• Title/Summary/Keyword: 지역사회간호사정

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Factors Affecting Fear of Dementia of Aged in the Community (지역사회 거주 노인의 치매두려움에 미치는 영향 요인)

  • Kim, Min Suk;Kim, Jeong Sun
    • 한국노년학
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    • v.40 no.1
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    • pp.179-196
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    • 2020
  • The purpose of this study was to identify the factors impacting fear of dementia, targeting the aged in the community. The study targeted 258 seniors aged 65 or older attending the senior college or using the senior citizen community center in areas of Jeollannam-do. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and a stepwise multiple linear regression. Fear of dementia of the aged showed significant positive correlations with dementia anxiety, and aged anxiety. dementia anxiety, aged anxiety, dementia experience, use of a hearing aid, religion, level of dementia interest were significant predictors influencing fear of dementia of aged in the community, and these variables accounted for 37.2% of the variance. Therefore, this study suggests that in order to p revent fear of dementia of aged people in the primary health care setting, it is necessary to have a nurse's assessment on the factors affecting dementia as well as a multi-faceted education strategy for proper recognition of dementia.

Effects of a Community-Based Health Promotion Project for Elderly People (지역사회 중심 노인 건강증진 사업의 효과)

  • Im, Mee Young;Lee, Ju Yul
    • Journal of Korean Academy of Rural Health Nursing
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    • v.5 no.2
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    • pp.63-73
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    • 2010
  • Purpose: The purpose of this study was to identify the effect of a community-based health promotion program for elders. Method: The research design was a nonequivalent control group experimental design. The participants were 415 elders who were above 65 years of age (mean age: 80.7, experimental group: 126, control group: 289). For 4 months, the health promotion project which consisted of health education and activity related to smoking, drinking, nutrition and exercise was given to the experimental group. Data were analyzed using descriptive statistics, ${\chi}^2$-test, and t-test with the SAS V8e program. Result: After the intervention, the experimental group showed a higher level of health promotion behavior compared to the control group in health education experience, exercise, smoking, and drinking. There were no differences between the experimental and control groups for nutrition, or high risk drinking and smoking. Conclusion: The results of this study show that the health promoting program for elders provides useful information in developing effective community-based programs and can be recommended as effective interventions to improve the health promoting behavior of elders.

The Comparison of Health Status, Functional Status, and Home Environment Hazards in Terms of the Fear of Falling in Community-dwelling Older Adult (재가 노인의 낙상공포 여부에 따른 건강상태, 신체기능상태 및 가정환경 위험 비교)

  • Lim, Kyung-Choon;June, Kyung Ja;Yoon, Jong-Lull
    • 한국노년학
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    • v.29 no.4
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    • pp.1577-1589
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    • 2009
  • The purpose of this study was to compare the health status, functional status, and home environment hazards by the fear of falling and explore the factors that contribute to the fear of falling. This was a descriptive study. Data were collected for two years with 973 older adults who enrolled in a health center at A city. Trained nurses visited subjects' home and collected data using Resident Assessment Instrument MDS-HC. The average age of the subjects was 76.8 (±7.6) and female was 74.8%. 20.7% of subjects reported fear of falling. In terms of the fear of falling, two groups were compared. There were significant differences in vision, urinary incontinence, pain that interrupts daily activity, unstable gait, comorbidities, frequency of depressive or anxious sign. The greater the age, IADL and ADL dependency, comorbidities, unstabled gait, the more fear of falling. In conclusion, this study reassured the importance of assessing the major factors related to fear of falling such as age, IADL and ADL, comorbities, gait among older adults. This study will contribute to establish strategies for preventing fall. Reducing the fear of falling through the comprehensive nursing intervention will ultimately improve the quality of life in the elderly.

A Study on the Assessment of Dementia Patients in Community (지역사회 치매환자 사정도구 개발을 위한 일 고찰)

