• 한국노년학
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• 제38권1호
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• pp.169-185
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• 2018

당뇨병 노인환자의 자기관리 교육은 대상자의 건강행위를 변화시켜야 하는 목표를 성취해야하므로 노인의 자기관리 역량 강화에 중점을 두고, 노인 대상자의 특성과 개별적인 상황 및 조건을 반영해야 한다. 그러나 이러한 노인 특화 프로그램은 매우 제한적이고, 대상자 중심의 효과가 평가된 경우도 드물다. 이에 본 연구는 노인복지관을 이용하는 지역사회 거주 당뇨병 노인 맞춤형 당뇨자기관리 프로그램을 실행연구 방법으로 적용하고, 그 효과를 평가하기 위해 시행되었다. 본 연구는 실행연구방법의 계획, 실행, 평가, 성찰단계를 각 회기마다 시행하여 이전 회기의 결과가 다음회기의 중재계획의 변화에 근거가 되는 체계적인 순환과정을 3회기에 걸쳐 순차적으로 적용하였다. 일개의 지역사회 복지관에서 15개월에 걸쳐 12주의 소규모 노인 당뇨병 교육 프로그램을 제공한 후 양적, 질적 자료를 모두 사용하여 참여대상자 측면의 평가가 충분히 포함되도록 하였다. 총 46명중 43명(93.48%)이 프로그램을 이수하였다. 양적인 프로그램의 효과결과에서는 당화혈색소(p<.001), 공복혈당(p<.001), 신체질량지수(p=.016), 허리둘레(p=.001), 수축기혈압(p=.036), 당뇨병 자기관리 행위(p<.001), 노인 건강행위지식(p=.008)이 통계적으로 유의하게 향상되었다. 질적 평가 자료에서는 본 프로그램은 개별적인 맞춤 관리로 느껴지며 이를 통해 역량 강화하게 되었고, 상호작용을 통한 능동적인 참여를 통해 자신의 자기관리 이행에 자신감과 실천의 즐거움을 느꼈다고 하였다. 본 연구는 실행연구방법을 적용하여 지역사회 노인을 대상으로 당뇨병 교육 프로그램을 적용한 결과로 대상자의 신체적 지표와 행위지표, 유용성 등의 양적인 효과뿐만 아니라 대상자 측면에서의 주관적인 효과성을 확인 한 것은 효율성과 실현 가능성을 살펴보는 의미 있는 시도였다. 따라서 이러한 실행연구 방법을 통한 프로그램의 적용과정과 평가는 현장 실무자에게 대상자의 요구 중심의 맞춤형 중재 프로그램 시행의 가이드가 될 것이다.

• Korean journal of health promotion
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• 제17권2호
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• pp.109-118
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• 2017

연구배경: 아동기 인구 집단에서 허리둘레/신장 비율을 기준으로 한 복부비만이 체질량지수를 기준으로 한 전체비만보다 심혈관건강과 더 강력한 부적관련성을 보고하고 있으나, 아직 그 근거가 부족하다. 이에 본 연구는 아동기 인구 집단에서 체질량지수는 물론이고 '허리둘레/신장 비율'과 심혈관건강 간의 관련성을 규명하고자 한다. 방법: 본 연구는 제5기 국민건강영양조사 원시자료(2010-2012년)를 활용한 횡단적 역학연구설계에 의해, 10-18세인 2,363명을 대상으로 성별(소년/소녀 집단)과 연령별 집단(10-12세/13-18세)으로 구분하여 분석하였다. 전체비만은 체질량지수 백분위수에 의해 비과체중군(<85), 과체중군(${\geq}85$)과 비만군(${\geq}95$)으로, '허리둘레/신장 비율'을 기초로 정상군(<0.5)과 복부비만군(${\geq}0.5$)으로 구분하였다. 심혈관건강은 7개 하부지표와 통합지표인 심혈관건강점수(표준화점수, z-score)로 분석하였다. 아동의 인구사회학적 특성과 부모의 사회경제적 특성을 보정한 후 복합표본 일반선형회귀분석을 수행하였다. 결과: 체질량지수를 기준으로, 비만군은 비과체중군에 비해 7개 심혈관개별지표와 심혈관건강점수 모두에서 통계적으로 유의하게 심혈관건강이 악화되어 있었다(P<0.05). '허리둘레/신장 비율'을 기준으로, 그 관련성 또한 위와 유사한 패턴을 보였으나(P<0.05), 이는 체질량지수 비만도를 보정한 후에도 여전히 13-18세 인구 집단에서는 심혈관건강점수가 비만군에서 비과체중군에 비해 통계적으로 유의하게 악화되어 있었으며, 이 패턴은 특히 남학생에서 유의하게 나타났다(P<0.01). 결론: 국내 13-18세의 소년 집단에서 '허리둘레/신장 비율' 복부비만 지표는 체질량지수를 보정한 후에도 심혈관 건강과 밀접한 관련성이 있었다. 이에 늦은 청소년 집단에서 '허리둘레/신장 비율'은 체질량지수보다 강력한 심혈관 건강을 반영할 수 있으므로, 학령기 청소년 집단을 위한 심혈관질환 조기 예방과 건강증진 차원에서 복부비만 지표는 간호사정의 지표로 고려될 필요가 있겠다.

