scholarly journals Applying of Neuman’s Systems Model in the course of nursing care of a patient who has Cervical Disc Herniation treatmentNeuman Sistemler Modelinin servikal disk herni tedavisi gören bir hastanın hemşirelik bakımı sürecinde kullanılması

2018 ◽  
Vol 15 (3) ◽  
pp. 1597
Author(s):  
Handan Eren ◽  
Nurcan Çalışkan

Nursing is a professional health discipline and nursing models based on nursing theories form its scientific foundations. Neuman’s Systems Model is one of these models. The model focuses on the individual's well-being and is based on holistic nursing care. In the model, the individual is an open system interpreting the stressors he perceives. By defining these stressors, the nurse develops the defense mechanisms of the individual on the primary, secondary and tertiary level. The nurse is responsible for the planning, implementation and evaluation. The cervical disc hernia that affects life activities is helped cope with the stressors perceived by the individual receiving the diagnosis. Thus, the quality of life of the individual can be increased, the treatment process can be shortened and the cost can be reduced. In this study, the nursing care process of a patient who was diagnosed with cervical disc herniation was examined according to Neuman’s Systems Model. Person-specific, interpersonal and extrinsic stressors were identified in the direction of the obtained data, and nursing diagnoses suitable for the patient were established in the direction of stressors. As a result, it was found that the use of the model in this case was appropriate and it was suggested to be applied in other patient groups to evaluate the effectiveness of the model. Extended English summary is in the end of Full Text PDF (TURKISH) file.ÖzetHemşirelik profesyonel bir sağlık disiplinidir ve bilimsel bilgi kaynağını kavram,[Mh1]  kuram ve modellerden almaktadır. Neuman Sistemler Modeli bu modellerden birisidir. Model bireyin iyilik haline odaklanmakta ve bütüncül hemşirelik bakımını esas almaktadır. Modelde birey, algıladığı stresörleri yorumlayan açık sistemdir.  Hemşire bu stresörleri tanımlayarak bireyin savunma mekanizmalarını birincil, ikincil ve üçüncül düzeyde geliştirecek bakımın planlanması, uygulanması ve değerlendirilmesinden sorumludur. Günlük yaşam aktivitelerini olumsuz etkileyen servikal disk herni tanısı alan bireyin algıladığı stresörlerle başa çıkmasına yardım edilerek bireyin yaşam kalitesi artırılabilir, tedavi süreci kısaltılabilir ve maliyet azaltılabilir. Bu çalışmada servikal disk hernisi tanısı alan bir hastanın hemşirelik bakım süreci Neuman Sistemler modeline göre incelenmiştir. Elde edilen veriler doğrultusunda kişiye özgü, kişiler arası ve kişi dışı stresörler belirlenmiş, stresörler doğrultusunda hastaya uygun hemşirelik tanıları konulmuştur. Sonuç olarak, modelin bu olguda kullanımının uygun olduğu görülmüş, modelin etkinliğini değerlendirmek amacıyla başka hasta gruplarında da uygulanması önerilmiştir.

2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Ahmet Aslan ◽  
Ünal Kurtoğlu ◽  
Mustafa Özgür Akça ◽  
Sinan Tan ◽  
Uğur Soylu ◽  
...  

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tong Yu ◽  
Jiu-Ping Wu ◽  
Jun Zhang ◽  
Hai-Chi Yu ◽  
Qin-Yi Liu

