• 제목/요약/키워드: 간호문제

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요양병원 근무 간호사의 직무배태성에 미치는 영향: 근무환경과 역할갈등 중심으로 (The Effects of Nursing Work Environment and Role Conflict on Job Embeddedness among Nurses of Long-term Care Hospital)

  • 손숙연;김신미
    • 한국노년학
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    • 제39권4호
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    • pp.663-677
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    • 2019
  • 본 연구는 요양병원 근무 간호사의 근무환경, 역할갈등 및 직무배태성을 확인하고 직무배태성에 미치는 영향요인을 파악하기 위하여 수행되었다. 본 연구를 위하여 일개 도에서 자료 수집을 허락한 10개 기관에서 총 200명의 간호사를 대상으로 2018년 7월과 8월에 걸쳐 자료를 수집하였다. 본 연구에서는 구조화된 설문지를 통해 일반적 특성과 간호사의 근무환경, 역할갈등 및 직무배태성을 평가하였으며 배포한 200부 중 분석에 적합한 190부를 최종 분석하였다. 수집된 자료는 SPSS 버전 25.0를 이용하여 서술적 통계, t-test, ANOVA, Pearson's correlation coefficients, 다중회귀분석을 실시하였다. 분석 결과 직무배태성은 5점 만점에 2.98±0.46점이었고, 하위영역별로는 적합성, 연계, 희생 순으로 나타났다. 간호사의 근무환경은 평균 3.14±0.42점이었고 하위영역별로는 수간호사의 리더십, 실무체계, 동료와의 관계, 기관의 지원 순이었다. 역할갈등은 평균 3.43±0.51점이었고 하위영역 중 환경장애가 가장 높았다. 직무배태성은 간호사들이 인식하는 근무환경과 통계적으로 유의한 정적 상관관계를 보였고, 역할갈등과는 통계적으로 유의한 부적 상관관계를 보였다. 최종적으로 본 연구의 종속변수인 요양병원 근무 간호사들의 직무배태성에 영향을 미치는 요인은 근무환경, 연령, 역할갈등이었으며 설명력은 50.4% 이었다. 본 연구결과를 통해 요양병원에 근무하는 간호사들의 근무환경, 역할갈등과 직무배태성을 확인하였으며 현재 문제가 되고 있는 간호사들의 높은 이직률과 관련하여 직무배태성 제고를 위한 방향성을 점검하였다. 즉 요양병원 조직의 차원에서 간호근무환경 개선과 역할갈등 완화 노력이 요구되는데 이를 위한 조직과 정책적 뒷받침이 필요해 보인다. 또한 근무 중인 간호사 연령층의 특성을 고려할 필요성을 확인한 것 역시 의미있는 발견이라 하겠으며 앞으로 더욱 가속화될 고령인구 증가와 더불어 요양병원 근무 간호사들의 직무배태성 제고에 더욱 관심을 가질 필요성이 제기된다.

문제학생가족과 정상학생가족의 가족역동 비교연구 (The Comparative Study of Family Dynamics between Families of Problem Students and of Normal Students)

