• 디지털융복합연구
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• 제12권10호
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• pp.353-361
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• 2014

본 연구는 간호사의 전통적, 사회적, 전문적 및 개인적 이미지의 차원에서 전공자와 비전공자간의 지각차이가 존재하는가와 미디어에 비친 간호사역할 이미지 지각차이가 있는가 및 간호사와 관련된 정보를 접하는 매체와 간호사 관련 정보와 이미지 접촉매체에서 기존의 연구결과와 차이가 있는가를 확인하고자 하였다. 이를 위해 간호학 전공자와 비전공자를 대상으로 설문조사 하였다. 연구결과 첫째, 간호사의 전통적, 사회적, 전문적 및 개인적 이미지에서 인식의 격차가 높게 나타났다. 둘째, 미디어에 비친 간호사의 이미지는 의사의 보조역할을 담당하고 있는 것에 대한 이미지가 높게 나타났다. 셋째, 간호사 정보 접촉매체는 TV가 매우 높게 나타났다. 본 연구결과는 환자와 간호사간의 공감커뮤니케이션을 활성화하는데 근거자료를 제공해 줄 것이며, 특히 매체활용(PPL전략과 퍼블리시티 활용전략)을 통한 간호사 이미지 향상방안을 제언하는데 의의가 있다.

• 중환자간호학회지
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• 제10권1호
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• pp.13-30
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• 2017

Purpose: The purpose of this study was to integrate the results of qualitative studies to understand critical care survivors' experience of the post-intensive care syndrome (PICS). Methods: This was a meta-synthesis of primary studies that used qualitative methods. We reviewed 26 qualitative studies on PICS selected from 8 international and Korean databases and from a manual search. Thomas and Harden's 3 stages (free coding, development of descriptive themes, generation of analytical themes) for thematic synthesis were utilized to analyze the collected qualitative data. Results: Four descriptive themes emerged from the thematic synthesis: weak physical conditions, psycho-emotional changes, the painful-memory of intensive care units, and social vulnerability. The analytical theme for the current study was "unfamiliarity with the vulnerable self." Critical care survivors had to confront entirely different "selves" after discharge from intensive care units. They had become physically weak, psychologically unstable, and the critical memories continued to create distress. These changes increased their social vulnerability by making them dependent on others, causing family conflicts, and changing interpersonal relationships. Conclusions: Finding from this qualitative synthesis and other related literature highlight the severity of PICS and the importance of rehabilitative intervention for critical care survivors.

• 중환자간호학회지
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• 제10권2호
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• pp.24-33
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• 2017

Purpose: This study aimed to investigate the differences in exudate and bleeding incidence and the changes in back pain and discomfort based on the weight of a sand bag applied to the femoral puncture site after hepatic transcatheter arterial chemoembolization. Methods: This quasi-experimental study comprised 82 patients randomly divided into three different groups. Experimental group 1 patients had a 600g sandbag, experimental group 2 patients an 800g sandbag, and control group patients a 1900g sandbag, on femoral access sites post procedure. The three groups of patients were assessed on level of exudate and bleeding and asked about back pain and discomfort at 30, 60, 120, 180 and 240 minutes after the procedure. Results: There were no significant differences in exudate and bleeding between the three groups before and after application of the sandbag post procedure. Both back pain and discomfort were significantly lower in the experimental groups than in the control group. Conclusion: There was no significant effect on bleeding and exudation due to the weight of the sandbag. The lowest level of back pain and discomfort was found in the group with the lightest weight (600 g). Therefore, the use of lighter-weight sandbags to prevent post procedure vascular complications is proposed.

