• 제목/요약/키워드: Clinical Practices

검색결과 493건 처리시간 0.03초

임상 간호원을 위한 실무교육 과정으로서의 가족계획 (Family Planning as a Part of the Nursing-Staff In - Service Education Program)

  • 전춘영
    • 대한간호학회지
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    • 제5권1호
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    • pp.112-132
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    • 1975
  • When Korean family planning services began as a part of the National Policy in 1962, the annual population growth was 3.0%. This growth rate has been decreased to 2.0% during last ten year period. And it seems imperative that all hospitals, as well as related organizations, should participate in family planning in order to contribute to achieving the National goal of 1.5% population growth by 1976, the end of the Third Five Year Economic Development Plan. Nurses should be considered the most important human resources in charge of the core of family planning services in any setting. For the family planning services in the general hospital setting, nurses as a core members contribute much as change agent, motivators, counsellors, educators etc. A nurse can work with patients and their relatives when she is equipped with relevant knowledge and skills. Fur the more family planning cannot be ignored even in hospital setting where more comprehensive nursing care is needed Thus, the general objective of this study is to provide baseline data for better programming of In-service education in family planning so that effective hospital family planning nursing services can be made a part of comprehensive nursing care contributing to the national population program and human welfare. In order to meet the general objective, this study has the following specific objectives : 1. To find out the general characteristics of the clinical nurses working in Y Hospital 2. To evaluate their attitudes and practices of family planning 3. To assess their knowledge, attitudes and practices of population and family planning as professional nurses. 4. To examine and compare data collecting methods for the planning of an In-service Educational Program 5. To explore the contents to be included in this In-service Education Program. The study population randomly selected one hundred nurses working in Y Hospital A cross-sectional survey with questionnaires developed for this study was chosen for the study method. To collect reliable data, the questionnaires were distributed to and answered by the study population in a controlled situation. X²test and t-test was employed in analyzing the data. The findings of this study are as follows: 1. Y Hospital nurses had a lower ideal number of children (X=2.02) and showed no strong preference for male children, and 74% of them expressed the desire to use permanent methods of birth control 2. of this thirty Y Hospital nurses who were married 66.7% stated they were already practicing contraceptive methods. Most of them preferred male methods of contraception. 3. According to objective evaluation about knowledge of various aspects of population and family planning, respondents from collegiate programs significantly knew better the subjects on the average than did respondents from diploma programs of nursing. 4. There was a marked difference in the results of self-evaluation and objective evaluation in their family planning knowledge. It was found that the self-evaluation family planning knowledge seemed to be unreliable. Accordingly, the objective test methods appeared to be more reliable in the evaluation of knowledge levels. 5. The subject areas needed to be included in In-service education for the Hospital family planning services in Y Hospital are 1) rhythm methods, 2) tubal-legation, 3) family planning effects of contraceptives, 4) population growth, 5) demographic traction, 6) population structure and 7) infant mortality facts. In addition, 1) various oral contraceptives, 2) basal temperature method, 3) laparoscopic female sterilization, 4) interfering factors of family planning, 5) anatomy and physiology of the female reproductive organs were additional areas to be taught to respondents from 3-year diploma schools of nursing. Demographic transition was one subject area in which the four-year graduates need further study. 6. Population problems guidance and counselling in family planning instruction in the theory and practice of contraceptives should be included in future In-service Education Programs in order to provide more effective hospital Family Planning Services, stated 77.0% of the respondents.