  • Oh Jin Joo
    • Journal of Korean Public Health Nursing
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    • v.11 no.2
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    • pp.141-151
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    • 1997
  • As concerns about dementia patients increase gradually in society, the nursing of them becomes more and more important. For intervening in dementia patients effectively, the most fundamental thing is to understand their characteristics and to increase the ability of assessing them. The assessment data supply us with the foundations of Nursing diagnosis and nursing plan. The reaseons why the assessment data are especially important to dementia patients are as follows; First, dementia patients have great differences among them in intellectual, physical ability. And their condition varies from time to time. Second, the intervention without planning results in the deficiency of consistence, and it rather embarrasses and makes dementia patients uneasy. Third, nursing of dementia patients requires participation of multi-disciplinary team because of characteristics of that disease. The development of an unitary assessment tool is essential for all members of the team to have close relations between them and care for dementia patients. Fully understanding the importance of assessment data, this study investigate the content to be included in the assessment before developing assessment tools to be used in community. It points out that the assessment should include the informations about patients, their family, and main care-giver. And it sets up items that can supply with detailed information on each person. In the future it is necessary to transform the contents of this study to more concrete items and develope the assessment tools for dementia patients. And recording paper for follow up should be supplemented to check any changes in family caring for dementia patients and describe the changes in detail. To make assessment tools is one of the fundamental works in controlling dementia patients. Therefore the official assessment tools should be provided as soon as possible. This study aimed at presenting the guiding principles for developing that assessment tools.

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A study on environmental status, FIM and Illness intrusiveness of home stayed stroke patients (재가 노졸중 환자의 환경상태, 기능적 독립, 질병으로 인한 장애영향에 관한 연구)

  • Kim, Keum Soon;Roh, Kook Hee
    • 한국노년학
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    • v.25 no.2
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    • pp.143-154
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    • 2005
  • This study was conducted to examine the environmental status, FIM(Function Independence Measure), Illness intrusiveness of home stayed stroke patients. Data were collected on 145 patients living in K city and the neighborhood located in southern part of Korea. The data were analyzed by means of SPSS program. Results : In assessment of environmental safety, 46.2%(67) felt unsafe around their residential area. The most dangerous facilities in their residence was stairs(58.2%), gas/electric facilities(14.9%). For sanitary problems, 28.2%(41) felt they have problems at their home. The most important problems were outdoor polluted toilet(22.0%) and scattered and dirty residential circumstances(22.0%). The average FIM score was 74.52(4.14) of total score 126(7). In motor area FIM was lowest at stair walking(3.01) and bathing(3.16). In cognitive area FIM was lowest at social activities(3.36). The mean score of Illness intrusiveness was 58.86(4.52) of total score 91(7). The major area largely impacted by stroke were health(5.61), working(5.68), active leisure activities(5.56). There was significant reverse correlation between FIM and illness intrusiveness(r=-0.66, p=0.00). Conclusion : It was needed environmental improvement and rehabilitation program for stroke patients, and repeated follow up study.

Factors Influencing Fear of Falling in Patients with Parkinson's Disease in the Community (지역사회에 거주하는 파킨슨병환자의 낙상공포 영향 요인)

  • Seon, Sun Hee;Kim, Jeong Sun
    • The Journal of the Korea Contents Association
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    • v.16 no.1
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    • pp.676-687
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    • 2016
  • The purpose of this study was to examine the relation of motor function, depression, and fear of falling, and to identify factors influencing fear of falling in patients with Parkinson's disease in the community. The participants were 180 patients with Parkinson's disease who were selected by convenience sampling. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient and multiple linear regression. There was a significant difference in fear of falling according to gender, occupation, walking assistance device, number of falls, Parkinson's disease stage, duration of illness, antihypertensive drug, motor function, and depression. Fear of falling showed significant positive correlations with motor function, and depression. Depression, number of falls, Parkinson's disease stage, gender, antihypertensive drug, and motor function were significant predictors influencing fear of falling in patients with Parkinson's disease, and these variables accounted for 36.0% of the variance. Depression of the influencing factors was the strongest factor. The results of this study suggest that a variety of intervention strategies for preventing or mitigating depression with systematic nursing assessment of the influencing factors on fear of falling are needed to prevent fear of falling in patients with Parkinson's disease.

Development of Community Health Center-Based Hospice Management Model: Pilot Project at a Community Health Center in Busan (보건소 중심 호스피스 운영모델 개발 - 부산지역 일개 보건소 시범사업을 중심으로 -)

  • Kim, Sook-Nam;Choi, Soon-Ock;Kim, Young-Jae;Lee, So-Ra
    • Journal of Hospice and Palliative Care
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    • v.13 no.2
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    • pp.109-119
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    • 2010
  • Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

Factors Influencing Post Stroke Depression in Acute Stroke Patients (급성기 뇌졸중 환자의 뇌졸중 후 우울에 영향을 미치는 요인)