  • 김윤희;문희자
    • 대한간호학회지
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    • 제23권2호
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    • pp.187-206
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    • 1993
  • The study was done to better understand problem behavior in high school students as described in family system theory, which explains the individual’s problem within the family interactions. The purpose of the study 1. To analyze the difference in the parents’ relationship as a couple between the two groups. 2. To analyze the difference in the parent-adolecent relationship between the two groups. 3. To analyze the difference in the family function (cohesion adaptability) between the two groups. The method of the study The staudy subjects consisted of a total of 176 families (528 persons), 109 high school students (End grade) with problem behavior and their parents (problem family group) ,and 69 high school students (same grade) with normal behavior and their parents (normal family group) residing in the Seoul area. Data were gathered from structured, self-reporting qestionaires which included a Couple Relation measurement (95 items) , Parent-Adolescent communication measurement (20 items), Family Cohesion Adaptability Scale (20 items) by DavidH. Olson et al., and a behavior evaluation tool. The results of the study 1. The results as related to the hypothesis were as follows. Hypothesis 1 : “satisfaction within The couple's relationship of the parents of problem family group will be lower than the normal family group was supported significantly(t=3.07, p=.005). Hypothesis 2: “The parent-adolescent relationship of the problem family group will be more negative and problematic than the normal family group” was supported significantly(t=4.06, p=.000). Hypothesis 3: “The family function (cohesion adaptability) of the problem family group will be lower than the normal family group" was supported significantly(t=2.20, p=.022) 2. The results of related analysis were as follows 1) Analysis of a causal relation between the couple’s relationship, the parent-adolescent relationship, family function and adolescent behavior showed that the Above 3 variables influenced adolescent behavior.. In cases where couple’s relation-ship, the parent-adolescent’s relationship, the family function are the better, their adolescent’s behavior is better. 2) Discriminant analysis of the research tool showed The discriminant ability of couple’s relationship tool was 75.57%, the Parent-Adolescent communication tool, 67.05, the family adaptability cohesion tool.67. 61%. In summary, interpersonal relationships in the family subsystems are interactive and their relation influences the behaviors. of adolescents in the family. Therefore, family therapy would be a more effective method than individual therapy, to resolve negative problem for adolscents, and the research tool used in this study are very useful for family system diagnosis and nursing intervention.

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마리화나 남용환자의 역동적인 발달요인과 문제해결 (Dynamic Developmental Factors and their Problem Solving of Patients that Abuse Marihuana)

  • 원정숙
    • 대한간호학회지
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    • 제4권3호
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    • pp.105-116
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    • 1974
  • This study was made on patients who were Hospitalized due to sickness caused by the abuse of marihuana at the Psychiatric Section of a hospital during the period from Feb. to Oct., 1974. The following conclusion was obtained by reviewing the literature with respect to the nursing, and problem solving of those patients. 1. It appears that marihuana is a comparatively mild intoxicant in ordinary preparation without causing physical dependence or tolerance. 2. According to the status of men who are marihuana smokers, approximately 20% of them were college students, those preparing to retake college entrance examinations, non-employed and pharmacists. The men belong mostly to the middle foreigner′s mistress of higher, income bracket, and in the case of women, most of the smokers were US. servicemen entertainers. 3. Dynamic developmental factors: Case 1. : The patient had a characteristic, hysterical and emotionally unitable character, and was of low intelligence, In addition, to this already existing problem, the added uses of marihuana caused a mental illness to develope. Case 2 : The character, was reserved and introspective, her creative power and sentiment was fading and his ability of self-control was weakened. She used the smoking of marihuana to get rid of her own feeling of inferiority complex and tensions coming from interpersonal relationships. Case 3 : The patient was unconditionally resistive to the authoritativeness of superiors and irresponsible in his relationship with women, in his attitude concerning sex in general. He smoked marihuana because he felt become peace-loving and get enchanted experience through smoking it. 4. The points of issue appearing from the above case; (1) Movement of anti-social feelings against the "established system" by the youngsters. (2) Family problem. (3) Shamelessness, loss of motivation, disorderly attitude toward the sex, (4) Worries concerning the future. (5) Lack of knowledge concerning smoking of cigarette and marihuana. Chronic use of marihuana made, those youngman who had originally been ambitions to achieve something in life, lazy, inefficient, unable to make long-term plans, are such weak mined persons that they did not try to overcome problems when encountered. This will pose a great and important question in the mental health of the society, 5. Treatment and Problem sieving According to the literature, we will have to place importance upon hospitalized treatment The phases of treatment were divided into five parts. (1) Prehospital phase (2) Withdrawal Phase (3) Rehabilitation phase (4) Transitional phase (5) After-care phase The experiments have proved that there was much progress in the recovery of patients through environment therapy, supportive therapy and group psychotherapy. This was the above mentioned 5 phases of treating process in accordance with the weekly schedule of the hospital. It was thought that the patients would require prolonged after care management even after they were released from the hospital and that they will also require periodic visit, to the hospital and doctor′s interview with their family. In conclusion, the question of the young generation and marihuana smoking is becoming a great social problem in which their resistances to the "established system" and society is growing in the from of antiestablishment movements. In our country, the smoking of marihuana is gradually developing, therefore, I think, that it would be a very fortunate thing for us, if this report could be helpful for the motivation of further study on the questions of the young generation and its problems.