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철결핍빈혈 영·유아에서 어머니의 이유지식 (A study of mothers knowledge of weaning of infants with iron-deficiency anemia)

  • 김성진;김동현;장주희;전용훈;홍영진;손병관;김순기
    • Clinical and Experimental Pediatrics
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    • 제51권5호
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    • pp.468-473
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    • 2008
  • 목 적 : IDA로 진단된 영유아의 어머니를 대상으로 수유 방법과 이유 진행사항 등의 실태를 조사하였고, 설문지 답변을 통하여 어머니가 가지고 있는 이유식에 대한 지식을 알아보았고, 그들의 이유식 관련 지식과 실제 나타나는 현실과의 차이점을 분석하였다. 방 법 : 2006년 3월부터 2007년 5월까지 인하대병원 외래 또는 입원한 영유아 중 IDA로 진단 받은 6-40개월 환아 111명(남:여=1.6:1)의 어머니를 대상으로 이유 실태 조사 및 이유지식에 관한 설문조사를 하여 다음과 같은 결과를 얻었다. 결 과 : 1) 혈액학적인 분포는 Hb는 $9.5{\pm}1.0g/dL$이었고, Hb 8 g/dL미만이 8.1%이었고, 9 g/dL 미만이 27.9%에 달하였다. MCV 70미만이 92명(82.8%)이었다. IDA가 분명한데도 페리틴 10 ng/dL 이상인 경우가 54명(48.6%)에 달하였다. 2) 이유식을 3개월 또는 그 이전에 이유식을 시작한 경우는 한 예도 없었고, 7개월 이후에 시작한 경우가 33.3%에 달하였다. 이유식의 평균 시작시기는 6.4 개월이었으며, 4-6개월에 시작한 경우(n=74)의 Hb은 $9.6{\pm}1.0g/dL$으로서, 7개월 이후에 시작한 경우(n=37)의 Hb $9.3{\pm}1.0g/dL$에 비하여 유의하게 높았다. 3) 이유식의 시작 시기가 늦을수록 Hb 수치가 낮게 나타났고, 생후 6개월까지 모유수유만 하고 이유식을 시작하지 않은 영유아들의 Hb 수치가 낮게 나타났다(P<0.05). 4) 처음 시도하는 이유식으로는 미음(82.6%), 과일즙(10.8%), 선식(4.5%) 등 순이었고, 주로 먹는 이유식의 종류는 야채죽(38.7%), 미음(36.9%), 과일즙(17.1%)의 순이었다. 주로 사용한 이유식은 집에서 만든 것이 87명(78.3%)이었고, 상품화된 이유식 사용은 7명(6.3%)이었다. 5) 어머니의 이유지식 점수는 대졸이상 그룹과 고졸 그룹 사이에 유의한 차이를 보이지 않았다. 또한 이유지식이 IDA중증도에 미치는 영향도 유의하지 않았다. 6) 이유식을 시도하여 4주 이내에 완성된 경우가 56명(50.4 %) 이었고, 나머지는 1개월 이상 걸렸으며, 3개월 이상 걸린 경우도 22명(20.0%)에 달하였다. 결 론 : 급성 감염이나 발열시에 페리틴 측정만으로 철결핍 및 IDA 진단을 내리기에는 한계가 있으며, 소구성 적혈구증 역시 IDA를 판정하는 중요한 지표가 될 수 있을 것이다. 많은 어머니가 이유지식이 부족하였고, 또한 상당한 이유지식을 가지고 있음에도 그 자녀에서 IDA가 발견되었으므로, 현재와 같은 이유식 방법을 지양하고, 이유식에 관한 교육 및 홍보를 강화한 좀더 개선된 방법이 모색되어야 할 것이다.

표면처리에 따른 금속과 간접복합레진간의 전단결합강도 비교연구 (Comparison of shearbond strength between metal and indirect resin according to the different conditionings)