• 성인간호학회지
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• 제25권5호
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• pp.515-526
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• 2013

Purpose: The study aims to evaluate the effects of Tai Chi applied cardiac rehabilitation program(TCCRP) on cardiovascular risks, recurrence risk in ten years, and cardiac specific quality of life in individuals with coronary artery disease. Methods: The sample was comprised of individuals diagnosed with coronary artery disease within six months of the study who were referred by their primary physicians to participate in the TCCRP. The design was a pretest/posttest with non-equivalent groups with 30 in TCCRP program and 33 wait-listed comparison group. Results: The average age of all participants was sixty seven years. At the completion of the TCCRP, the Tai Chi group showed significant reduction in their ten year recurrent risk for coronary artery disease measured by Framingham's algorithm. The quality of life for the experimental group was reported as significantly higher than the comparison group, especially the area of general symptom. Conclusion: The outpatient cardiac rehabilitation with Tai Chi was applied effectively and safely without any complication to individuals with coronary artery disease. Tai Chi can be useful as an alternative exercise for cardiac rehabilitation program which may provide more access to individuals for cardiovascular risk management in the community settings.

• 임상간호연구
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• 제20권3호
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• pp.326-336
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• 2014

Purpose: The purpose of this study was to compare the effectiveness of heparin and 0.9% normal saline solution flushing for maintaining patency of non­tunneled central venous catheters in patients with surgery. Methods: A randomized controlled clinical trial was performed. Fifty­eight patients were prospectively enrolled and fifty-four patients were completed the study. The heparin group consisted of 30 patients given 100u/ml diluted heparin flushing and the normal saline group consisted of 24 patients with 0.9% sodium chloride flushing. Results: There was no significantly difference in occlusion between the heparin group and the normal saline group in non­tunneled central venous catheters' occlusion. Also there was no difference between these two groups in catheter­related infections. Conclusion: Flushing with 0.9% normal saline is as effective as flushing with heparin solution in maintaining the patency of non­tunneled central venous catheters. In this study, however, the duration of central line use was short and the infection occurrence was little. Further studies are warranted with a larger sample size at multiple centers.

• 성인간호학회지
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• 제23권1호
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• pp.60-71
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• 2011

Purpose: This study explored cardiovascular health (CVH), depressive symptoms, and well-being among community-based Korean women according to hwa-byung (HB) symptoms. Methods: This cross-sectional study measured HB symptoms, depressive symptoms, quality of life (QoL), and spiritual well-being (SWB) in addition to biophysical indicators of CVH. Results: Fourteen women of the HB group are more likely to live alone with lower income than 36 women in the comparison group. Compared to the comparison group, the HB group has larger mean waist circumference and higher prevalence of abdominal obesity along with more knee arthritis and back pain. Although women in the HB group appeared worse in other CVH than their counterparts, this was not statistically significant. It is noteworthy, that the HB group showed a higher probability of having a hard cardiovascular event (CVE) within 10 years than the comparison group. Women in the HB group reported more depressive symptoms, poor QoL, and low SWB as well as smoking and sleep difficulties. Conclusion: Despite the small sample size, significant relationships of HB symptoms to abdominal obesity, the probability of a hard CVE within 10 years, and psychosocial health were found. Strategies for effective community-based cardiovascular programs for Korean women may include HB screening and/or management.

• 대한간호학회지
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• 제42권6호
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• pp.791-798
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• 2012

Purpose: The purpose of this study was to analyze the effectiveness of saline solution vs. heparinized-saline for maintenance of arterial lines and to detect changes in platelet and aPTT as physiological indexes. Methods: In this nonequivalent control group, non-synchronized, double-blind study the effects of heparinized and saline solution on the maintenance of arterial lines were compared. Fifty five patients received the heparinized solution and fifty nine patients received the saline solution. All patients who had surgery in K-university hospital between September and December 2011 were eligible for participation in the study. Results: There was no statistically significant difference between the saline and the heparin group in the maintenance time of the arterial lines or the number of irrigations. There was no statistically significant difference between the groups in changes in the number of platelets and aPTT for interaction between the groups and time intervals. Conclusion: The results indicate that saline solution can be used as an irrigation solution for the maintenance of arterial lines of adult surgical patients, rather than heparinized-saline, in view of potential risk factors in the use of heparin.