  • Park, Soonjoo
    • The Journal of the Korea Contents Association
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    • v.20 no.10
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    • pp.385-394
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    • 2020
  • This study was carried out to investigate the post stroke depression (PSD) occurrence in acute stroke patients and to identify the factors that influence PSD. The study subjects were 104 adults in their 20s or older who were scheduled to be discharged due to inpatient treatment for ischemic stroke in two hospitals. Data were collected using Post Stroke Depression Scale for PSD, Multidimensional Scale of Perceived Social Support for social support, National Institutes of Health Stroke Scale for stroke severity, and Modified Rankin Scale for disability. The average length of stay after stroke onset of the study subjects was 5.9±2.1 days, and 79.8% were within 7 days. Stroke severity score was an average of 2.4±2.5 out of 42 points, and disability score was an average of 1.6±1.1 out of 6 points. Among the subjects, 32.7% had mild or more severe depression after stroke. The subjects with no religion, severe disability, high stroke severity, and less family support had a higher likelihood of experiencing PSD. These results show that depression can appear in the early stages of stroke onset. Therefore, it is necessary to develop nursing guidelines for depression intervention after acute stroke, including continuous early assessment of depression from the acute phase of stroke and religion or family support.

AN EXPLORATORY STUDY TO DETERMINE HOW ADOLESCENT STUDENT NURSES VIEW PEDIATRIC NURSING EXPERIENCE AS STRESSFUL SITUATION (소아과 간호학 실습시에 느끼는 성년기 간호학생들의 긴장감에 대한 실험적 연구)

