• 기본간호학회지
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• 제7권1호
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• pp.109-121
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• 2000

Increasingly nursing science is embracing the concepts and methodology derived from psycho-neuroimmunology. It has been previously shown that stress increases and immune function declines in students undergoing examinations. To date, however, no many studies have been reported on stress levels, immune function and interventions in Korean students undergoing their first clinical nursing rotation. It was proposed that nursing students during their first clinical rotation experience increase in stress because of the novelty of the situation and their lack of clinical knowledge. It was also hypothesized that biofeedback and progressive relaxation, methods of self-regulation of involuntary autonomic nervous system responses, would reduce the stress response. The purpose of this study is to test the effectiveness of progressive muscle laxation using biofeedback The effectiveness of the experimental methods was tested by measuring the degree of symptoms of stress (SOS) and the values of ephinephrine, pulse rate, blood pressure and natural killer cells. The subjects of this study were thirty nursing students divided into two groups: experimental group was progressive muscle relaxation group using biofeedback and control group. This study was conducted for 8 weeks of clinical practice. Biofeedback training was done by software developed by J&J company (1-410 form for progressive muscle training). Progressive muscle relaxation training according to Jacobson's Theory was done by messaged word from biofeedback. The data was analyzed using Chronbach' ${\alpha}$ and t-test of the SPSS program and the significance level of statistics was 5%. The results of the study were : 1) The progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress(t=-4.248, p<.001) under clinical practice stress conditions. 2) The progressive muscle relaxation training using biofeedback was not effective for the values of epinephrine(t=-1.294, p=.206). 3) The progressive muscle relaxation training using biofeedback was effective for the reduction of systolic blood pressure (t=-2.757, p=.01). 4) The progressive muscle relaxation training using biofeedback was effective for the reduction of diastolic blood pressure (p=-2.032, 0=.05). 5) The progressive muscle relaxation training using biofeedback was not effective for the reduction of pulse rate(t=-15, p=.988). 6) The progressive muscle relaxation training using biofeedback was effective for the maintenance of natural killer cells (t=2.381, p=02). The first clinical rotation for student nurses is a stressful experience as seen by the rise in the SOS in the control group. Biofeedback using progressive muscle relaxation were effective in preventing the rise of symptoms of stress and the blood pressure means when comparing the pre to post clinical experience, The mean natural killer cell count was depressed in the control group but not significantly different in the experimental groups, It is proposed here that stress via the hypothalamic - pituitary - adrenal axis suppressed the NK cell count whereas the relaxation methods prevented the rise in stress and the resulting immune depression. We recommend relaxation techniques using biofeedback as a health promotion technique to reduce psychological stress. In summary. the progressive muscle relaxation training using biofeedback was effective for the reduction of symptoms of stress under clinical practice stress conditions.

• 문화기술의 융합
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• 제10권2호
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• pp.429-438
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• 2024

본 연구는 간호대학생의 임상실습 전 스트레스에 영향을 미치는 요인을 조사하고자 진행되었다. 연구대상은 첫 임상실습을 앞둔 3학년을 대상으로 설문조사를 실시하였다. 자료수집 기간은 2023년 12월 22일부터 2024년 1월 10일까지 간호대학생 191명을 대상으로 하였다. 연구도구는 스트레스(Pss), 셀프리더십, 의사소통능력(GICC) 도구를 사용하였다. 자료 분석은 t-test, ANOVA, Scheffé test, Pearson 상관분석, 다중회귀분석을 사용하였다. 연구결과, 스트레스는 셀프리더십 (r=-.29, p=<.001), 의사소통능력(r=-.40, p=<.001)과 음의 상관관계가 있는 것으로 나타났다. 단계적 다중회귀분석에서, 간호대학생의 임상실습 전 스트레스는 성별, 학업 만족, 의사소통능력이 영향을 주는 요인으로 나타났고, 이 변수들의 설명력은 33.7%였다. 본 연구를 바탕으로 간호대학생의 임상실습 전 스트레스를 감소시킬 수 있는 교육 프로그램 개발을 고려할 필요가 있겠다.