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일부 지역 청소년들의 신체적$\cdot$정신적$\cdot$성적$\cdot$사회문화적 영역별 문제경험정도와 상담의 필요성에 관한 연구 (A Study about the Experienced Problems and the Demands of Counseling of the Adolescents according to the Physical, Psychological, Sexual and the Socio-cultural Problem Categories)

  • 김진경;김은숙;이정애
    • 한국보건간호학회지
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    • 제11권2호
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    • pp.152-170
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    • 1997
  • The purpose of this study was to identify physical. psychological. sexual and socio-cultural problems that the adolescents have experienced and to assess the demands of counseling about the experienced problems. The design of this study was descriptive-survery study. The sample size was 601 middle and high school students. Data analysis was done by frequencies. Percent. t -test. ANOVA. Pearson correlation coefficiency, stepwise regression and Cronbach's $\alpha$ Score was produced for the reliability of the tool by using the item analysis method. The results was as follows : 1. The distribution of the each item that the adolescents experienced according to the physical, psychalogical. Sexual and Socio-cultural problem Categories was examined. In the physical problem category, the number of items that half and more than half of the adolescents experienced of often or frequently were 10 among all 19 items. In the psychological problem category. 13 item were among all 19 items. In the sexual problem category, 1 item among all 17 items and in the socio-cultural problem category, 10 items were among all 30 items. 2. The distribution of the each items that the adolescents wanted to the counseling according to the physical. psychological. sexual and socio-cultural problem categories was examined. In the physical problem category, the numbers of the items that half and more than half of the adolescents wanted counseling were 1 among all 19 items. In the psychological problem category, the numbers of the items that half and more than half of the adolescents wanted counseling were 2 items among all 19 items. In the sexual problem category, 0 item among all 17 items and in the socio-cultural problem category, 2 items were among all 30 items. 3. In the comparison of the female student and male student about the experienced problems and the demands of counseling according to the physical. psychological. sexual and socio-cultural problem categories. There was a significant difference statistically in all categories between groups(P<.001) 4. In the comparison of high school students and middle school students about the demands of counseling according to the physical. psychological. sexual and socio-cultural problem categories(P<.001). Particulary, grade II of high school students have experienced problems according to the physical. psychological. sexual and socio-cultural problem categories. There was a significant difference statistically in all categories(P<.001). 5. In the correlation between the experienced problem and the demands of counseling according to 4 categories. there was the positive correlation at P<.001 level. 6. The less the satisfaction for family and school life. the more experienced problems according to the physical. psychological. sexual and socio-cultural problem categories. There was a significant difference statistically in all categories(P<.001).

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치매노인 가족부양자의 대처방법에 관한 연구 (A Study on a Coping Method of the Family Caregivers of Demented Patients)

  • 유광수
    • 지역사회간호학회지
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    • 제13권4호
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    • pp.648-667
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    • 2002
  • This was a descriptive study designed to identify the level of coping method and its influencing factors on the family caregivers of demented patients, and resolve the family caregivers' level of stress. The data were collected from September 10 to October 10, 2001. Subjects for this study were recruited from four clinics, which were chosen from 15 clinics located in Chunbuk-Do as the study sites because of their cooperation for the study. They were similar in terms of size, the characteristics of the local community. and the population and registration status of the demented patients. The instruments used for the study were as follows: 1. Problematic behaviors of demented patients are measured by the Memory and Behavior Problem Checklist (Zarit, 1980), and the Linguistic Communication Symptoms Questionnaire (Bayles and Tomoeda, 1991) 2. The ability to carry out daily activities was measured using the Barthel Index (1965) and Katz Index (1963), which as well-known ADL assessment methods. 3. Burden was measured using Cost of Care Index by the Kosberg and Cairl (1986). 4. Coping strategy was measured Bell's 18 methods (1977). The data were analyzed using SPSS/PC. The study results were as follows: 1. The total stress score was 2.90 out of a maximum score of 5. The highest score reported was 3.09 on the dimension of restriction of individual and social activities, and the lowest region reported was 2.58 on the dimension of mental and physical health. 2. The total score of the coping method was 2.65 out of a maximum score of 5. The highest score reported was 4.01 on the dimension of thinking that includes an ideation such that it is better than any possible worst case, and the lowest score reported was 1.45 on the dimension of the self-image as a scapegoat. 3. There were significant differences in coping method among the subjects by age (F=2.752 p=0.04), caregiver (F=4.33 p=0.003), care-giving period (F=2.68 p=0.049), and dementia stage (F=2.87 p=0.034). 4. There were highly negative correlations ($\gamma$=-0.301 p=0.000) between problematic behaviors of demented patients and the coping method of their family caregivers. The highest correlation coefficient ($\gamma$=-0.339 p=0.000) was found between aggressive behaviors of the demented patients and the coping method of their family caregivers. 5. There was a low negative correlation ($\gamma$=-0.201 p=0.019) between the ADL of the demented patients and the coping method of their family caregivers. 6. There were highly negative correlations ($\gamma$=-0.213 p=0.005) between stress and the coping method of the family caregivers. The highest correlation was found between financial burden ($\gamma$=-.327 P=.000) and the coping method of the family caregivers. There was no significant correlation among unpleasant aspects of the demented patients, willingness to the demented patients, and the coping method of the family caregivers.

