• Title/Summary/Keyword: 자가관리이행

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The Effects of a Cognitive Behavioral Stress Management Program on Diabetic Self-Care and Glycemic Control with Diabetes Mellitus Type II (인지행동 스트레스관리 프로그램이 제2형 당뇨병 환자의 자가간호 이행과 당대사에 미치는 효과)

  • Park, Kyung Yeon;Park, Hyoung Sook;Seo, Ji Min
    • Korean Journal of Adult Nursing
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    • v.19 no.5
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    • pp.1-11
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    • 2007
  • Purpose: The purpose of this study was to examine the effects of a cognitive behavioral stress management program on diabetic self-care and glycemic control with type 2 diabetic patients. Methods: Thirty three diabetic patients who were older than 40 were recruited from a public health center and conveniently assigned into both experimental(n=16) and control groups(n=17). Participants in the experimental group had attended the weekly cognitive behavioral program for 8 weeks. Data were collected from June 2005 to August 2006 and analyzed by independent t-test using the SPSS WIN program. Results: After an 8 week intervention, participants in the experimental group reported on increasement of diabetic self-care behaviors and an increasement of blood glucose levels, which were significantly different from those in the control group. Conclusion: On the basis of those findings, we concluded that the cognitive behavioral stress management program has positive effects on diabetic self-care and glycemic control for the patients with DM. Further research is needed to identify the long-term effects of the cognitive behavioral program.

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Postoperative Quality of Life in Patients with Papillary Thyroid Cancer (갑상선 유두암환자의 수술 후 삶의 질)

  • Kim, Ju-Sung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.3
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    • pp.1260-1269
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    • 2011
  • The purpose of this study was to determine postoperative quality of life(QoL), thyroid specific symptoms(TSSs), self care compliance, anxiety and depression in patients with papillary thyroid cancer and to identify factors influencing their postoperative QoL. 154 patients were surveyed using structured questionnaires and data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression with SPSS/WIN 18.0 program. The mean score of postoperative QoL in the subjects was 2.72 and the postoperative QoL score of social/family well being subscale showed the lowest score. Most of the subjects suffered from TSSs such as fatigue, cold intolerance, and mood swings. The most frequent activity for self care compliance was taking thyroid hormone(100%) and OPD follow up was the second activity(99.4%). Anxiety score was 45.3 indicating a medium level however 63% of the subjects were evaluated as depression status. Postoperative QoL in thyroid papillary cancer patients showed significantly negative correlations to TSSs, anxiety, and depression (r=-.573, p<.001; r=-.739, p<.001; r=-.742, p<.001). The factors influencing postoperative QoL were TSSs, anxiety, and depression, which explained about 64.9% of the variance. Thus to improve postoperative QoL in patients with papillary thyroid cancer, health care providers should relieve negative emotions related to long term cancer management, develop the support system and provide practical information to apply patients' physical, and psychological symptoms control.

Effects of Camping Programs on Self-efficacy and Sick-role Behavioral Compliance in Juvenile Diabetes Mellitus Patient (소아 당뇨 환자의 캠프 프로그램이 자기효능과 환자 역할 행위이행에 미치는 영향)