• 중환자간호학회지
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• 제10권2호
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• pp.34-44
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• 2017

Purpose: The purpose of this study was to identify post-operative discomfort, sense of loss, family support, and resilience in breast cancer surgery patients, and to investigate factors that affect resilience. Method: The sample of this study consisted of 108 patients who underwent surgery for breast cancer in two university hospitals located in B city. The collected data was analyzed with descriptive statistics, t-test, ANOVA, and Scheffé test, Pearson's correlation coefficients, and hierarchical multiple regression. Results: The factors that significantly affected resilience were as follows: having a religion (${\beta}=-.20$, p=.006), having an occupation (${\beta}=.14$, p=.049), having a high school diploma (${\beta}=.31$ p=.001), making less than 2-3 million won (${\beta}=-.19$, p=.036) per month, experiencing a sense of loss (${\beta}=-.22$, p=.003) and family support (${\beta}=.44$, p<.001). The total explanatory power amounted to 53.8% (F=14.83, p<.001, $AdjR^2=.54$). Conclusion: Educational intervention programs for breast cancer surgery patients that improve resilience by reducing the sense of loss and increasing family support must be developed.

• 중환자간호학회지
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• 제11권1호
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• pp.15-27
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• 2018

Purpose : This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS). Method : The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others. Results : Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics. Conclusion : To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

• 중환자간호학회지
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• 제11권1호
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• pp.46-66
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• 2018

Purpose : The purpose of this study was to systematically review the instruments utilized to assess physical impairment in post-intensive care syndrome (PICS) of intensive care unit (ICU) survivors. Method : Online databases searched were MEDLINE, Cochrane, CINAHL, and Embase. Studies that met the following criteria were included: 1) the study population exclusively had experience with ICU admission; 2) the study assessed pulmonary, neuromuscular, and physical functions; and 3) the study was published in English language journals after 2007. Results : A total of 56 instruments (2 pulmonary, 25 neuromuscular, 29 physical function) from 94 studies were reviewed. They were classified into self-report, observation, and measurement according to the type of assessment. No instrument measured all 3 areas of physical impairment. Five instruments were originally developed for the ICU patients. The most frequently applied instruments were the Medical Research Council and the 36-item Short Form Survey (physical component summary), which were used in 23 studies each. Only 13.8% of reviewed studies reported the reliability or validity of the instruments. Conclusion : Our results suggest that the appropriateness of instruments assessing physical impairment in PICS cannot be guaranteed. Despite the multidimensional concept of physical disabilities, most studies measured only one area, and studies that reported psychometric properties were limited. Accordingly, we propose to develop a unique and multifaceted instrument for ICU survivors.

• 중환자간호학회지
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• 제11권1호
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• pp.35-45
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• 2018

Purpose : Nurses' knowledge regarding advance directives may affect their administration of and confidence towards end of life care. This study aimed to describe the relationships of knowledge, confidence, and learning needs with advance directives among hospital nurses. Method : This cross-sectional study was performed at a tertiary university hospital in Seoul between September 25 and October 14, 2017. Convenience sampling was used to recruit nurses who provided bedside care and had at least 1 year of clinical experience. We used a validated self-report questionnaire. Results : The mean score of knowledge, confidence and learning needs were $5.00{\pm}1.73$, $29.81{\pm}7.52$, and $64.54{\pm}8.48$ respectively. Hospital nurses' knowledge, confidence and learning needs were significantly different according to age, job position, educational level and perceived advance directives. Knowledge regarding advance directives was significantly associated with confidence (r = .27, p < .001) and learning needs (r = .16, p = .005). Conclusion : Knowledge regarding advance directives was relatively low compared to the findings of previous studies. Therefore, nurses should be knowledgeable and encouraged to initiate advance directives. It is necessary to develop a standardized educational program regarding advance directives based on Korean cultures.