  • Oh, Kasil
    • Journal of Korean Academy of Nursing
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    • v.4 no.3
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    • pp.33-56
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    • 1974
  • 간호를 장래의 전문직으로 택하려고 공부하는 간호학생들은 완전한 성인으로서의 발달 과정중 후기 성년기에 속한다. 이시기는 자아를 발견하고 인간이 무엇을 믿으며 인간의 가치가 무엇인가를 추구하는 중요한 시기이다. 다시 말해서 어른과 어린이의 과도기에 서서 자신의 이상적 가치와 기성사회의 기존 가치를 잘 융화시켜 독립된 인간으로서 성숙하려는 노력의 시기이다. 그러므로 성년기의 갈등은 인생의 어느 시기보다도 그 정도가 심하게 나타난다. 간호학생들은 이상의 일반적인 성년기 발달의 요구 외에도 간호대학이라는 특수한 배움의 여건 때문에 좀 더 심각한 문제에 대두된다. 특히 소아과 간호대학이라는 실습환경은 여러 가지 복잡한 병실 사정으로 많은 긴장감을 주는 학습경험이다. 어린이의 간호에는 그들의 발달과정에 따른 다양한 역활이 요구된다. 또한 병원이라는 낯선 환경과 어머니를 떨어져야하는 두려움으로 불안한 어린이와 그 어린이의 불안과 두려움으로 인해 우울과 죄의식에 있는 어머니의 간호는 여러 면에서 성년기 학생들에게 긴장감을 일으키게 하는 요인이 된다. 본 연구의 문헌조사는 주로 미국 문헌에 나타난 간호 대학생들의 성년기 성숙을 위한 발달의 요구와, 소아병실의 복잡한 여건으로 발생되는 긴장감을 다루고 있다. 문헌을 기초로 하여 저자는 긴장감을 주는 간호활동을 크게 다섯 부군으로 묶었다. 1. 어린이 환자의 신체적 간호, 2. 어린이 환자나 부모와의 원만한 대화와 상호관계를 위한 간호활동 3. 소아병실에서 요구되는 다양한 간호원의 역활 4. 어린이나 부모의 간호에 대한 의뢰심 5. 간호의 가치나 이상적 간호. 연구방법으로는 49개의 폐쇄식 질문 항목을 가진 질문지를 사용하였다. 질문 항목들은 문헌연구에서 소아과 간호학 실습시 학생들이 긴장감을 느낀다고 밝혀진 내용들이 다. 학생들은 자신의 경험을 "긴장감이 없었다. ""긴장감이 있었다. ""심한 긴장감이 있었다. ""실습 중 경험이 없었다. "의 사항 중 택일을 하게 되어 있다. 연구대상으로는 모 대학교 간호대학 학생으로 산부인과 간호학 실습을 마친 후 소아과 간호학 실습 8주를 완료한 4학년 학생 42명이었다. 자료분석의 결과는 대부분의 학생들에게 소아과 간호학 실습은 긴장감을 주는 경험이 있다고 나타났다. 다음은 연구결과 주목할만한 몇 가지 사항들이다. 1. 어린이 환자의 신체적 간호는 성년기 학생들에게 긴장감을 주는 실습 경험이었다. 특별히 심하게 긴장감을 주었던 간호활동은 어린이환자의 상태가 중한 경우로, 장기간 앓는 아이, 선천성 기형이 있는 아이, 회복이 불가능하여 죽게될 아이나 사망하는 경우의 어린이 간호였다. 이 결과는 간호학의 기본과정 즉, 기초간호학이나 내 외과 간호학 실습만으로 소아과 간호학 실습을 위한 충분한 준비가 되지 못한다는 것을 뜻 할 수도 있다. 한편, 문헌연구에서 밝힌바와 같이 어리고 연약해 보이는 어린이들의 신체조건이 학생들의 간호활동을 어렵게 하는 경우도 될 수 있겠다. 2. 간호학생들의 어린이 환자와의 대화나 원만한 인간관계에서의 긴장감은 이 연구결과로 평가나 제언이 힘들다. 조사결과에서 학생들은 주로 어린이의 상태가 좋지 않은 경우에 심한 긴장감을 가졌고 일반적인 간호의 경우에는 별로 긴장감이 없었다. 이것은 질병의 상태나 화제, 이야기 할 때의 상황에 따라 긴장감의 여부가 달라질 수 있다는 결론이 되겠다. 3. 소아병실에서의 다양한 역활을 수행하는 것은 비교적 긴장감이 많이 생기는 간호활동으로 나타났다. 그러나 재미있는 사실은 학생들이 간호원으로서의 전문가적인 입장에서, 환자나 보호자를 가르칠때는 별로 문제가 없었으나 어린이 기르는 방법이나 어린이 이해면에서 좀 더 잘 안다고 생각되는 어머니가 지켜 볼때의 어린이 간호에는 긴장감을 가진다는 사실이다. 이것은 Jewett의 연구에서 밝힌바와는 상반되는 결과다. 그의 연구에서 학설들은 부모나 어머니들에 의해 전문가로서 인정받고 기대되는 경우가 제일 어려운 경험이 있다고 밝혔다. 4. 어린이 환자나 그들 부모의 간호에 대한 의뢰심은 학생들에게 심한 긴장감을 주는 경험이 있다. 특히 신체적 간호에 대해 의뢰하는 경우에는 더 심한 긴장감을 준다고 표현한다. 일반적으로 부모가 병실에 상주하는 경우에는 그들의 의뢰심이 심하며 이것은 학생들에게 감당하기 힘든 긴장과 어려움을 주게된다. 왜냐하면 성년기의 학생들은 그들 자신이 먼저 타인에게서 이해받기를 원하며 또 관용을 베풀어주기를 원하는데 그것을 남에게 주어야 하는 입장은 학생들을 긴장되게 하는 실습활동인 것이다. 5. 학생들은 그들이 배운 간호의 이상이나 가치가 실습지에서의 여러 경우와 맞지 않는 것을 보았을 때 극심한 긴장감을 갖는다고 밝혔다. 의사나 병원 행정의 사실이 자신의 이상과 맞지 않는다는 것보다는 간호원의 간호업무의 차이에서 더 비판적인 반응을 보였다. 대부분의 성년기 학생들은 그들의 이상적인 간호원상을 그들의 선배나 실무 간호원 중에서 찾으려는 시기에 그들의 간호활동이 이론과 다른 점이나 학생 자신의 소아과 간호의 가치와 다른 것을 보았을 때는 심한 반감과 긴장감을 갖게된다. 이 문제는 어린 사람이 윗 어른과 함께 동료의식을 갖고 일하기 어려운 한국적 사회구조 때문에 더 심하게 긴장감을 주는 경험인지도 모른다. 선배 간호원의 전문인으로서의 권위와 어린이 환자 보호자의 어른으로서의 권위 사이에서 자신의 이상과 가치의 추구는 용이하지 않으며 내적 갈등은 어쩔수 없는 일 일 것이다. 6. 대부분 높은 백분율의 긴장 반응은 죽음이나 환자의 사망에 관련된 간호활동 항목에서 나타났다. 이 연구의 대상 학생들은 2, 3학년에서 죽음에 대한 강의를 들었지만 이 연구 결과에 의하면 충분한 학습 경험이 주어진 것 같지 않다. 어떠한 경우의 죽음에라도 어린이 환자나 그 보호자들의 심리를 잘 이해하고 반응을 잘 관찰해서 적절한 간호를 해 줄 수 있는 다양한 방법의 학습 경험이 필요하다고 보겠다. 7. 학생들의 긴장도가 어린이 간호에 더 심한가, 보호자 간호에 더 심한가를 알기 위한 비교 결과는 비교적 비슷한 정도로 나타났다. 8. 학생들의 소아과 간호학 실습시의 긴장도는 과거의 병실 실습기간의 장, 단이나 가정에서의 어린인 간호의 경험과는 별 연관성이 없었다. 연구의 대상자가 적기 때문에 단정을 하기는 힘이 들지만 소아과 간호학 실습이 다른 병실의 실습과는 분리되어서 완전히 다르게 다루어 져야만 하며 간호교육자들의 주의 깊은 관심과 노력이 필요한 실습교육이 라 하겠다. 이상의 전반적인 고찰에 의하면 한국 성년기 간호학생들의 소아과 간호학 실습은 미국의 경우와 마찬가지로 긴장감을 주는 경험이다. 문화배경의 다른 점은 무시하고라도 Davis와 Oleson이 결론한 바와 같이 "간호대 학생은 어디를 막론하고 다 같은 성격과 문제를 가지고 있다. " 앞으로 보다 효과적인 학생들의 소아과 간호학 실습을 위한 연구를 위해 다음의 몇 가지를 본 연구의 결과를 가지고 제언한다. 1. 보다 여러 지역에서 다양한 교육 방법을 가진 학교의 학생을 대상으로 한 연구의 필요성. 2. 학생들이 실습 전 선입견이나 이미 들어서 생긴 긴장감의 개입 여부를 밝힐 수 있는 연구. 3. 학생 개인의 과거 경침이 긴장감 유발에 미치는 영향을 위한 연구 4. 이 연구의 결과를 입증할 수 있는 종단적 연구. 5. 이 연구에서 나타난 긴장감이 학습 행위에 미치는 영향을 알기 위한 관찰적 연구. 이 연구를 위해 많은 도움을 주셨던 보스턴대학의 Dr. Kennedy와 연세대학의 여러 선생님께 심심한 감사를 드립니다.