  • Park, Yeon-Hee
    • Korean Journal of Health Education and Promotion
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    • v.14 no.2
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    • pp.59-68
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    • 1997
  • 당뇨병은 고혈당을 조절 안할 경우에는 돌이킬 수 없는 신체적 합병증은 물론 정신적 손상까지 받지만, 고혈당은 노력만 하면 조절이 가능하며, 정상에 가까울 정도로 조절되면 정상인과 같은 삶을 영위할 수 있다. 그러나 보건의료 전문가의 인슐린 주사 요법, 식사 및 운동요법 등의 일방적인 처방만으로 성공적인 당조절을 기대하기에는 어려움이 있다. 그래서 당뇨병 환자에게 당뇨병이라는 것이 무엇이며, 어떻게 이 병을 스스로 조절할 수 있게 만드느냐가 더욱 중요한 것이다. 따라서 우리나라에서도 당뇨병에 대한 관심이 높아짐에 따라 각 지역과 의료기관마다 다양한 당뇨병 교육 프로그램이 실시되고 있다. 특히 소아 당뇨병 환자는 이러한 전통적인 당뇨병에 관한 교육을 통해서 당뇨병에 관한 지식은 많이 가지고 있지만, 당뇨병 자가 조절을 위한 환자 역할 행위(sick-role behavior)를 변화시키는데는 그다지 성공절이라 할 수 없다. Bandura(1977)는 자기 효능은 ‘할 수 있다는 자신감’으로 수행 성취, 대리 경험, 언어적 설득, 정서적 각성에 관한 정보에 의해 결정된다고 하였다. 따라서 이러한 정보들은 자기 효능을 증진시키기 위한 중재의 방향을 제시해 준다. 오늘날 이러한 정보를 활용한 중재 프로그램 중에서 가정과 학교를 떠나 자연 환경 속에서의 집단 활동을 통하여 사회 학습 경험을 하는 캠프 프로그램에 대한 관심이 높아지고 있다. 캠프에 참여한 당뇨병 아이들은 캠프 활동속에서 다른 동료 아이들이 자신이 갖고 있는 문제들을 성공적으로 해결해 나가는 것을 관찰하여 대리 경험하게 될 때 희망을 가지게 되며, 당뇨병을 가진 다른 동료들과 공통의 경험을 공유할 수 있는 기회를 갖게 되어 그들은 자신이 더 이상 혼자가 아니며 남과 ‘다르지’도 않다는 것을 깨닫게 되어 점차 자신감을 가지고 살아갈 수 있게 된다. 본 연구는 캠프 프로그램이 소아 당뇨병의 자기 효능을 증진시키고, 당뇨병 환자 역할 행위 이행 정도를 높여주는지를 규명해 봄으로써, 소아 당뇨병 환자를 위한 효과적인 간호 중재 방안을 제시하고자 비동등성 대조군 전후 실험 설계의 유사 실험 연구를 시도하였다. 1996년 8월 10일 부터 12월 12일까지 종합병원에서 추후 관리하고 있는 소아 당뇨병 환자중 선정 기준에 맞는 환자 41명을 연구대상으로 하였으며, 그 중 19명은 실험군으로 Bandura의 자기 효능 증진을 위한 정보원을 활용한 캠프 프로그램을 5박 6일간에 걸쳐 실시하였고, 다음 22명은 대조군으로 캠프 프로그램을 실시하지 않았다. 자료수집은 자기 효능 척도와 환자 행위 역할 이행 척도를 캠프 프로그램을 실시하기 전에 사전 조사를 하고 중재 후 4주째 사후 조사를 하였다. 수집된 자료는 SPSS/PC+로 Chi-square test, t-test, ANCOVA, Pearson correlation을 이용하여 분석하였으며, 그 결과는 다음과 같다. 캠프 프로그램은 소아 당뇨병 환자의 자기 효능을 증진시키고 환자 역할 행위 이행을 높여주는데 효과적 이었다. 소아 당뇨병 환자의 자기 효능은 환자 역할 행위 이행과 순 상관 관계가 있어, 자기 효능이 증진될수록 환자 역할 행위 이행 정도가 높아졌다.

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Structural Equation Modeling on Self-Care Behavior and Quality of Life in Older Adults with Diabetes Using Citizen Health Promotion Centers (시민건강증진실을 이용하는 노인 당뇨환자의 자가관리 이행 및 삶의 질 예측모형)

  • Lee, Songheun;Kim, Hyunli
    • Journal of Korean Academy of Nursing
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    • v.47 no.4
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    • pp.514-525
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    • 2017
  • Purpose: The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior and Quality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination of the Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants. Methods: Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabetes who regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factor affecting the participants' DSM behavior and QoL. Results: The supported hypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (${\gamma}=.55$, p=.007). 2) The variables that had a direct effect on DSM behavior were DSM information (${\gamma}=.15$, p=.023), DSM confidence (${\gamma}=.25$, p<.001), and autonomous motivation (${\gamma}=.13$, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (${\gamma}=.33$, p<.001). Conclusion: The major findings of this study are that supporting patient's autonomous motivation is an influential predictor for adherence to DSM behavior, and integrative intervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continue DSM behavior and improve QoL.

A Study on Legal and Institutional Improvement Measures for the Effective Implementation of SMS -Focusing on Aircraft Accident Investigation-

