to with BMDs at all parts of the body(r=.19~.46, p=.025~.000; r=.18~.45, p=.039~.000). But the percent Fat had a correlation with only femur neck BMD(r=.19, p=.024).
This study showed a majority of healthy college women were exposed to the risk for osteoporosis. Additional study is required to develop nursing interventions to remove the risk factors of osteoporosis. In particular, the acquisition of balanced body composition is necessary, increasing body weight and BMI through the increase of LBM, not through the quantitative increase of BFM.
The purpose of this study was to determine the effects of smartphone apps applying BodyThink program on BMI, percentage of body fat, skeletal muscle rate, body image, and self-esteem of adolescent girls.
Sixty-eight high school girls with a BMI of over 25kg/m2 were recruited to participate in this study. Girls from four schools were divided into two groups: the experimental group, which used the smartphone apps applying BodyThink program, and the control group, which used smartphone apps and small group counseling. The experimental group received the BodyThink program 6 times, scheduled once a week, with each session lasting 40~50 minutes. Test measures were completed before and after the 6 week intervention period for all participants. Collected data was analyzed using Shapiro-Wilk test, descriptive statistics, χ2 test, independent t-test, Mann-Whitney U test with the SPSS/WIN 18.0 program.
The girls in the experimental group significantly improved their results in BMI(Z=-1.67,
Mobile applications applying psychological and emotional intervention programs have the potential to be effective alternative methods to improve the body composition and self-esteem of obese adolescent girls.
This study was done to assess the bone mineral density (BMD), biochemical bone turnover markers (BTMs), and factors associated with bone health in young Korean women.
Participants were 1,298 women, ages 18-29, recruited in Korea. Measurements were BMD by calcaneus quantitative ultrasound, BTMs for Calcium, Phosphorus, Osteocalcin, and C-telopeptide cross-links (CTX), body composition by physical measurements, nutrients by food frequency questionnaire and psychosocial factors associated with bone health by self-report.
The mean BMD (Z-score) was -0.94. 8.7% women had lower BMD (Z-score≤-2) and 14.3% women had higher BMD (Z-score≥0) than women of same age. BTMs were not significantly different between high-BMD (Z-score≥0) and low-BMD (Z-score<0) women. However, Osteocalcin and CTX were higher in women preferring caffeine intake, sedentary lifestyle and alcoholic drinks. Body composition and Calcium intake were significantly higher in high-BMD. Low-BMD women reported significantly higher susceptibility and barriers to exercise in health beliefs, lower bone health self-efficacy and promoting behaviors.
Results of this study indicate that bone health of young Korean women is not good. Development of diverse strategies to intervene in factors such as exercise, nutrients, self-efficacy, health beliefs and behaviors, shown to be important, are needed to improve bone health.
To investigate the effect of progressive resistance training (PRT) on body composition, physical fitness, quality of life, lipid and nutritional profile of patients on hemodialysis (HD).
A non equivalent comparison group pretest and posttest design study was used with 40 participants who were randomly assigned to the exercise group (20 participants) and the comparison group (20 participants). The exercise group received PRT for 30 minutes per session, 3 sessions a week, for 12 weeks, while the comparison group received usual care. The PRT consisted of upper and lower body exercises using elastic bands and sandbags. Outcome measures evaluated were: body composition, physical fitness, quality of life, and lipid profile.
Skeletal muscle mass, grip, leg muscle strength, and quality of life all improved significantly in the exercise group. Body fat rate, total cholesterol and triglyceride rate decreased significantly in the exercise group.
These results suggest that PRT improves body composition, physical fitness, quality of life, and lipid profile of patients on HD. PRT using elastic bands and sandbags can be utilized as part of a regular care plan for these patients.
This study was done to identify the time interval to pressure ulcer and to determine the optimal time interval for position change depending on pressure ulcer risk in patients using foam mattress in intensive care units.
The Braden scale score, occurrence of pressure ulcers and position change intervals were assessed with 56 patients admitted to an intensive care unit from April to November, 2011. The time to pressure ulcer occurrence by Braden scale risk group was analyzed with Kaplan-Meier survival analysis and log rank test. Then, the optimal time interval for position change was calculated with ROC curve.
The median time to pressure ulcer occurrence was 5 hours at mild or moderate risk, 3.5 hours at high risk and 3 hours at very high risk on the Braden scale. The optimal time interval for position change was 3 hours at mild and moderate risk, 2 hours at high and very high risk of Braden scale.
When foam mattresses are used a slight extension of the time interval for position change can be considered for the patients with mild or moderate pressure ulcer risk but not for patients with high or very high pressure ulcer risk by Braden scale.
This study was done to analyze the effects of an exercise program on body composition and physical fitness of obese female college students.
Data was collected from September 29, 2003 to December, 29, 2003. The research design was arandomized control group pretest-posttest experimental design. The subjects were college nursing students at K University. Forty four students, 20 in the experimental group and 24 ina control group, with more than 30% body fat were randomly assigned. The subjects in the experimental group participated in an exercise program for 12 weeks, sixty minutes per session, five times per week. Body composition and physical fitness was measured by a body composition analyzer, cardiovascular endurance, muscle endurance, muscle strength(grip strength, back strength), flexibility, balance, agility(whole body reaction time) and power(standing long jump).
Body weight(F=4.76, p=0.035), body fat(kg)(F=5.68, p=0.022) and body mass index(F=5.73, p=0.021) of the experimental group were significantly different from the control group, but there were no significant differences in body fat(%), lean body mass, muscle mass and WHR. Back strength(F=6.50, p=0.015), flexibility(F=14.62, p=0.000), muscle endurance(F=7.98, p=0.007), power(F=5.76, p=0.021) and balance(F=2.46, p=0.018) of the experimental group were significantly different from the control group, but there were no significant differences in cardiovascular endurance, grip strength or agility.
The exercise program was effective in improving body weight, body fat(kg), body mass index, back strength, muscle endurance, flexibility, balance and power of obese female college students.