Journal of the Korean Society of Physical Medicine
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v.14
no.2
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pp.79-88
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2019
Purpose: This study was conducted to understand the client relationship experience of the physical therapists working at elderly care facilities and to lay the foundation for finding the identity of physical therapists. Methods: In-depth interviews were conducted on eight incumbent physical therapists who had experienced working in elderly care facilities for at least one year. Data collection was conducted between June and September 2017, and the interview took an hour to an hour and a half to complete. After an in-depth interview, it was arranged as a file and analyzed according to the four steps of the phenomenological research method of the Giorgi. Results: Data were collected and analyzed; 19 categories, 6 themes and 5 domains were derived. Six themes were presented according to the 5 domains; the subject of relationships included 'diversity elderly'; context of relationships included 'the world of elderly nursing homes I did not know'; influence of relationships included 'the physical therapist is heartbroken because of the tormenting elderly'; condition of relationships included 'a reality that is tied to work'; aspects of relationships included 'how to reestablishing relationships with the elderly' and 'recognized and identified as a physical therapist'. Conclusion: This study shows that physical therapists working in elderly care facilities generally tend to fulfill their responsibilities and interact with clients; we found that identity of physical therapists was primarily defined by relationship experiences with patients.
Purpose: The purpose of this study is to investigate the perception of nursing students' on-site clinical experience at intensive care unit(ICU), which will help on developing fundamental tool to enhance the effect of their clinical practice. Method: Van Manens hermeneutic-phenomenological method has been used to analyze the data. Participants consisted of 74 third-year nursing students who performed the clinical practice at an ICU in C university hospital. The students got the group interviews and kept the clinical diaries. Data was collected from series of group interviews and contents of the students clinical diaries. Result: Major concerns related to students clinical practice were found as follows : "being nervous about unfamiliar machines and situations", "being frustrated about the patients", "feeling of helplessness", "being stupefied from witnessing a death", "realizing the importance of health", "realizing individual patient's precious value through family's love", "realizing the importance of treating a patient as humanbein g", "realizing the differences between theory and practice", "modelizing two aspects of nursing: professional and personal", "readiness to become a capable nurse". Conclusion: We are able to obtain in-depth understandings about the nursing students lived experience of clinical practice at the ICU. Based upon this, there is a need to develop a better nursing intervention enhance the effectiveness of the nursing students clinical practice.
Purpose: This study aimed to identify the factors influencing on patients' participation in their treatment decision making, and influences of patients' experience on their health status. Methods: Data from the 2015 Korea National Health and Nutrition Examination Survey were used for the analysis. Multivariate logistic regression analysis was conducted to identify the factors influencing on patients' participation in their treatment decision making. The influences of patients' experience on their health status were analyzed using multiple linear regression analysis. Results: Of the 4,497 respondents, 3,698 (82.2%) respondents mostly participated in their treatment decision making. Those who experienced enough visit duration, physicians' explanation easy enough to understand, or more opportunities to ask were more likely to participate in their treatment decision making. After controlling for their sociodemographic factors and health status, those who had better experience during the outpatient visits were more likely to have better self-rated health or quality of life. Conclusion: To improve patients' health outcomes and satisfaction of health care uses, it is necessary to provide better experiences and expand the opportunities for participation in treatment decision making during their hospital visits.
Purpose: The purpose of this study are to understand the meaning and essential structure of clinical nurses' experiences of verbal violence and find nursing intervention for them by applying phenomenological research method. Methods: The participants in this study were seven clinical nurses with experience of verbal violence. Data collection were conducted from August 2016 through January 2017 until data saturation. Data analysis was performed through a cyclical process of data collection and analysis by applying Giorgi's phenomenological method. Results: Four categories were identified: A weapon of the mind: the shock of verbal abuse; negative emotions that shake my heart; skepticism about the value and meaning of a job; an unforgettable wound. Conclusions: The results of this study provide a deeper understanding of the pain caused by verbal violence experienced by nurses from their care recipients. These results suggest that nursing interventions for nurses with experience of verbal violence will contribute to resolving the problem.
Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.