  • 최수영;최현민;문홍석;심준성;박영범;이근우
    • 대한치과보철학회지
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    • 제55권3호
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    • pp.264-271
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    • 2017
  • 목적: 본 연구에서는 4종의 간접복합레진에 대하여 금합금과 Ni-Cr합금에 대한 결합강도의 차이와 각각의 합금에 표면형태를 다르게 하여 일정한 온도의 증류수에 보관 전과 후에 전단결합강도의 차이가 있는지 알아보고자 하였다. 재료 및 방법: 금속 시편을 주조 제작하였는데, 금합금과 Ni-Cr합금의 표면형태를 flatting, bead, loop로 하여 4종의 간접복합레진(Gradia, Tescera Sinfony and in;joy)당 60개씩 총 240개를 준비하였다. 이후 금속표면에 각각의 제조사에서 지시한대로 간접 복합레진을 접착하였다. 간접복합레진의 중합 24시간 후에 만능시험기를 이용하여 전용 지그에 금속시편을 부착 후, 전단결합강도를 측정하였다. 또한 증류수에 240시간 보관 후에 같은 방법으로 전단결합강도를 측정하였다. 결과: 금속의 표면 형태에 따른 전단결합강도 측정에서 4종의 레진 모두 bead군에서 높은 결합강도를 보였고 loop, flatting 순이었다 (P < .05). 수조에서 240시간 보관 후에는 Gradia가 모든 군에서 다른 레진 군에 비해 비슷하거나, 통계적으로 유의하게 높은 (P < .05) 전단결합강도를 나타내었다. 결론: 금속표면의 형태에 따라, 금속의 종류에 따라, 물속 보관 전후에 따라 금속과 간접복합레진의 결합력의 차이를 나타내었고 추가 실험을 통해 최적의 조합에 따른 임상에서의 적용가능성을 보여주었다.

병원과 지역사회에 근무하는 정신보건간호사의 전문직 자아개념 (Professional Self-concept of Psychiatric Mental Health Nurse Practitioners in Hospitals and Public Health Centers)

  • 양수;유숙자
    • 한국보건간호학회지
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    • 제15권2호
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    • pp.351-362
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    • 2001
  • This study was conducted to investigate and compare the degree of professional self -concept (PSC) of the psychiatric mental health nurse practitioners (PMHNP) in hospitals and public health centers and to identify the factors predicting PSC of them, in order to provide basic data for developing PSC increasing program PSC. The 355 PMHNP were sampled from the university or general hospitals. mental hospitals, community mental health centers and public health centers across the country. The scales used in this study were PSCNI by Arthur (1990), PSI by Heppner & Petersen (1982) and the Index of work satisfaction by Slavitt et al. (1978). The results of the study were as follows : 1. The average item score of PSCNI of PMHNP in hospitals was $2.83\pm0.27$, and that of PMHNP in public health centers was $2.76\pm0.28$. There was significantly different between two groups (p=0.0202) 2. A comparison of the scores for the dimensions of the PSCNI were as follows ; the mean item score of professional practice of nurses in hospital was $2.90\pm0.30$, and that in public health centers was $2.83\pm0.35$. There were significant differences between two groups in the scores of professional practices (p=0.0315), leadership (p=0.0071) and skills (p=0.0231). 3. There were significant differences between two groups according to education (p=0.0057) with no significant interaction effect of group and education. 4. Job satisfaction (JS) was the highest factor predicting PSC of PMHNP in hospitals $(34.5\%)$, and problem solving inventory score (PS) was the highest factor predicting PSC of PMHNP in public health centers $(33.6\%)$. JS and PS accounted for $42.6\%$ in PSC of PMHNP in hospitals. and PS, JS, age, marital status, religion, and career accounted for $57.6\%$ in PSC of PMHNP in public health centers. In the light of these results. to gam the professional self-concept. nurses should be educated continuously through role modeling in clinical nursing and research. Also, nurse educators and administrators need to develop programs and policies to increase professional self-concept of nurses, particularly of community PMHNP.

