• 제목/요약/키워드: Home Nursing Care

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모유수유 전화 상담 내용의 분석 (Analysis of the Content of Telephone Counseling with Breastfeeding mothers)

  • 김혜숙
    • 대한간호학회지
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    • 제25권1호
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    • pp.17-29
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    • 1995
  • This study was done to analysis data on breastfeeding mothers. This stud was conducted using data from telephone counseling in one metropolitan area. The subjects who had received consultation about breastfeeding were 100 breastfeeding mothers. The period of consultation was from Mar. 9, 1994 to August 23, 1994. Consultants were referred from UNICEF, hospitals, TV, newspapers or magazines. Analysis of the problem patterns resulted in 11 classifications. These were physio -anatomical factors(11 cases) , psychological factors(15 cases), breastfeeding methods(21 cases), breastfeeding intervals and frequency(19 cases) , disease in the breastfeeding mothers(13 cases), disease in the babies (12 cases), lack of support (4 cases), food and drugs while breastfeeding(5 cases), weaning(11 cases), others(27 cases). The highest frequency was for breastfeeding methods (21 cases). When the contents of the counselling were analyzed for the 100 cases, 36 problem patterns were identified. Patterns with over 10 responses were diarrhea, insufficient milk supply, sore and cracked nipples, weaning, inverted nipples and jaundice. The age of infants when mothers were telephoned was as below : 1 week(28 cases), 2 weeks(12 cases), 3-4 weeks(18 cases), 5-8 weeks(7 cases), 9 weeks-3 menths(4 cases), 4 menths-6 months(12 cases), over 6 months(2 cases), and the number of pregnant women was 12. The nursing diagnosis were classified according to problem patterns and each diagnosis was assigned an appropriate Problem Pattern The total number of nursing diagnoses was 22. When clients are referred for counselling nurses need guidelines about problems, possible causes and nursing. In this study, the example of guidelines for sore nipples is suggested. The recommendations based on the telephone counseling results are as follows : Prenatal education about the advantages of breastfeeding and breast care, and home visits after delivery for counseling related to breastfeeding. During the hospital stay, nursing intervention such as education on breastfeeding methods using slides, audio-visual tapes, pamphlets are needed as well as an initial trial of breastfeeding. Further research is indicated on the perceived lack of breast milk and on the effectiveness of nursing interventions to pro-mote breastfeeding.

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지역사회 거주 노인의 허약선별도구 타당도 평가 (Validation of Instruments to Classify the Frailty of the Elderly in Community)

  • 이인숙;박영임;박은옥;이순희;정인숙
    • 지역사회간호학회지
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    • 제22권3호
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    • pp.302-314
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    • 2011
  • Purpose: This study aimed to validate instruments to classify the frailty of Korean elderly people in community. Methods: For this study, 632 elders were selected from community-based elderly houses and home visiting registries, and data on frailty were collected using three instruments during November, 2008. The Korean Frail Scale (KFS) was composed of 10 domains with the maximum score of 20. The Edmonton Frail Scale (EFS) had 10 domains with the maximum score of 17. The 25_Japan Frail Scale (25_JFS) was composed of 6 domains with the maximum score of 25. Internal consistency was measured with Cronbach's ${\alpha}$. Sensitivity, specificity and area under the curve (AUC) of ROC were measured to see validity with long.term care insurance grade as a gold standard. Results: The Cronbach's ${\alpha}$ was .72 for KFS, .55 for EFS, and .80 for 25_JFS. Sensitivity, specificity, and AUC were 70.0%, 83.2%, and .83, respectively, at cutting point 10.5 for the KFS, 50.0%, 80.9%, and .66, respectively, at 8.5 for EFS, and 80.0%, 85.9%, and .86, respectively, at 12.5 for 25_JFS. Conclusion: KFS and three JFS showed favorable internal consistency and predictive validity. Further longitudinal studies are recommended to confirm predictive validity.