  • Yoo, Kyung-In
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.2
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    • pp.101-127
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    • 2017
  • Even with the most advanced aviation technology benefits, aircraft accidents are constantly occurring while air passenger transportation volume is expected to double in the next 15 years. Since it is not possible to secure aviation safety only by the post aircraft accident safety action of accident investigations, it has been recognized and consensus has been formed that proactive and predictive prevention measures are necessary. In this sense, the aviation safety management system (SMS) was introduced in 2008 and has been carried out in earnest since 2011. SMS is a proactive and predictive aircraft accident preventive measure, which is a mechanism to eliminate the fundamental risk factors by approaching organizational factors beyond technological factors and human factors related to aviation safety. The methodology is to collect hazards in all the sites required for aircraft operations, to build a database, to analyze the risks, and through managing risks, to keep the risks acceptable or below. Therefore, the improper implementation of SMS indicates that the aircraft accident prevention is insufficient and it is to be directly connected with the aircraft accident. Reports of duty performance related hazards including their own errors are essential and most important in SMS. Under the policy of just culture for voluntary reporting, the guarantee of information providers' anonymity, non-punishment and non-blame should be basically secured, but to this end, under-reporting is stagnant due to lack of trust in their own organizations. It is necessary for the accountable executive(CEO) and senior management to take a leading role to foster the safety culture initiating from just culture with the safety consciousness, balancing between safety and profit for the organization. Though a Ministry of Land, Infrastructure and Transport's order, "Guidance on SMS Implementation" states the training required for the accountable executive(CEO) and senior management, it is not legally binding. Thus it is suggested that the SMS training completion certificates of accountable executive(CEO) and senior management be included in SMS approval application form that is legally required by "Korea Aviation Safety Program" in addition to other required documents such as a copy of SMS manual. Also, SMS related items are missing in the aircraft accident investigation, so that organizational factors in association with safety culture and risk management are not being investigated. This hinders from preventing future accidents, as the root cause cannot be identified. The Aircraft Accident Investigation Manuals issued by ICAO contain the SMS investigation wheres it is not included in the final report form of Annex 13 to the Convention on International Civil Aviation. In addition, the US National Transportation Safety Board(NTSB) that has been a substantial example of the aircraft accident investigation for the other accident investigation agencies worldwide does not appear to expand the scope of investigation activities further to SMS. For these reasons, it is believed that investigation agencies conducting their investigations under Annex 13 do not include SMS in the investigation items, and the aircraft accident investigators are hardly exposed to SMS investigation methods or techniques. In this respect, it is necessary to include the SMS investigation in the organization and management information of the final report format of Annex 13. In Korea as well, in the same manner, SMS item should be added to the final report format of the Operating Regulation of the Aircraft and Railway Accident Investigation Board. If such legal and institutional improvement methods are complemented, SMS will serve the purpose of aircraft accident prevention effectively and contribute to the improvement of aviation safety in the future.

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Development and Application of Index Framework to Assess Cost-effectiveness of Payments for Forest Ecosystem Services in Korea (산림생태계서비스지불제의 비용효과성 평가를 위한 지수체계 개발 및 적용)

  • Ahn, SoEun;Rho, Paikho
    • Journal of Korean Society of Forest Science
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    • v.105 no.3
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    • pp.377-390
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    • 2016
  • The aim of this study is 1) to design an auction-type and area-based payments for ecosystem services (PES) in application to private forest in Korea, 2) to develop the framework of index to implement the PES program proposed, and 3) to examine the feasibility and validity of the index framework by conducting a case study. The index framework measures quantities of ecosystem services currently supplied, improvement of ecosystem services anticipated from the proposed management activities, and real implementing costs of the program. The total scores from the case study vary from 301 to 501 for site 1, Goesan-gun and 273 to 460 for site 2, Pyeongchang-gun, respectively, indicating that total index score - measurement of cost-effectiveness - can be varied by the levels of management and real cost even if the scores from ecosystem service indicator group are the same. The index framework which can locate a cost-effective program has significant policy implication given the budget constraints in biodiversity/ecosystem services policy arena.

Psychometric Properties of the Hypertension Self-Care Behavior Scale for Elders with Hypertension in Korea (노인 고혈압 자가간호행위 측정도구의 타당도와 신뢰도 검증)

  • An, Na;Jun, Younghee;Song, Youngshin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.1
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    • pp.1-8
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    • 2017
  • Purpose: The purpose of this study was to evaluate the psychometric properties of the Hypertension Self-Care Behavior Scale for older adults with hypertension in Korea. Methods: A cross-sectional descriptive study was used with 196 participants. Translation and back-translation were performed by bilingual nursing professionals and a nutritionist. Reliability and validity such as content validity, construct validity, and concurrent validity were conducted. To evaluate the concurrent validity, the correlation coefficients between the Korean version of Hypertension Self-Care Behavior and concurrent scales (hypertension adherence scale and self-efficacy scale) were calculated. Results: The total 20 items for the Korean version of the Hypertension Self-Care (HBP-SC) Behavior Scale were retained during item-analysis. In explanatory factor analysis, a two-factor solution was proposed and the two factors named, 'HBP-SC Diet behavior' and 'HBP-SC Health behavior (except diet)'. The two factors accounted for 48.9% of the variances. The Korean version of the Hypertension Self-Care Behavior Scale correlated with concurrent variables such as hypertension adherence and self-efficacy. For reliability of the Korean version of the Hypertension Self-Care Behavior, Cronbach's ${\alpha}=.92$. Conclusion: Findings show that the Korean version of the Hypertension Self-Care Behavior is reliable and valid for measuring self-care behavior of older adults with hypertension.