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구타, 성폭력, 이혼을 중심으로 본 여성건강 문제에 관한 고찰 (The Study on Woman's Health Problem in the View of Battering, Sexual Violence and Divorce)

  • 최의순;고명숙;이규은;길숙영
    • 여성건강간호학회지
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    • 제2권1호
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    • pp.106-124
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    • 1996
  • This paper reviews battering, sexual violence and divorce experienced among women. There three problems have negative influence on health status in women and are further developed to social problems such as family dissolution. The victims of the problems may manifest physical injury, emotional difficulties and social withdrawl, while their children may show problems caused by lack of parental caring and by resembling abusive behaviors of their parents. Hence, nurses need to pay attention to batting, sexual violence, and divorce and to develop relevant nursing interventions for them. Some strategies of dealing with those problems are presented in the following. First, we have to eliminate sexism prevailing in out society. Our society is assigning inequal and asymmetrical gender role. Mass media should inspire equality between genders and show a healthy model of family and community. Second, social system and laws should be changed through collective efforts. Those living conditions of women cannot be changed by the effort of women themselves only. We all need to work for establishing and changing the law, so that those women in suffering can obtain immediate and adequate protection. Third, social support system of consulting and referring women's problems should be established. Such support system as hot line, shelter and counseling clinics would help women in crisis. Fourth, job training and arrangement should be available to women who are divorced. Fifth, there should be self-help group for those women in suffering. Self-help group would help those women in sharing their problems and feelings and in establishing coping strategies. Nurses, as the largest group among health professionals, are sensitive and respond to health needs of clients and have an effect on managing women's health. However, we nurses have not been ready for dealing with problems of women, although most of us are women. we not need to change our perspective of women's health problems from a traditional medical perspective to feministic one. Accordingly, nurses need to develop realistic way of caring those women in suffering and to assist them in making decisions for their lives by themselves.

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입원환자가족의 가정문제에 관한 연구 (A Study on the Family Problem of the Hospitalized Patients)