자녀를 양육하는 북한이탈 기혼여성의 직장생활 체험에 관한 해석학적 현상학적 연구 (Hermeneutic Phenomenological Study on the Experiences of Employment of Married North Korean Women Defectors Rearing Children)

  • 조현미;최은정
    • 대한간호학회지
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    • 제50권1호
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    • pp.39-51
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    • 2020
  • Purpose: This study aimed to understand the experiences of married North Korean women's child-rearing, working lives, and their home and work environment in depth. Methods: This study adopted van Manen's hermeneutic phenomenological method to qualitatively analyze data. The participants were 8 married North Korean women defectors. Data were collected through in-depth interviews and observations from July 4 to August 20, 2018. Results: Nine essential themes emerged: more personal challenges after overcoming a life-threatening crisis; hopes of firmly settling in this land; the wound from the north, which chased them here; a body that becomes stronger through hardship; being stuck in a past full of anxiety and pain; the present is full of hope; hope for the future; sense of alienation from coworkers that cannot be overcome; and sense of power to endure an exhausting work life. Conclusion: This study provided a broader understanding of the life and experiences of married women from North Korea. It highlights the need for nurses to recognize their importance in nursing care. The study also suggests that academic and practical approaches for nursing, and basic data for a nursing intervention for married women from North Korea be provided. The study findings can be used as a basis for preparing a national policy that will help North Korean defectors to find employment and gain stability.

노인요양시설에 대한 고령자 인식 및 시설 내부 색채선호 경향에 관한 연구 (A Study on the Awareness & Preferences about the Nursing Homes)

  • 정무린;박혜경
    • 한국과학예술포럼
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    • 제29권
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    • pp.319-331
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    • 2017
  • 우리나라는 2015년 기준, 65세 이상 노인인구 비중이 13.1%로써 '고령화 사회(aging society)'에 진입하였으며, OECD 국가 중 인구 고령화 증가율 1위에 이를 정도로 급속한 노인인구 증가를 나타내고 있다. 이에 대한 대비책의 일환으로 한국정부는 2008년 7월, '노인장기요양보험제도를 시행하였고, 이후 2015년까지 노인요양시설의 규모는 무려 220.2%에 이르는 급속한 양적 신장을 나타내고 있다. 이러한 양적 증가에 대하여 환경의 질적 향상에 대한 필요성이 대두되며 색채환경은 가장 효과적인 환경개선의 방법으로 인정받고 있다. 따라서 본 연구는 양적 증가일로에 있는 한국 노인요양시설 환경의 질적 향상을 위하여, 이의 공간적 기능을 지원하는 색채환경을 파악하고, 예비수요자인 고령자들을 대상으로 노인요양시설 색채환경에 대한 의식조사 및 선호색채 조사를 실시하여, 수요자 의식 및 선호경향이 반영된 노인요양시설의 색채환경 계획의 방향 제시를 목적으로 하였다. 이를 위하여 노인요양시설의 정의 및 현황, 선행연구 동향, 그리고 공간기능별과 색채환경을 파악하고, 부산, 경남지역 60대 이상 고령자 총 100명(남자 52명, 여자 48명)을 대상으로 설문조사를 실시하여, 노인요양시설 색채환경에 대한 의식 및 기능별 선호색채를 도출하였다. 본 연구의 결과는 다음과 같다. 첫째, 노인요양시설 색채환경에 대한 '의식조사' 결과로 노인요양시설 선정 시 가장 중요하게 생각하는 요소는 서비스(37%), 의료수준(20%), 위치(19%)의 순으로 나타났으며, 실내색채 계획에 대한 중요성은 대부분 인식하지 못한 것으로 나타났다. 그러나 노인요양시설 실내색채계획에 대한 필요성은, '그렇다'(32%), '매우 그렇다'(25%)의 순으로 나타나 요양시설의 색채도입이 필요함을 시사하고 있다. 둘째, 노인요양시설 실내색채에 대한 설문조사 결과, 거주공간기능(침실)에 대한 선호색상은 R, P, G의 순으로, 간호공간기능(프로그램실)에 대한 선호색상은 G, R, Y의 순으로, 공용공간기능(로비)에 대한 선호색상은 R, G, Y의 순으로 나타나, 전반적으로 R계열의 색상을 선호하는 것으로 나타났다.