Abstract Background Posterior percutaneous endoscopy cervical discectomy (p-PECD) is an effective strategy for the treatment of cervical diseases, with a working cannula ranging from 3.7 mm to 6.9 mm in diameter. However, to date, no studies have been performed to compare the clinical outcomes of the use of endoscopes with different diameters in cervical disc herniation (CDH) patients. The purpose of this study was to compare the clinical outcomes of patients with unilateral CDH treated with p-PECD using a 3.7 mm endoscope and a 6.9 mm endoscope. Methods From January 2016 to June 2018, a total of 28 consecutive patients with single-level CDH who received p-PECD using either the 3.7 mm or the 6.9 mm endoscope were enrolled. The clinical results, including the surgical duration, hospitalization, visual analog scale (VAS) score and modified MacNab criteria, were evaluated. Cervical fluoroscopy, CT, and MRI were also performed during follow-up. Results Tthere was a significant difference in regard to the average identification time of the “V” point (18.608 ± 3.7607 min vs. 11.256 ± 2.7161 min, p < 0.001) and the mean removal time of the overlying tissue (16.650 ± 4.1730 min vs. 12.712 ± 3.3079 min, p < 0.05) for the use of the 3.7 mm endoscope and the 6.9 mm endoscope, respectively. The postoperative VAS and MacNab scores of the two endoscopes were significantly improved compared with those the preoperative scores (p < 0.05). Conclusion The application of both the 3.7 mm endoscope and 6.9 mm endoscope represent an effective method for the treatment of CDH in selected patients, and no significant difference can be observed in the clinical outcomes of the endoscopes. The 6.9 mm endoscope shows superiority to the 3.7 mm endoscope in terms of the efficiency of “V” point identification, the removal of overlying soft tissue and the prevention of spinal cord injury. However, the 6.9 mm endoscope may be inferior to the 3.7 mm endoscope in regards to anterior foraminal decompression due to its large diameter; this result needs to be further evaluated with the support of a large number of randomized controlled trials.


2013 ◽  
Vol 20 (12) ◽  
pp. 612-616 ◽  
Author(s):  
Emanuele Di Ciaccio ◽  
Massimiliano Polastri ◽  
Alessandro Gasbarrini

2019 ◽  
Vol 5 (22;5) ◽  
pp. 421-431
Author(s):  
Laxmaiah Manchikanti

Background: Neck pain is one of the major conditions attributing to overall disability in the United States. There have been multiple publications assessing clinical and cost effectiveness of multiple modalities of interventions in managing chronic neck pain. Even then, the literature has been considered sparse in relation to cervical interlaminar epidural injections in managing chronic neck pain. In contrast, cost utility studies of lumbar interlaminar injections, caudal epidural injections, cervical and lumbar facet joint nerve blocks, percutaneous adhesiolysis demonstrated costs of less than $3,500 for quality-adjusted life year (QALY). Objectives: To assess the cost utility of cervical interlaminar epidural injections in managing chronic neck and/or upper extremity pain secondary to cervical disc herniation, post-surgery syndrome in neck, and axial or discogenic neck pain. Study Design: Analysis based on 3 previously published randomized trials of the effectiveness of cervical interlaminar epidural injections assessing their role in disc herniation, cervical post-surgery syndrome, and axial or discogenic pain. Setting: A contemporary, private, specialty referral interventional pain management center in the United States. Methods: Cost utility of cervical interlaminar epidural injections with or without steroids in managing cervical disc herniation, cervical post-surgery syndrome, and cervical discogenic or axial neck back pain was conducted with data derived from 3 randomized controlled trials (RCTs) that included a 2-year follow-up, with inclusion of 356 patients. The primary outcome was significant improvement defined as at least 50% in pain reduction and disability status. Direct payment data from all carriers from 2018 was utilized for the assessment of procedural costs. Overall costs, including drug costs, were determined by multiplication of direct procedural payment data by a factor of 1.67 to accommodate for indirect payments respectively for disc herniation, discogenic pain, and cervical post-surgery syndrome. Results: The results of the 3 RCTs showed direct cost utility for one year of QALY of $2,412.31 for axial or discogenic pain without disc herniation, $2,081.07 for disc herniation, and $2,309.20 for post surgery syndrome, with an average cost per one year QALY of $2,267.57, with total estimated overall costs with addition of indirect costs of $3,475.38, $4,028.55, $3,856.36, and $3,785.89 respectively. Limitations: The limitation of this cost utility analysis includes that it is a single center evaluation. Indirect costs were extrapolated. Conclusion: This cost utility analysis of cervical interlaminar epidural injections in patients nonresponsive to conservative management in the treatment of disc herniation, post surgery syndrome and axial or discogenic neck pain shows $2,267.57 for direct costs with a total cost of $3,785.89 per QALY. Key words: Cervical interlaminar epidural injections, chronic neck pain, cervical disc herniation, cervical discogenic pain, post surgery syndrome, cost utility analysis, cost effectiveness analysis, quality-adjusted life years


2016 ◽  
Vol 29 (2) ◽  
pp. 119 ◽  
Author(s):  
Tae Ha Lim ◽  
Soo Il Choi ◽  
Jee In Yoo ◽  
Young Soon Choi ◽  
Young Su Lim ◽  
...  

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