• 한국산학기술학회논문지
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• 제18권3호
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• pp.258-269
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• 2017

본 연구는 Pender(1996)의 건강증진모형을 중심으로 유방암 환자의 건강증진행위 예측요인을 파악하기 위해 시도한 서술적 조사연구이다. 2015년 9월 18일부터 10월 26일까지 구조화된 설문지를 이용하여 유방암 환자 121명을 대상으로 자료를 수집하였다. 수집된 자료는 SPSS 20.0 for Windows 프로그램을 이용하여 t-test, ANOVA와 Scheffe 사후검정, Pearson correlation coefficients 및 위계적 다중회귀분석 방법으로 분석하였다. 대상자의 건강증진행위 예측요인은 사회적지지, 행동계획 몰입, 이전건강 행위, 행위관련 감정, 지각된 자기효능감, 가족기능, 지각된 유익성, 상황적 영향 등 8가지 변수로 파악되었고, 총 설명력은 58%이었다. 이상으로 유방암 환자들이 재활기에 최적의 건강을 유지하고 질 높은 삶을 살 수 있도록 돕기 위해서는 대상자의 건강증진행위 수준을 상승시키도록 돕는 간호중재의 개발과 적용이 필요하다. 특히 본 연구결과 유방암 환자의 건강증진행위 예측요인으로 밝혀진 사회적 지지, 행동계획 몰입, 이전건강 행위, 행위관련 감정, 지각된 자기효능감, 가족기능, 지각된 유익성 및 상황적 영향 수준이 낮은 대상자들에게 특별히 관심을 가질 필요가 있겠다.

• 종양간호연구
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• 제2권1호
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• pp.5-16
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• 2002

Purpose: This study was to develop a stress-adaptation model for family caregivers of cancer patients that could provide the basis of planning nursing intervention. Method: A hypothetical model was developed using the family adaptation model proposed by Haley et al. (1987). In the literature, the stressor was identified as patient's characteristics, caregiver's characteristics, duration of illness, and family life events. It affected stress appraisal, family resources, family coping and finally caregiver's adaptation. In this model, 18 paths were constructed. Data were collected from 241 caregivers, whose family members were in treatment between June and August 2000, at 3 university hospitals and were analyzed by SPSS and LISREL programs. Results: 1) The overall fitness indices of the hypothetical model were x 2=267.78 (P= .0), GFI= .92, AGFI= .87, NFI= .93, NNFI= .93, PNFI= .64, PGFI= .55, and RMR= .43. Ten of the eighteen paths proved to be significant. 2) To improve the model fitness, the hypothetical model was modified considering modification indices and the paths proved not significant. Final model excluded 3 paths demonstrated to be improved by x2=161.96 (P= .00), GFI= .95, AGFI= .91, NFI= .96, NNFI= .96, and RMR= .23. Twelve of fifteen paths proved to be significant. 3) Stress appraisal was influenced by disease related characteristics and duration of illness and was explained 22% of the variance. Family resources were influenced by stress appraisal and was explained 57% of variance. Family coping was influenced by disease related characteristics, caregiver's characteristics, duration of illness, family life event, and stress appraisal and was explained 57% of variance. Family caregiver adaptation was influenced by disease related characteristics, caregiver's characteristics, stress appraisal, and family coping and was explained 31% of variance. Twelve of fifteen paths were significant. Conclusion: Based on this study, to help family caregivers to adapt, individual intervention is necessary with consideration of disease related and caregiver's characteristics and duration of illness. The intervention should include efforts to raise the family resources and to identify positively the stress they encounter, and there is a need to establish an adaptation model that considers emotional aspects of family caregivers. Since there is a difference in emotional status depending on the disease stage, a study needs to be done to analyze the differences among the disease stages (diagnosis, treatment, recurrence, and terminal stages).

• 한국산학기술학회논문지
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• 제18권4호
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• pp.408-417
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• 2017

본 연구의 목적은 의료기관 간호사 확보수준이 수술한 암환자의 원내 사망과 원내 감염에 어떠한 영향을 미치는지 알아보고자 하였다. 이차자료를 이용하였으며, 2012년 상반기에 260개 의료기관에서 수술 후 사망률이 높은 6개 암으로 수술받은 암환자 24,510명을 대상으로 하였다. 단순 로지스틱 회귀분석과 일반화추정방정식(GEE) 모형을 이용하여 분석하였다. 환자 및 의료기관 특성(기관 종별 유형, 소재지, 수술건수)을 보정 후, 사망 가능성은 간호사 확보수준 0-1등급에 비해 2-3등급 군(odds ratio [OR], 1.46; 95% confidence interval [CI], 1.00-2.11), 6-7등급 군(OR, 3.28; 95% CI, 1.87-5.74)에서 더 높은 것으로 나타났다. 병원 감염이 발생할 가능성은 간호사 1인당 침상수가 하나씩 증가할 때마다 증가하여, 0-1등급 군에 비해 2-3등급 군은 6.63배(95% CI, 3.00-14.62), 4-5등급 군은 5.79배(95% CI, 1.88-17.78), 6-7등급 군은 8.4배(95% CI, 1.82-38.84) 높은 것으로 나타났다. 낮은 간호사 확보수준은 환자안전과 의료의 질을 반영하는 지표인 높은 수술 후 원내 사망과 감염발생과 관련이 있었다. 이는 적절한 간호사 확보 수준은 수술 후 암 환자 결과와 관련 있음을 보여준다. 수술한 암환자의 의료의 질 향상과 환자 안전을 위해서는 적절한 간호사 수가 확보되어야 하며, 이를 위한 정책 유지가 필요하다.