치매노인을 돌보는 가족의 부담감과 우울반응에 관한 연구 (A Study on the Burdens and Depressive Reactions on Families who Cared for Patients Suffering from Senile Dementia)

  • 김영자;이평숙
    • 대한간호학회지
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    • 제29권4호
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    • pp.766-779
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    • 1999
  • The purpose of this study was to investigate the relationship between the burden on families who live with an elderly person suffering from senile dementia, and the degree of their depression. There were 400 participants in this study, staying in the Seoul and Kyonggi areas from August 1, 1997 to February 28, 1998. Among the group, 100 participants took care of their patient at home, and another 300 participants left 100 patient at a day-care center, 100 sanatorium for senile dementia(asylum for helpless elderly people), 100 an infirmary for elderly people. Eventually 242 subjects out of the 400 were selected for the data analysis. The Zarit (1980) tool was employed to measure the degree of burden and Zung's(1965) “Self-Rating Depression Scale” was employed for the data analysis. The data was analyzed, and the percentage, t-test, ANOVA and Person's Correlation Coefficient were calculated. The results are as follows : 1. The average degree of burden that care-giving families felt was 49.13, which is somewhat high. 2. The average degree of depression that care -giving families felt was 51.95, which is relatively high. 3. The degree of burden was directly affected by the relation with the patient(F=2.48, P<.05), and the socio-economic status of the family(F=5.17, P<.05). Its also affected by the patient's educational status(F=2.17, P<.05). 4. The degree of depression of the family was significantly dependent on sex(t=-2.05, P<.05), age (F=2.99, P<.05), the relationship with the patient(F=3.65, P<.01), socio-economic status (F=7.74, P<.001), occupation(t=2.82, P<.01), health status(F=4.42, P<.01), and the place of residence(F=4.30, P<.01), The patient characteristics was significantly dependent on his/her educational status(F=3.85, P<.01), the period of suffering from senile dementia(F=2.47, P<.05), and smoking habit(F=6.17, P<.001). 5. The relationship between the degree of burden and that of depression reads r=0.43, which is statistically positive correlation in the high significant level. Upon analyzing the entire summation, most care-givers for elderly patients suffering from senile dementia lack time in caring for themselves. They also experience chronic fatigue and mental discomfort caused by the isolation from society, curtailment of certain activities, a sense of responsibility for their patients, and limits of their endurance in taking care of their patients over time. In conclusion, this study emphasizes the necessity for the following propositions : 1. In order to measure the degree of burden that Korean care-giving families undergo, a new tool must be developed on the basis of Korean culture. 2. An educational program based on the demands that care-giving families undergo must be developed, and its clinical effect also has to be examined.

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뇌졸중 환자의 재활과정에 따른 스트레스 변화 양상 (A Study of a Pattern of the Stress Perceived by Stroke Patients through the Rehabilitative Process)