• 융합정보논문지
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• 제10권3호
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• pp.104-114
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• 2020

본 연구의 목적은 간호대학생이 임상실습 중 경험한 무례함 정도를 조사하고 무례함, 스트레스 대처전략이 간호전문직관 형성에 미치는 영향을 파악하는 것이다. 연구대상은 총 290명을 대상으로 삼았다. 연구도구는 무례함, 스트레스 대처전략, 간호전문직관을 사용하여 측정하였다. 자료 분석은 SPSS WIN 20.0을 이용하여 분석하였다. 연구결과 첫째, 일반적 특성 중 성별, 학년, 임상실습만족도, 임상실습환경만족도, 임상실습 중 무례함을 경험한 경우에 무례함 정도에 유의한 차이가 있었다. 또한, 간호전문직관의 차이는 전공만족도, 임상실습만족도, 임상실습환경만족도에 따라 유의한 차이를 보였다. 둘째, 무례함은 문제해결 중심대처(r=.36), 사회적지지 중심대처(r=.26), 회피중심대처(r=.25), 간호전문직관(r=-.16)과 상관관계가 있는 것으로 나타났다. 셋째, 간호전문직관에 유의미한 영향을 미치는 요인으로는 사회적지지 추구 대처(β=.23), 임상실습 환경 만족도(β=.22), 임상실습 만족도(β=.16)로 나타났으며, 총 설명력은 14% 이었다. 본 연구의 결과는 간호대학생의 간호전문직관 형성을 위해서는 적절한 스트레스대처전략, 만족스러운 임상실습환경과 임상실습 경험이 중요함을 시사한다.

• 의학교육논단
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• 제25권3호
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• pp.229-242
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• 2023

Health systems science is a new medical educational field added to the traditional medical education curricula of basic and clinical sciences. Health systems science emphasizes a more comprehensive approach utilizing systems thinking to care for patients, including interactions between multiple healthcare systems. In this review, I explore how health systems science education can be applied when medical instructors teach students in clinical clerkships through representative case studies. This study first looks at examples of health systems science education in clinical clerkship in the United States and suggests how to develop the curriculum of health systems science for clinical learning environments in Korea by combining Kotter's 8-step change management model and Kern's 6-step curriculum development model. Finally, based on practical examples from actual clinical practice education situations, suggestions are made regarding how to develop the entire educational program of a medical school from the stage of applying health systems science at the individual level to clinical practice education.

• 대한간호
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• 제17권3호통권95호
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• pp.73-84
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• 1978

The Clinical practice in fundamentals of nursing is the first clinical experience andi the self-confidence that the students obtain in the cause of fundamentals of nursing procedures through clinical experience will contribute substantially to a successfu

• 한국응급구조학회지
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• 제6권1호
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• pp.39-53
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• 2002

This descriptive study was conducted to identify the attitude toward euthanasia of EMT and nursing students and to compare their attitude before and after clinical practice. The convenience sample was comprised of 40 first grade and 40 second grade EMT students attended at G college in G-city, and 40 first grade and 40 third grade nursing students attended at C college in C-province. The variable was tested with an euthanasia attitude scale developed by Kim Ae Kyoung(2001). The valid responses were obtained and analyzed by using SPSS PC+ from November 25 to December 6, 2002. The results showed that most of the respondents agreed to have positive attitude toward euthanasia in terms of client's right and client's quality of life. Also, they thought that euthanasia should be legalized and the right to die with dignity should be guaranteed. The EMT respondents having a clinical experience showed significantly higher score than respondents having no experience in the subarea of medical ethics, and nursing respondents who had a clinical practice showed significantly higher score than others no experience in the subarea of quality of life. But, the other sub-areas had no significant difference between the respondents before and after clinical practice. The attitude toward euthanasia composed of sub-areas such as being after the quality of life, having a high regard for a life and recognizing client's right was not affected by the single factor of clinical practice. Therefore, much supportive intervention need to be done for the students about the significant affecting factors found in this study like a religion, values, education and observing experience of someone's death.

• 한국방사선학회논문지
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• 제16권7호
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• pp.985-993
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• 2022