• 성인간호학회지
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• 제25권2호
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• pp.219-230
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• 2013

Purpose: This study is reviewed of the available literature to identify the evidence of the value of Kegel exercise programs as an intervention to decrease urinary incontinence and the improvement of the quality of life following a radical prostatectomy in localized prostate cancer. Methods: We searched studies of randomized controlled trials that utilized the Kegel exercise programs with patient with a radical prostatectomy. The review was conducted electronic bibliographic database of Ovid-Medline, Embase, Scopus, KoreaMed and NDSL, etc. Of 630 publications identified, seven studies that met the inclusion criteria, and all studies analyzed by meta-analysis. To ensure the quality of the studies, we used Cochrane's Risk of Bias. Results: Kegel exercise helped patient to achieve continence more quickly (after 1, 3, 6, 12 months) than men not using Kegel exercises. Especially, Kegel exercise significantly reduced the development of urinary incontinence at one month after prostatectomy. The effectiveness of Kegel exercise after prostatectomy was found to improve the quality of life at a significant level. Conclusion: Based on available evidence, Kegel exercise that nurses can teach improved the return to continence more than usual care in men with prostatectomy urinary incontinence.

• 재활간호학회지
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• 제3권1호
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• pp.43-58
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• 2000

Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.

• 한국간호교육학회지
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• 제13권1호
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• pp.41-51
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• 2007

Purpose: This research studied the nurses' knowledge and attitude about pain management. Method: The research subjects were 465 nurses working at three university hospitals in Seoul and at one university hospital in Kyunggi-do. The survey results were collected between October 13 and 21 in 2004. Result: The overall mean score of correct answers on knowledge about pain management was 73.34, general knowledge 71.08, and cancer pain control was 93.93. Similarly, the mean score of correct answers on knowledge about the classification of analgesics was 75.89, while the knowledge of their use was only 52.48. The overall characteristics related to the degree of the nurses' knowledge about pain management were their educational background and their experiences of pain education. In a similar view, the overall characteristics related to the knowledge about the classification of analgesics were age and religion. Likewise, the use of analgesics was related to field of service and the experience of pain education. Finally, the overall characteristics related to the nurse's attitude toward pain management were their field of service and their position. Conclusion: The results of this study could be useful to institutions involved in the education and application of patient pain management.

• Journal of Hospice and Palliative Care
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• 제8권1호
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• pp.1-7
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• 2005

목적: 본 연구는 입원한 폐암환자의 수면의 질을 파악하기 위한 것으로 그 구체적인 목적은 대상자의 제(인구사회학적, 질병관련) 특성을 파악하고, 수면의 질과 제 특성에 따른 수면의 질을 파악하는 것이다. 방법: 연구대상은 B시에 소재한 K대학 부속병원에서 임의표집 한 입원 폐암환자 50명을 대상으로 하였다. 자료수집기간은 2001년 1월 21일부터 4월8일까지였다. 자료수집방법은 환자에게 설문지를 배부하여 대상자가 직접 기입하도록 하여 회수하였다. 측정도구는 수면의 질을 측정하기 위해 오진주 등(1999)이 개발한 15문항으로 구성된 '수면측정도구 A'를 사용하였다. 자료분석은 SPSS 10.0 프로그램을 이용하여 통계처리 하였으며, 실수와 백분율, 평균, 평균평점과 표준편차, t-test, ANOVA, Post-hoc test(Scheffe's test)로 분석하였다. 결과: 본 연구의 결과는 다음과 같았다. 1. 대상자의 수면의 질은 평균 $35.64{\pm}7.59$로 나타났다. 2. 대상자의 제 특성과 관련된 수면의 질은 현재 통증(t=-1.943, P=.046), 주간호제공자(F=2.863, P=.047), 체중의 변화(F=5.906, P=.019)에 따라 유의한 차이가 나타났다. 사후검정(Scheffe's test)결과 체중 증가군($43.50{\pm}4.03$)이 체중변화가 없는 군($29.44{\pm}6.00$)보다 유의하게 수면의 질이 높은 것으로 나타났다. 결론: 폐암환자의 수면의 질과 관련된 변수로 나타난 현재 통증, 주간호제공자, 체중변화의 요인들을 간호제공 시 고려함으로 폐암환자의 수면의 질을 향상시키고, 건강을 증진시킬 수 있으리라 생각된다. 폐암환자의 수면의 질 향상을 위해 수면에 영향을 주는 다른 변인에 관한 연구가 필요하고, 수면을 개선시킬 수 있는 간호 중재방안의 개발이 요구된다.