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A Study on Need Assessment in Health Promotion Programs for Developing Nursing Centers - Breast Self Examination- (간호센타 개발을 위한 건강증진 프로그램 요구사정 연구-유방자가검진 프로그램을 중심으로-)

  • Park, In-Hyae;Kang, Hae-Young;Lee, Jeong-Hee;Ryu, Hyun-Sook
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.21-36
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    • 2000
  • The purpose of this study was to assess the needs of breast self examination education (BSEE) programs for developing nursing centers. A first, we reviewed the literature of activity and management-related factors of nursing centers: and, second. we used a questionnaire to discover the degree of knowledge, attitude, and practice on breast cancer, as well as an individual's intention to participate BSEE program. 1. Reviewing the literatures of nursing center activities. Nursing centers which were administered by a professional nurse are an ideal site for faculty and student practices. With the use of nursing models of health. professional nurses in nursing centers diagnose and treat human responses to potential and actual health problems and offer holistic, client-centered health service. In nursing centers professional nursing services include health education, health promotion, and health-related research. A nursing center is comprised of the advisory and exacutive commitee; the advisory commitee serves consultants and links community needs to the nursing center, while the director of the exacutive commitee identifies the potential resources to generate funds, support, and facilitate the activities of staffs in a nursing center. Nursing centers mobilize various financal resources for reimbursement of services from college and insurance companies, collect minimum service fees from the client, and further collect fees for providing programs to community groups, this also includes membership fees, and donations. The services provided by nursing centers focus on services related to primary prevention, health maintenance & health promotion, direct nursing care for acute & chronic diseases, and holistic care for actual and potential health problems. The client satisfaction for the services was high. Students also showed positive reponses for their clinical experiences and independent working conditions. 2. The degree of knowledge, attitudes, and practices for breast cancer. and an individual's intention to participate in the BSEE program. The subjects of this study were 308 females in K-city in the Republic of Korea. Data were collected using a self-administered questionnaire. The mean age of the respondents was 35.0 years old. Those who already participated in the BSEE were 64.9%, and those who had support and encouragement to practice BSE from significant others were 25.1 %. Clients intent to participate in the BSEE were 37.0%. The mean score of knowledge(2.4 out of 5 points) and practices(1.8 out of 5 points) for breast cancer were quite low, but the mean score of attitudes was relatively positive04.5 out of 20 point) for breast cancer. Those who already had BSEE showed significantly high scores in knowledge(t=6.48, p<0.01), attitudes (t=10.54, p<0.01). and practices(t=57.07, p<0.001) for breast cancer than those who had not participated in the BSEE. In all age groups no intention to participate in the BSEE was higher than who the intention to participate. These findings suggest some strategies should be developed to increase the awareness of breast cancer's early detection.

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