• 중환자간호학회지
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• 제11권3호
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• pp.45-57
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• 2018

Purpose : This study was performed to identify the influencing factors of unplanned intensive care unit (ICU) readmission. Methods : The study adopted a Rretrospective case control cohort design. Data were collected from the electronic medical records of 844 patients who had been discharged from the ICUs of a university hospital in Incheon from June 2014 to December 2014. Results : The study found the unplanned ICU readmission rate was to be 6.4%(n=54). From the univariate analysis revealed that, major symptoms at $1^{st}$ ICU admission, severity at $1^{st}$ ICU admission (CPSCS and APACHE II), duration of applying ventilator application during $1^{st}$ ICU admission, severity at $1^{st}$ discharge from ICU (CPSCS, APACHE II, and GCS), and application of $FiO_2$ with oxygen therapy, implementation of sputum expectoration methods, and length of stay of ICU at $1^{st}$ ICU discharge were appeared to be significant; further, decision tree model analysis revealed that while only 4 variables (sputum expectoration methods, length of stay of ICU, $FiO_2$ with oxygen therapy at $1^{st}$ ICU discharge, and major symptoms at $1^{st}$ ICU admission) were shown to be significant. Conclusions : Since sputum expectoration method was the most important factor to predictor of unplanned ICU readmission, a assessment tool for the patients' capability of sputum expectoration needs to should be developed and implemented, and standardized ICU discharge criteria, including the factors identified from the by empirical evidences, might should be developed to decrease the unplanned ICU readmission rate.

• 중환자간호학회지
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• 제11권3호
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• pp.108-119
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• 2018

Purpose : This study evaluated the nutritional status and effect of nutritional support team (NST) management in critically ill patients. Methods : From January 2015 to August 2017, the study retrospectively investigated 128 patients aged above 19 years admitted to a medical intensive care unit (MICU). The patients were divided into two groups: NST (n=65) and non-NST (n=63) groups. Nutritional status, classification of bedsore risks, incidence rate of bedsore and clinical outcomes were compared. Results : The study found a higher rate of the use of enteral nutrition in the NST group (${\chi}^2=45.60$, p < .001). The prescription rate of parenteral nutrition (PN) was found to be lower in the NST group (4.6%) compared to the non-NST group (60.3%). There was a higher PN of total delivered/required caloric ratio in the NST, compared to the non-NST, group (${\chi}^2=3.33$, p=.025). There were significant differences for higher albumin levels (t=2.50, p=.014), higher total protein levels (t=2.94, p=.004), and higher proportion of discharge with survival rates (${\chi}^2=18.26$, p < .001) in the NST group. Conclusions : Providing NST management to critically ill patients showed an increase in the nutrition support. Further, to achieve effective clinical outcomes, measures such as nutrition education and continuous monitoring and management for the provision of nutritional support by the systemic administration of a nutritional support team should be considered.

• 대한가정학회지
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• 제48권4호
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• pp.83-102
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• 2010

본 연구는 노인부양에 관한 부부간 의사결정 과정에서 부양의 주체인 여성 배우자의 의사결정 파워가 실제 노인부양참여를 위한 결정에 어떤 역할을 하고 있는지 알아보기 위하여 미국내 중고령층을 대상으로 한 2002년 HRS(Health and Retirement Study) 자료를 사용하여 실증분석하였다. 또한 이 연구에서는 배우자 양쪽의 부모로부터 동시에 부양의 역할이 요구되었을 때 부부간 교섭력(Bargaining Power)을 대표할 수 있는 여성의 경제력과 교육수준이 부양결정에 어떤 영향을 미치는지를 다항 로짓 분석 (Multinomial Logit) 분석을 사용하여 검증하였다. 분석결과는 부부의 노부모 부양결정은 부부간 교섭력 보다는 양쪽 부모의 상대적 건강상태, 재정상태, 그리고 간호를 위한 대체 인적자원의 여부등에 의존하는 것으로 밝혀졌다. 또한 남성과는 다르게, 여성의 연령과 노동참여는 여성 자신의 노부모 부양결정에 결코 부적 영향을 주지 않았으며, 또한 양쪽 부모로 부터 동시에 부양참여가 요구되었을때 성인자녀가족의 부양결정은 같은 조건이라면 여성배우자쪽 부모의 부양에 보다 더 적극적으로 반응하는 것으로 밝혀졌다.