• Journal of Hospice and Palliative Care
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• 제7권1호
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• pp.8-16
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• 2004

목적: 본 연구는 자궁경부암 환자의 삶의 질을 파악하고, 질병 진행 단계와 치료 형태에 따른 삶의 질을 분석하는데 있다. 방법: 자료 수집은 3개의 종합병원에서 자궁경부암 환자 67명을 대상으로 하였으며, 자료수집 기간은 3월 15일부터 6월 4일까지 이었다. 연구 도구로는 Ferrell[18]의 삶의 질-암 환자용 도구(Quality of Life-cancer version)를 번역하여, 자궁경부암 환자에게 맞지 않는 4문항을 제외한 총 37문항으로 사용하였다. 자료 분석은 SPSS 통계프로그램을 이용하여, t-test, ANOVA, Scheffe test로 검증하였고 도구의 신뢰도 검증은 Cronbach's Alpha를 산출하였다. 결과: 자궁경부암 환자의 질병 진행 단계에 따른 삶의 질 정도는 유의한 차이가 있었다.(F=5.06, P=.003) 질병 진행 단계에 따른 영역별 삶의 질 정도에서는 신체적 안녕 영역(F=3.97 P=.012), 정신적 안녕 영역(F=3.91, P=.013), 사회적 안녕 영역(F=4.96, P=.004)에는 유의한 차이를 보였으나, 영적 안녕 영역(F=1.36, P=.262)은 유의한 차이를 보이지 않았다. 치료 형태에 따른 삶의 질정도는 유의한 차이를 보이지 않았다.(t=-1.83, P=.073) 치료 형태에 따른 영역별 삶의 질정도에서는 정신적 안녕 영역(t=-2.14, P=.037), 사회적 안녕 영역(t=-2.15, P=.036)에는 유의한 차이를 보였으나, 신체적 안녕 영역(t=-.93, P=.356), 영적 안녕 영역(t=.73, P=.469)에는 유의한 차이가 없었다. 결론: 자궁경부암 환자의 삶의 질은 질병 진행단계와 치료 형태 및 일반적 특성에 따라 차이가 있었다. 그러므로 자궁경부암 환자에게 질병 진행 단계와 치료 형태 및 일반적 특성을 고려한 간호 중재를 적용할 필요가 있다.

• Journal of Hospice and Palliative Care
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• 제23권1호
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• pp.27-38
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• 2020

Purpose: The purpose of this study was to compare differences in spiritual needs (SNs) and factors influencing SNs between patients with progressive terminal kidney disease and their family caregivers. Methods: An explorative comparative survey was used to identify the SNs of patients (N=102) with progressive terminal kidney disease undergoing hemodialysis and their family caregivers (N=88) at a general hospital located in Seoul, South Korea. The data were analyzed using descriptive statistics, the chi-square test, the independent t-test, one way analysis of variance, the Scheffe test, and multiple regression with dummy variables. Results: The SNs among family caregivers were higher than in the patient group. SNs were higher among those who were religious in both groups. Loving others was the highest-ranked subdimension in the patient group, followed in descending order by maintaining positive perspective, finding meaning, Reevaluating beliefs and life, asking "why?", receiving love and spiritual support, preparing for death, and relating to God. In the family group, the corresponding order was maintaining positive perspective, loving others, finding meaning, receiving love and spiritual support, preparing for death, relating to God, and asking "why?". The factors that had a negative influence on the level of SNs were not being religious in the patient group and having only a middle school level of education in the family group. Conclusion: The results of this study may serve as evidence that spiritual care for non-cancer patients' family caregivers should be considered as an important part of hospice and palliative care.

• 대한간호학회지
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• 제32권2호
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• pp.243-253
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• 2002

The purpose of this study was to develop Nurse's Suffering Experience Scale and to test the reliability and validity of the instrument. Method: The subjects used to verify the scale's reliability and validity were 220 nurses who were taking care of the end stage cancer patients, while working at university and general hospitals in Daegu and Kyungbuk province from April 20. to July 10, 2001. The data was analyzed by the SPSS/WIN 8.0 program. Results: A factor analysis was conducted, and items that had a factor loading more than .40, and an eigen value more than 1.0. were selected. The factor analysis classified a total of seven factors statistically, and it's communality was 44%. The explanation of factors based on the conceptual framework and item content are as follows: The first factor was expanding self consciousness, the second factor was forming empathy with family, the third factor was professional challenge, the fourth factor was change of values, the fifth factor was spiritual sublimation, the sixth factor was helplessness, and finally the seventh factor was rejection to death. Cronbach's coefficient to test reliability of the scale was .8665 for total of 44 items. The Scale for Nurse's Suffering Experience developed in the study was identified as a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for the evaluation of the degree of nurse's suffering experience in clinical settings.