본 연구는 COVID-19 전·후 다양한 규모의 기관에서 임상 실습을 진행한 학생을 대상으로 임상 실습에 대한 기대도 및 만족도 등을 비교 평가하고 이를 통해 앞으로의 임상 실습 지도방법 및 운영 방향성에 대한 제언을 목적으로 시행하였다. 실습에 대한 만족도의 평가는 COVID-19 전·후에서 유의한 차이가 나타났는데 특히 실습 지도, 실습환경, 실습시간에 대한 만족도 평가에서 COVID-19 이후의 만족도가 낮아짐을 확인할 수 있다. 실습만족도와 관련된 결정적인 영향 인자를 분석한 결과 대학병원에서 실습을 시행한 학생들은 기관의 환경적인 요인을 높게 평가하였고, 중소병원에서 실습을 시행한 학생들은 참여 중심의 실습에서 만족감을 높게 나타내었다. 따라서 대학병원에만 의존하는 임상 실습보다는 대학병원과 중소병원의 장단점을 활용하는 실습이 효과성이 높을 것으로 생각된다. 그러나 중소병원으로 실습 기관을 다각화하기 위해서는 실습목표와 교육과정에 맞는 표준화된 실습 과정 및 실습 지도 방법, 평가방법에 관한 매뉴얼을 만들어 기관에 제공하고 교육하는 것이 선행되어야 할 것이다. 그리고 기관과의 충분한 의견교환과 협의를 통해 운영된다면 학교에서는 실무형 인재양성의 기회를 얻고 인력확충에 있어 어려움이 있는 중소병원도 훌륭한 인적자원을 우선적으로 확보할 수 있을 것으로 사료된다.

• Child Health Nursing Research
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• 제5권1호
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• pp.5-17
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• 1999

This study was designed to determine the schemata and their characteristics of stress experience the subjectivity of stress experience(structure of subjectivity) would be a basic step for the effective clinical education through the stress management for characteristics of these types. Q-methodological method was used for that purpose. The research method statements were collected prior to the study through indepth interviews. For the study, 31 Q-statements were selected. There were 34 nursing students as subjects for the research. The 34 nursing students sorted the 31 statements using the principal of forced normal distribution. The principle of forced normal distribution, which has 9 scales to measure the individual opinions, was called. Q-factor analysis by using PC QUANL program supply the material. According to the outcomes of this study, there were 3 types of special opinion about the stress experience of clinical practice. The first type is called 'Influence of practical atmosphere type'. Members of this type experienced stress by an inadequate orientation and undesirable role model of nursing. The second type is called 'conflict of nursing role type'. Members of this type experienced stress by an inadequate orientation and undesirable role model of nursing. The third type is called 'Lack of confidence type'. Members of this type experienced stress because of a lack of confidence for their own nursing knowledge and skill. As a result, we now need further study to identify individual psychological aspects of stress for clinical practice. The findings will guide the development in effective approaches for clinical education. Finally, the result of the study will provide us the need for developing systematic and integrated practice education program for students and active involvement of clinical instructor.

• Kidney Research and Clinical Practice
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• 제36권2호
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• pp.111-116
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• 2017

The Korean Society of Nephrology participated in the task force team consisting of government authorities and civilian experts to prevent and control the spread of Middle East respiratory syndrome (MERS) in 2015. The Korean Society of Nephrology MERS Task Force Team took an immediate action and drafted 'the clinical recommendation for hemodialysis facilities' to follow when the first and the only confirmed case was reported in the hemodialysis unit. Owing to the dedicated support from medical doctors, dialysis nurses, and related medical companies, we could prevent further transmission of MERS infection successfully in hemodialysis units. This special report describes the experience of infection control during MERS outbreak in 2015 and summarizes the contents of 'the clinical practice guideline for hemodialysis facilities dealing with MERS patients' built upon our previous experience.

• 임상간호연구
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• 제17권3호
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• pp.363-374
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• 2011

Purpose: The purpose of this study was to identify the types and causes of non-value-added (NVA) activities in nursing practice, and to determine the frequency of each NVA type and causes of NVA in clinical area. Methods: This study was conducted using Delphi technique. First, in order to identify NVA and their causes, 24 nurses with 7 years or more of clinical experience were recruited from medical/surgical units in six general hospitals in Korea. Then the NVA types and causes were tested using a larger sample of 130 nurses with more than 3 years of clinical experience at two general hospitals in Korea. Results: NVA was categorized into 6 different types, which are repeating, duplicating, waiting, reverse-proxy working, reworking, and searching. The most prevalent NVAs were repeating and duplicating works. Reworking and searching were less frequent types than others. The causes of NVA were classified into personnel-related, supporting departments, records, regulations, information, materials or instruments, and others. Among them, personnel-related and supporting departments were reported with the highest scores. Conclusion: NVA leads to waste cost and time. These results demonstrated the situations and causes of NVA occurred in nursing practice. Further studies on the typology and moderation of NVA activities are warranted to improve the efficiency and quality of nursing care in day-to-day practice.