  • 황영빈
    • 한국보건간호학회지
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    • 제4권2호
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    • pp.79-99
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    • 1990
  • This study was conducted to identify the family problems of the in-patients and to analize factors Influencing to the family problems. The subjects for this study were 277 family members those who were giving care for the adult patients during hospitalized in general wards at Seoul National University Hospital in Seoul. Data were collected through interviews with the questionnaire from September second to September twentieth in 1989. The instrument used for this study was the family problems scale which was developed by the researcher. Analysis of data was done by frequency, percent, mean, t-test, ANOVA, Pearson-Correlation Coefficients, and Stepwise Multiple Regression Analysis. The results of this study are summarized as follows: 1. General characteristics of the care-giver in family. The average age of care-givers was 37.9 years, and the $26.4\%$ of monthly Income of family was 310,000-500,000 won group. The $93.5\%$ of family had taken the responsibility of caring for the patients instead of hiring the care-givers, and the $12.3\%$of the care-givers complained weakning of health status during care giving for the patients. The spouse took the largest part of responsibility of the care-giving services to the patient among the family members. 2. General characteristics of the patients. The average age of patient was 47 years, and the $80.9\%$ of patient was married status. The $39\%$ of patient was father in the position of family, and the $41.5\%$ had the responsibility to support their family before hospitalization. The average hospitalization period of patient was 24.3 day and the $50.9\%$ had admission experience. 3. The factors of family problems which were faced by the family were classified into six problems. The factors of family problems were ranked as follows; the first rank problem was related to care-giving for the patients. the second problem was resulted from the patients diseases, the theirds problem was related with adaptation to the hospital enviroments, the fourth problem was related to the arisen conflicts with medical team. the fifth problem was related to the change of family function. and the sixth problem was the financial problem. 4. The relationship between the family problems and the general charateristics of the care-givers showed that the nuclear type family was higher the family problems, that the admission period of patients became longer, and that the family who had the worse condition of health status of the care givers during care giving for the patients. From the above results, it was confirmed that the family care giving for patients was faced with some problems resulted from patient's illness, relation to the medical team, adaptation to the hospital enviroment, financial problem. change of family function, and care-giving for patients.

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인공임신중절과 관련된 윤리학적 논쟁과 문제 분석 (Ethical Argumants and Problems Analysis Related to Induced Abortion)

  • 엄영란
    • 여성건강간호학회지
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    • 제2권2호
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    • pp.230-252
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    • 1996
  • Over one million cases of the induced abortion have been conducted annually in Korea. Among those cases, most of all were illegally done, but this has not been addressed in the literature. While Korean Nurse Association Code of Ethics presents the respect for life as one of the basic ideology, it was not dealt enough in nursing education. The purposes of the study were to activate the debate on the issues related to an induced abortion ; to introduce the related ethical theories ; and to seek the solution of the ethical problems, which will eventually result in establishing the morality of nursing practice. The ethical theories of an induced abortion have traditionally addressed two extreme perspectives ; the conservatives who emphasize the sanctity of human life and the right of life that will never ethically allow the killing fetus ; and the liberalists who insist the right to choice for women to control their body. Since these extreme theories has not been helpful to solve the ethical problems, the recent trend is leading to the modified theories both from conservative and liberal perspectives. The examples of the theories are the potentiality of fetus(Singer, 1993), the obligation of women to serve their body to fetus(Held, 1987), the Replacement theory (Callahan, 1987), and the Principle of Caring (Gilligan, 1982). The study conducted the indepth interviews with 17 women who experienced the induced abortion and the 6 cases were selected to be analyzed. The cases were analyzed and interpreted by using an integrated case method which was combined of the New Casuisty(Jonsen & Toulmin, 1988 ; Jonsen, 1991) and the Specified Principlism (Richardson, 1990 ; Degrazia, 1992). The result of analysis revealed three types of ethical problems ; (1) the responsibility of taking care of the baby to be born (2) the fear for the condition of the fetus, and (3) the choice of induced abortion as the method of birth control. The findings also revealed the related ethical principles for various situations ; the principle of caring was used for choosing an induced abortion by the subjects ; the principles of the potentiality of fetus and the obligation of women to serve their body were for the consideration for the life of fetus ; and the principle of replacement was utilized for the right to choice for women. The ethical principles related to an induced abortion introduced in the study provided the way to solve the moral problems by applying to the clinical situations for nurses. The study also revealed the possibility of modifying the current ethical theories from the method of applying the principles to the various situation in the study. The modified theories would be more useful to guide the clinical practice with similar ethical problems.

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자궁양성종양 환자의 고강도 초음파 집속술(HIFU) 치료 경험 (Experiences of High Intensity Focused Ultrasound (HIFU) Treatment in Benign Uterus Neoplasms)