The purpose of this study was to investigate the experiences of accident and visiting emergency center, and the experiences of education about emergency care for parents. The subjects of this study were 117 mothers whose children are attending 9 different nursery schools or kindergartens. The instrument used in this study was developed by researchers and validated by nursing professor, first aid doctor and the president of nursery school, and consisted of 'most important thing in child rearing' ,'experiences of accident and visiting emergency center', 'type of trauma' and 'need for parent education program' the result of this study were as followed ; 1.There were 70.09% of the experience of visiting emergency center among the subjects. The cause of visiting emergency center were high fever and convulsion(42.86%), and trauma by accident(28.04%) 2. The most common type of the indoor accident were fall down and slipping(76.92%), the common type of trauma were contusion (76.92%), abrasion(47.01%), laceration(29.06%), dislocation or fracture(12.82%), burn(10.26%), piercing(8.55%). 3.47.01% of subjects had the experience of education about emergency care for parents. They were educated by child rearing journals (32.72%), small books which were published by hospitals or community health center (25.45%), mass media(21.8%), parent seminar (12.72%), nursery school or kindergarten (5.45%). In conclusion, the need of emergency care for children was strongly found. Therefore, on the basis of above results, the parent education program which fits their cognitive level and their health care needs So, it must be directed on the further study of parents' knowledge about emergency care for children. To enhance the effectiveness of program and accomplish the children's health promotion, advanced instructional media and demonstration must be included.
Objectives : This study aims to examine the effects of death education program on meaning in life, death anxiety and attitude toward nursing care of the dying patients among nursing students. Methods : Subjects were 155 nursing students of the K college. Before and after the intervention, students responded a questionnaire developed to measure meaning in life, death anxiety and attitude toward nursing care of the dying patients. To analyse the data, Cronbach's ${\alpha}$, t-test, and paired t-test were used with an SPSS 12.0 program. Results : 1. Meaning in life and attitude toward nursing care of the dying patients levels significantly increased, death anxiety levels significantly decreased. 2. Meaning in life levels increased significantly in the 20-24 age group, female, first grade, no religion, no death experience of relatives. 3. Death anxiety levels decreased significantly in the 20-24 age group, female, no religion, no death experience of relatives, but increased significantly in a buddhist group. 4. Attitude toward nursing care of the dying patients levels increased significantly in the 20-24 age group, female, first grade, won buddhist, no death experience of relatives. Conclusions : This study, through the above result, shows that the death education program can be an effective nursing education to improve meaning in life and attitude toward nursing care of the dying patients and to decrease death anxiety. These results suggest that the death education program will be helpful for recognizing the values of themselves and their current lives and improving their nursing intervention care of the dying patients.
Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory. Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability. Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents. Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the "recall of experience" subscale, and reduction of the scale response level.
This study was carried out to analyze the job of care managers in their social welfare practicing fields about the frequency of care management duties they perform, types of duties considered to be most important and the reason, and types of jobs counted to be the most difficult and the reason by qualitative case study research methods. The job area of care management was elicited using DACUM method, and those 9 job areas derived from it were analysed according to frequency of performance, importance and difficulty. The subjects were 10 social workers serving more than 3 years with major duty of care management and chosen by reputational-case selection, and those collected data analysis was operated according to embedded analysis types. We discussed the implication of this research. : The experience of participants are the process of maintaining the tension, and search the equilibrium point between client centered service and institutional pressure. According to the results we proposed ① Construction of community based social work network, ② Institutional installation for guarantee care manager's Job competence ③ Standard manual for equilibrium and upward equalization
Purpose: This aim of this phenomenological study was to describe and understand the experience of spiritual conflict in hospice nurses by identifying the meanings and structures of the experience. Methods: Participants were 12 nurses working for one year or more at hospice units of general hospitals in a metropolitan city and experiencing of spiritual conflict as hospice nurses. Over six months data were collected using individual in-depth interviews and analyzed with the method suggested by Colaizzi. Results: The experience of spiritual conflict in participants was organized into three categories, six theme-clusters, and 13 themes. The participants felt existential anxiety on death and a fear of death which is out of human control and skepticism for real facts of human beings facing death. They also experienced agitation of fundamental beliefs about life with agitation of the philosophy of life guiding themselves and mental distress due to fundamental questions that are difficult to answer. Also they had distress about poor spiritual care with guilty feelings from neglecting patients' spiritual needs and difficulties in spiritual care due to lack of practical competencies. Conclusion: Findings indicate the experience of spiritual conflict in hospice nurses is mainly associated with frequent experience of death in hospice patients. The experience of spiritual conflict consisted of existential anxiety, agitation of fundamental beliefs and distress over poor spiritual care. So, programs to help relieve anxiety, agitation and distress are necessary to prevent spiritual conflict and then spiritual burnout in hospice nurses.
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