Analysis of Sustainable Management Factors in County Parks Based on the Sustainability Evaluation Framework of Korea Nature Parks - Focus on the 11 County Parks in Gyeongsangnam-do - (자연공원 지속가능성평가에 기반한 군립공원 지속가능성 영향요인 분석 - 경남권역 11개소 군립공원을 대상으로 -)

  • Hong, Sukhwan;Ahn, Rosa;Tian, Wanting;Heo, Hagyoung;Pak, Junhou
    • Journal of the Korean Institute of Landscape Architecture
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    • v.48 no.3
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    • pp.12-21
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    • 2020
  • This study aims to implement the Sustainability Evaluation Framework of Korea Natural Parks to county parks in Gyeongsangnam-do, and to review the performance status of management effectiveness evaluation (MEE) and identify factors that influence the improvement of management effectiveness in protected areas. County park officers evaluated current management using this framework that was developed based on the MEE framework designed by the Korean Ministry of Environment. Among the principal values of county parks, 'natural and ecological' is indicated as the most important, followed by 'cultural and historic value' and 'leisure and recreation'. Natural disasters and climate change, visitor impact-inappropriate visitor behavior are indicated as current threats, and three county parks administrators viewed that there was no particular threat to their park. According to MEE results, the most effective management fields were 'State of cultural and historic value', 'State of leisure and recreational value', 'Current state of principal value'. The comparatively weaker fields were 'Threatened species management', 'Invasive species management', 'Management monitoring and evaluation'. The effects of sustainable management on county parks were analyzed through a regression analysis, and the influence of management factors reveal 'Annual budget', will impact attaining higher management scores. This study presents the current management information about county parks and provides support for the basis for the planning of county parks in Korea, suggesting the influencing factor.

Relationship of Fatigue, Family Function and Self-esteem of Middle-aged Women in Menopausal Periods (폐경기 중년여성의 피로, 가족기능과 자아존중감 간의 관계)

  • Kweon, Yoo-Rim;Jeon, Hae-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.6
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    • pp.2579-2588
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    • 2012
  • The purpose of this study was to examine the relations between fatigue, family function and self-esteem among middle-aged women in menopausal periods. Data were collected through self-administered questionnaire survey form 133 middle-aged women. The data collection was done from March 2nd to April 10th, 2012. As a results, there were significant differences in fatigue by education level and menstrual status. And, there were significant differences in family function according to education level and marital status. Also, there were significant differences in self-esteem by education level, marital status and monthly income. Fatigue was negatively related to family function and self-esteem. And family function was positively related to self-esteem. These results suggest that nursing intervention should be developed to strengthen family function and self-esteem as a way to regulate fatigue for middle-aged women in menopausal periods. Especially, it is necessary to pay more attention to health management of middle-aged women belonging to menopausal transition, with low-income, low-education level.

Systematic Improvement for Effective Operation of Long-Term Continuous Construction Contracts (장기계속공사계약의 효율적 운영을 위한 제도 개선)

  • Cho, Youngjun
    • Korean Journal of Construction Engineering and Management
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    • v.20 no.6
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    • pp.3-10
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    • 2019
  • The entire duration of the long-term continuous construction contract project cannot be expected when calculating the initial budget as the construction of the contract is carried out annually according to the budget composition. In addition, the statutes related to the defect liability and execution of contracts have not been established systematically in relation to the contract. Therefore, there are many problems at the actual construction site with regard to the defect liability or the performance of the contract in relation to the contract. In this study, the following improvement directions were presented for the efficient operation of the contracts: First, the defect liability is legal and should be specified in an Act rather than an enforcement decree. Second, if the parties to the contract vary in the following order in the contract, the special agreement should be specified in the enforcement decree. Third, in the event of an indirect cost due to the extension of the period of the long-term continuous work, the contingency items of the total project cost management policy should be utilized. Fourth, in the case of general construction contract conditions, clauses related to the purchase of the premium of the CAR, inspection, taking over, defect repair, and defect inspection shall be supplemented.