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의사 대상 불면증 치료 현황 조사 연구 (Survey of Insomnia Treatment Status for Doctors)

  • 최연선;이미현;최재원;김수현;김지철;이유진
    • 수면정신생리
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    • 제23권2호
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    • pp.77-83
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    • 2016
  • 목 적 : 본 연구는 1차 및 2차, 3차 의료기관에 종사하는 의사 102명을 대상으로 설문조사를 통해 불면증 환자의 치료 실태를 조사하고자 하였다. 방 법 : 총 102명의 정신건강의학과 및 타과 전공 의사들이 설문에 참여하였고, 분석에 포함된 설문조사 대상자는 100명이었다. 결 과 : 실제 치료 장면에서 가장 자주 사용되고 있는 치료는 약물학적 치료였으며, 수면위생 교육과 인지행동 치료 등의 비약물학적 치료도 시행이 되고 있는 것으로 나타났다. 그러나 비약물학적 치료를 시행하더라도 그 효과에 대한 만족도는 높지 않았다. 의사가 보기에 불면증 환자들의 비약물학적 치료에 대한 관심은 일정 수준 있는 것으로 나타났으나 이에 대한 식견이나 의식 수준은 아직 미흡한 것으로 보고되었고, 치료의 실행도 충분히 적절하게 이루어지고 있지는 않은 것으로 보고되었다. 본 연구에서는 추가적으로 의료진이 생각하는 불면증 환자의 적정 진료를 위해 요구되는 점에 대해서도 탐색하였다. 결 론 : 본 연구는, 치료적 개입에 대한 보다 구체적인 정보를 획득하지는 못했다는 점, 환자를 대상으로도 설문을 실시하지는 못했다는 점 등의 제한점을 지니고 있으나, 그럼에도 불구하고 불면증 치료의 개선과 변화를 위해 필요한 현황 조사를 면밀히 실시했다는 점에서 그 의의가 있다. 결론적으로 다수의 의사들이 불면증의 비약물학적 치료가 중요하다고 생각하고 있었으나 진료 현실에서 적용하기 힘든 부분이 있다고 보고하였다. 본 연구 결과는 불면증에 대한 적정 치료를 위해 비약물학적 치료를 위한 진료 여건 개선 및 의사대상 교육이 필요함을 제시하였다.

천담유창여장석순적 「대기」론 (A Study in the Daqi- Theories by Yu Chang and Zhang Xi Chun)

  • 금지수;금경수;정숙이
    • 동의생리병리학회지
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    • 제18권5호
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    • pp.1232-1236
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    • 2004
  • In the Far-Eastern traditional medicine, Oi[Energy] implies a wide range of meaning and is emphasized. There is nothing that is not related to this Qi, as seen in physiology, pathology, the relationship between human body and nature, the movements of intestines and gyeongnak[energy networks], the process of outbreak and change of illness, remedial laws, the features and effects of drugs, and so on. Accordingly, Nei Jing also says, 'every sickness arises from OL' The Qi has multi-meanings, and each of lots Of past physicians researched and analyzed it in different perspective, thus making the Qi-theories much richer. Still. there were not so many physicians who discussed the theme of Daqi. The denomination of Daqi is seen in Nei Jing and Jin Gui Yao Lue, and the physicians like Yu Chang in Ming dynasty and Zhang Xi Chun in Cheng dynasty, etc. applied and utilized Daqi by exploring its functional actions for human life and associating it with clinical practices. Yu Chang said that Daqi is Xiong Zong Yangqi[Positive Energy in Breast] governing every Qi, and that if this Qi is full, it spreads through body and protects the body from sickness, and vice versa. Summarizing his researches on the Daqi in Jin Gui Yao Lue and on the opinions of Yu Chang as well as his experiences, Chang Xi Chun maintained that the Qi accumulated in breast must be named Daqi, which constitutes the contents of Zongqi[Chief Energy] mentioned in Nei Jing. Once the Qi is vacant, breathing is not smooth, whole body is enervated, spirit becomes dim, thinking ability falls drastically. Furthermore, if the Qi is extremely vacant or more worsens, breathing stops. And he prescribed the medicines including Sheng Xian Tang as remedies against the symptom of Daqi XiaXian[Fall in Great Energy]. The recognitions of Daqi by Yu Chang and Zhang Xi Chun are consistent with each other. At any rate, their theories and prescriptions may be high in practical value in contemporary clinics.