• Journal of Korean Biological Nursing Science
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• 제6권1호
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• pp.33-42
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• 2004

Background : Intravenous(IV) access is becoming an increasingly important part of health care today. The current drive for clinical effectiveness and cost-effective health care serves to increase the need for reliable vascular access. Venous access devices were developed to overcome problems associated with limited peripheral access and frequent venipuncture in patients with long-term therapy. Although the peripherally inserted central catheter(PICC) have become popular during recent years in USA, its procedure is rare in Korea. Purpose : The goal of this study was to analyze the PICC inserted patient data by IV CNS intervention. Method : A Total of 62 PICCs were inserted into 51 patients by the IV CNS during a 10-month period form November, 14, 2002, to October 2, 2002. Data was obtained retrospectively through chart review. Result : The patient population included 34(54.8%) men and 28(45.2%) women, with a mean age 50.6 years. The main indication for PICC placement was to access vein in poor peripheral venous status(40.3%). The mean served interval for PICC insertions was 16.7 days(range, $2{\sim}61$ days). The reasons for removal were completed therapy in 18 cases(29.0%), patient death in 13 cases(21.0%), and mechanical or functional PICC problem in 10cases(16.1%). The three PICCs removed for presumed infection, and one had only positive tip cultures(0.2%). Conclusion : PICCs are rapidly growing popularity and required an extended course of IV therapy.

• 여성건강간호학회지
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• 제16권3호
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• pp.224-233
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• 2010

Purpose: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. Methods: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. Results: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. Conclusion: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.

• 대한간호학회지
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• 제36권5호
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• pp.863-871
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• 2006

Purpose: A descriptive correlational study was designed to examine the relationship of trait anger and anger expression to blood pressure, cholesterol, and depression in middle-aged Korean men. In addition, this study investigated the mediating effect of social support in relation to anger and other variables. Methods: Two hundred and ninety nine men aged 40 to 64 years were recruited from a health center at K University Hospital located in Ansan City, Kyungki province, Korea. The instruments used were Spielberger's state trait anger expression inventory-the Korean version for trait anger and anger expression, Beck's depression inventory for depression, and a Personal resource questionnaire for perceived social support. Results: Men with high trait anger showed significantly higher systolic blood pressure(BP) and diastolic BP The level of cholesterol did not have a significant relationship with trait anger and anger expression. The severity of depression was significantly higher in men with high trait anger or more frequent uses of anger-in or anger-out. The perceived social support had a significant mediating effect in relation to trait anger and depression. Conclusions: Various nursing interventions for managing anger or improving social support need to be developed in a future study.

• 대한간호학회지
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• 제26권1호
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• pp.5-14
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• 1996

The purpose of this study is to find the Korean women's view to pregnancy within the Korean cultural context, to help nurses understand psychosocioemotional schema of the pregnant women, and to contribute to theory-building on the meaning of pregnancy. The interviewees were 21 women in their twenties or thirties and they were selected by theoretical sampling technique. Thirteen women of the interviewees were single and others married. Data were collected by in-depth interviews from September November in 1994. Interviews were tape-recorded and transcribed. Data were analyzed by Van Kaam's phenomenological method. Results were as follows. Eighty two descriptive expression were found and they were grouped under fourteen common factors. These are 「to maintain family」, 「instinct」, 「obligation」, 「what one should do」, 「to make home」, 「to tie couple firmly」, 「means to overcome a period of lassitude」, 「token of love」, 「hope」, 「to avoid loneliness」, 「wanted to have a baby」, 「to provide for old ages」, 「to be a mother」, 「to achieve her desire through baby」. Finally, fourteen common factors were grouped under four higher categories. Five common factors, 「to maintain family」, 「instinct」, 「obligation」, 「what one should do」, 「to make home」 were grouped under〈custom〉. Three factors, 「to tie couple firmly」, 「means to overcome a period of lassitude」, 「token of love」 were grouped under 〈love between couple〉. Four factors, 「hope」, 「to avoid loneliness」, 「wanted to have a baby」, 「to provide for old ages」 were grouped under 〈pursuiting safety〉. Two factors, 「to be a mother」, 「to achieve her desire through baby」 were grouped under 〈self-fulfillment〉. At present, the most distinguishing motivation of childbearing was rooted in the cultural custom. Korean women thought that it was their duties to have children and children were necessary in life. But they were beginning to recognize that baby could tie couple more firmly and get rid of their loneliness. Korean women no longer considered their children as the one who would take care of them when they were old or who would satisfy their unmet needs. As pregnancy is not women's duty only, authors recommend further studies on men's view to pregnancy.