  • 박서아;김혜영
    • 한국산학기술학회논문지
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    • 제19권4호
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    • pp.403-411
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    • 2018
  • 본 연구의 목적은 현상학적 접근을 통하여 고강도 초음파 치료를 받은 자궁양성종양 환자에 대한 경험의 본질을 심도 있게 파악하기 위해 이루어졌다. 연구 대상자는 자궁양성종양을 진단받고 고강도 초음파 집속술 치료를 받은 5명의 환자였다. 본 연구의 자료 수집은 2018년 2월부터 3월까지 이루어졌으며, 고강도 초음파 집속술을 시술하고 있는 D시 여성전문병원에서 시행되었다. 연구방법은 일대일 심층 면담을 통해 이루어졌으며, 자료는 비구조적이고 개방된 질문형태를 사용하여 자신의 의견과 경험을 자유롭고 유연하게 표현할 수 있도록 하였다. 인터뷰 자료는 Colaizzi의 현상학적 분석 방법을 사용하였다. 연구결과 5명의 대상자로부터 얻은 고강도 초음파 집속술 치료에 따른 건강문제는 총 3개의 범주로 구성되었고, 각각의 범주는 다시 하부 요인으로 구성되었다. 3개의 범주로는 '불편감', '양가감정', '의지와 요구' 로 나타났다. 본 연구는 고강도 초음파 치료를 받은 자궁양성종양 환자들의 경험을 이해하는데 도움을 줄 것이다. 나아가 본 결과는 향후 여성건강을 위한 새로운 치료법의 개발과 발전에 따라 올바른 간호학적 이해 및 고강도 초음파 치료를 받는 환자에 대한 지속적인 연구와 효과적인 간호 교육프로그램 개발이 이어져야 할 것이다.

간호사 국가고시문제의 내용분석 (A Content Analysis of the test of the National Examination for Registration Nurses in Korea over 3 years)

  • 서문자;윤순녕;유지수;송지호;최경숙
    • 대한간호학회지
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    • 제26권1호
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    • pp.73-93
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    • 1996
  • This study aimed to analyse the test contents of the national examination for the registered nurses (NERN) over 3 years from 1991 to 1993 in Korea. In recent years in Korea, the MCQ(multiple choice question) has been showing to be a highly recognized method for assessing the qualification of registered nurses. Unfortunately, nursing faculties have found NERN had some bad MCQs through having evaluation workshop for Some MCQs often provide so many unwriting clues which become a bias of the results, and some items fell into the category of the lower level of educational taxonomy such as isolated recall a fact or data. Frequently the stems of the questions are ambigous, unclear, disputable, esoterical or trivial. Considering those fallacies of the national examination, it is very critical to review the test items to see whether it is of high quality, is more fair, reliable and objective in depth. Therefore, this study was done to provide data for the improvement of the test contents as well as the teachers's assessment skill. For this study, the ad hoc committee was composed of 16 members, including 5 education board members of Korean Academic Nurses Association and 11 nursing faculty members. This committee had one day panel discussion and filled the checklist for this study. The process of analysing data was held over 10 times during 1992-1994. The analysis focussed on educational taxonomy such as cognitive domain(knowledge), psychmotor domain (skill), affective domain(attitude) and the level of learning such as recall, understanding, problems solving, and learning area of theory and practice, and the learning content categorised by nursing process and disease process. The test analysed using difficulty index and the structure of the test items was analysed. The conclusions and suggestion as follows : 1. In learning area, the average ratio of the theory and practice was 1 : 1.1 which was less than 1 : 2 suggested by Korean National Health Institute, and the ratio was different by the 8 leaning subjects of nursing. 2. In category of the educational taxonomy, the knowledge domain was emphasized mostly(79. 7%), the skill domain was 14.9%, and the attitude domain was 5.4% only. 3. In the level of learning, generally, the test items of the level of recall(45.5%) and the understanding(46.3%) were covered almost and the problem solving was 8.1%. 4. In the learning contents, generally, the test items related to nursing process was 67.2% and that of disease process was 32.8%. However, this proportion was different by the 8 leaning subjects. Even though the nursing diagnosis has been emphasized in nursing curricula recently, the test items of this was identified very few. 5. In the structure of the test item, some were not clear, incorrect grammar, unclear description and some have clues to answer. 6. In the item analysis, the non-acceptable level of the difficulty index (means too easy) was 65.7%, and the acceptable level was 33.9%. Considering the results we would like to suggest the followings, 1. Since the test items of knowledge domain was dominant, the test items of the practice domain and attitude domain should be emphasized more. 2. The regular review and analysis of NERN should be arranged in order to improve the quality of the test items which will give influence to the nursing education positively.

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