의학삼자경(醫學三字經)에 나타난 진수원(陳修園) 의학 사상에 대한 문헌적 연구 I (Study on $Ch{\acute{e}}n$ $Xiuyu\acute{a}n$ by analysing $Y\bar{i}xues\bar{a}nz\grave{i}j\bar{i}ng$)

  • 김재은;최달영
    • 동의생리병리학회지
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    • 제22권4호
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    • pp.709-717
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    • 2008
  • $Ch\acute{e}n\;Xiuyu\acute{a}n$(陳修園) was a famous doctor and educator of the late Tang Dynasty. He was well known both for his books for beginners, and for his unique medical theories based on his profound research of <$Sh\bar{a}ngh\acute{a}nl\grave{u}n$(傷寒論)> and <$J\bar{i}nku\grave{i}y\grave{a}ol\ddot{u}e$>. He wrote <$Y\bar{i}xues\bar{a}nz\grave{i}j\bar{i}ng$(醫學三字經)> to establish the basic textbook for the beginners to set up right principles in pursuing their medical career. <$Y\bar{i}xues\bar{a}nz\grave{i}j\bar{i}ng$> was written in rhyme form, so that it can be easily memorized and used in future practices. There are quite many medical books in rhyme form, but this book is very unique as $Ch\acute{e}n\;Xiuyu\acute{a}n$ annotated his own notes, which is rare in this form of books. This feature makes <$Y\bar{i}xues\bar{a}nz\grave{i}j\bar{i}ng$> very outstanding, also with the fact that $Ch\acute{e}n\;Xiuyu\acute{a}n$ was the one with profound understanding and original theories based on medical bibles such as <$N\grave{e}ij\bar{i}ng$(內經)> and <$Sh\bar{a}ngh\acute{a}nl\grave{u}n$(傷寒論)>. We have translated this precious educational material into korean, hoping that this work could be of any help to students of korean medicine. And while doing this work, we have found followings: <$Y\bar{i}xues\bar{a}nz\grave{i}j\bar{i}ng$> covers the entire fields of medicine from theoretical discussions to practical clinical information. Nevertheless, as this is written in rhyme form, there are few phrases that are not easily understood for the sake of rhyme. Beginners probably may have difficulties in reading this book. To make this difficulty alleviated, and to develop our own educational material, we need to study further on the notes that $Ch\acute{e}n\;Xiuyu\acute{a}n$ annotated himself.

폐경 후 골감소증 여성에 대한 12주간의 영양교육과 운동 중재 전.후 식품 및 영양소 섭취량 변화와 골밀도 지표 변화와의 관계 (The Association between Changes in Food and Nutrient Intakes and Changes in Bone Metabolic Indicators in Postmenopausal Women with Osteopenia after a 12-week Intervention of Nutrition Education and Aerobic Exercise)

  • 김서진;강서정;박윤정;황지윤
    • 대한지역사회영양학회지
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    • 제18권3호
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    • pp.213-222
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    • 2013
  • Few studies investigated the effects of nutrition education and exercises in women with osteopenia. This study examined the relationship between changes in dietary intakes and changes in indicators related to bone health in postmenopausal women with osteopenia (-2.5 ${\leq}$ T-score ${\leq}$ 1) after a 12-week intervention. Thirty-one postmenopausal women aged > 50 years residing in Seoul were recruited and participated in nutritional education regarding bone health and general nutrition practices and aerobic exercises (three times a week; 60 min per session). Twenty-five subjects completed the study and were eligible for the analysis. Bone mineral density (BMD) at femoral neck was measured by dual energy x-ray absorptiometry. Serum calcium, osteocalcin, and intact parathyroid hormone (PTH) were also measured. Dietary intake was estimated by using a one-day 24 recall by a clinical dietitian. After 12 weeks, meat consumption increased (P = 0.028) but vegetable intake decreased (P = 0.005). Intakes of animal protein (P = 0.024), vitamin B1 (P = 0.012) and vitamin $B_2$ (P = 0.047) increased, and sodium intake decreased (P = 0.033). Intact PTH (P = 0.002) decreased and osteocalcin (P = 0.000) increased, however, BMD decreased (P = 0.000). Changes in mushroom consumption were positively correlated with femoral neck BMD (r = 0.673, P = 0.003). Changes in animal iron intake were negatively correlated with intact PTH (r = -0.488, P = 0.013) but were positively correlated with osteocalcin (r = 0.541, P = 0.005). These results suggested that the association between animal iron intake and biochemical markers of bone turnover may play an important role in bone metabolism. Further studies are needed to shed light on complicated mechanisms of diet, hormonal levels of bone metabolism, and bone density.

신체적 억제대 지침 개발 및 사용 효과 (Development of physical restraints guidelines and use effect)

  • 정윤중;김혜현;김은한;김지연;차세정;김유진;강정은;정연화;정영선;김영환;경규혁;홍석경
    • 한국의료질향상학회지
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    • 제20권1호
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    • pp.42-57
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    • 2014
  • Objective: The objective of this research was to develop a guideline for more effective use of physical restraint on patients in the intensive care unit and training the nurses on it and applying it on clinical practice to assess its effectiveness. Method: This research analyzed the before and after effect of the development of a guideline for physical restraint by dividing the category into nurse and patient. In the case of nurse, a comparison of knowledge and nursing service regarding the use of physical restraint from before the training on physical restraint guideline(Jan. 2011) and after the training on physical restraint guideline(Dec. 2011) was made. In the case of patient, a comparison of physical restraint usage rate and average usage time, the number of unplanned extubation cases were compared from before the use of physical restraint (Jan.~Apr. 2011) and after the use of physical restraint (Sep.~Dec. 2011) were made. Result: After the training on the physical restraint guideline, the knowledge of the nurse and the nursing practice showed notable improvement by (p<0.000) and (p<0.048) respectively and in patient, physical restraint usage rate and average time of usage decreased by (p<0.001) and (p<0.001) respectively. And despite the decrease in the number of cases in which the physical restraint was used, the number of unplanned extubation cases remained the same. Conclusion: Physical restraint guideline training and guideline usage can be stated to have brought out positive effect in both the nurse and patient. In order to maintain such positive effects, continuous training is necessary and continuous revaluation is necessary, regarding knowledge and nursing practices.

The Versatility of Cheek Rotation Flaps

  • Kim, Kyung Pil;Sim, Ho Seup;Choi, Jun Ho;Lee, Sam Yong;Lee, Do Hun;Kim, Seong Hwan;Kim, Hong Min;Hwang, Jae Ha;Kim, Kwang Seog
    • 대한두개안면성형외과학회지
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    • 제17권4호
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    • pp.190-197
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    • 2016
  • Background: The cheek rotation flap has sufficient blood flow and large flap size and it is also flexible and easy to manipulate. It has been used for reconstruction of defects on cheek, lower eyelid, or medial and lateral canthus. For the large defects on central nose, paramedian forehead flap has been used, but patients were reluctant despite the remaining same skin tone on damaged area because of remaining scars on forehead. However, the cheek flap is cosmetically superior as it uses the adjacent large flap. Thus, the study aims to demonstrate its versatility with clinical practices. Methods: This is retrospective case study on 38 patients who removed facial masses and reconstructed by the cheek rotation flap from 2008 to 2015. It consists of defects on cheek (16), lower eyelid (12), nose (3), medial canthus (3), lateral canthus (2), and preauricle (2). Buccal mucosa was used for the reconstruction of eyelid conjunctiva, and skin graft was processed for nasal mucosa reconstruction. Results: The average defect size was $6.4cm^2$, and the average flap size was $47.3cm^2$. Every flap recovered without complications such as abnormal slant, entropion or ectropion in lower eyelid, but revision surgery required in three cases of nasal side wall reconstruction due to the occurrence of dog ear on nasolabial sulcus. Conclusion: The cheek rotation flap can be applicable instead of paramedian forehead flap for the large nasal sidewall defect reconstruction as well as former medial and lateral canthal defect reconstruction.