  • 이정민
    • 동서간호학연구지
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    • 제1권1호
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    • pp.82-98
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    • 1997
  • The purpose of this study was to determine pattern of the stress perceived by stroke patients over time. The ultimate goal of the research is to provide data to help nurses to design the plan of nursing care of the stroke patients both in the hospital and at home. A total of 57 admitted stroke patients were collected from one general hospital in Seoul from June, 12 to September, la, 1993. The data were collected for three phases(within one week after leaving the hospital). The tools for this study, three scales were used ; Stress scale developed by the investigator. Constitution classifing scale designed by Kho(1984), and Self-care measuring scale by Kang(1984). Data were analyzed in four steps using statistical analysis. First, demographic data were determined by descriptive statistics. Second. the pattern of stress perceived by stroke patients across three phases was measured using repeated measures ANOVA. Third, stress of stroke patients classified by constitution, paralyzed area. and attack frequency were measured using ANOVA or t-test, and the pattern of stress by group over time was determined using paired t-test in post hoc test. Fourth. Pearson correlation coefficients were calculated to determine the relationship between the stress and self-care activities. The results of this study are ; 1. The pattern of stress across three phases ; There was a decrease of the stress across three phases. In general. psychological stress as the highest among three phases(F=36.92. P=.000). There was a statistically significant difference of the physical stress(F=34.55, p=.000), the psychological stress (F=15.49, p=.0005) and the social stress (F=24.71. p=.000) among three phases. There was a statistically significant difference of the stress between the first phase (on admission) and the second phase(before leaving the hospital) and was a decrease of the stress (t =6.36. p=.000). 2. The pattern of stress of stroke patients classified by constitution across three phases ; Stroke patients classified as So-Eum perceived the highest stress among three groups(Tae-Eum, So-Eum. So-Yang). There was no statistically significant difference of stress according to the constitution of stroke patients among three phases. Hence. stress was not influenced by the constitution of stroke patients, but there was a statistically significant difference of stress over time. 3. The pattern of stress of stroke patients classified by the paralyzed area across three phases ; Right paralyzed stroke patients perceived higher stress than left paralyzed stroke patients. There was, however, no statistically significant difference of stress between two groups except 2nd phase. There was no statistically significant difference of the perception of stress bet ween the right and left paralyzed stroke patients. 4. The pattern of stress of stroke patients classified by the frequency of the relapse of the disease across three phases ; Stress was higher in stroke patients who had the relapse of the disease twice more than the first time. There was, however, no statistically significant difference of stress between two groups. There was no statistically significant difference of stress of stroke patients according to the relapse of the disease among three phases. Hence, stress was no influenced by the relapse of the disease. 5. The relationship between the stress and self-care activities ; There was a negative relationship between the stress and self-care activities each phase(on admission, r= -.1563 ; before leaving the hospital, r= -.4030 ; after leaving the hospital, r= -.5291). Hence, the higher the self-care activities, the lower the stress. This study has three important findings. First finding was that psychological stress perceived by stroke patients was the highest among three phases. The second finding was that factors such as the constitution, the paralyzed area, and the relapse of the disease did not have an influence on the stress perceived by stroke patients across three phases(on admission, before leaving the hospital, after leaving the hospital). There was a statistically significant decrease of the stress perceived by stroke patients across three phases. The third finding was that there was a negative relationship between the self-care ability and stress. In this study, these findings have implications for nursing care for the rehabilitation of stroke patients and suggest the need of nursing intervention to promote the self-care ability and to support the psychological self-esteem of stroke patients.

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재가노인의 장기요양예방과 자립지원에 관한 연구: 예방·자립지원 모형설계 방안제언 (A Study on a Prevention of Long-term Care self-reliance Support for the Elderly in Home: Proposal of an Prevention and Support for Self-reliance Support Model)

  • 김현실;황성자
    • 한국노년학
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    • 제30권4호
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    • pp.1359-1375
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    • 2010
  • 본 연구는 고령사회에 따른 장기요양재가노인 인구의 증가 현상을 예견하면서, 요양급여 의존 증을 최소화하고, 예방·자립지원의 유효성을 높이기 위하여 예방·자립지원 모형의 기초를 제시함으로 예방·자립지원의 실천적 함의를 얻고자 함이다. 연구방법으로는 첫째, 이론적 문헌연구를 통하여 장기요양노인에게 예방·자립지원에 대한 개념을 명확히 하며, 둘째, 표준장기요양이용계획서와 연구대상자가 소속된 노인복지센터의 장기요양급여 관련문서 분석을 통하여 예방·자립지원에 저해하는 요소를 분석하고, 셋째, 요양급여 이용자들의 요양급여이용실제에서 예방·자립지원을 저해하는 요소와 실제 욕구를 조사하여 이 세 가지의 질적 연구결과를 바탕으로 예방·자립지원 모형의 방향을 제시함으로써 예방·자립지원의 유효성을 높이기 위한 실천적 함의를 얻고자 하였다. 따라서 D시에 있는 주간보호센터와 노인복지센터의 사업자와 전문사회복지사의 협력과 승낙을 얻어 문서자료 수집과 연구 참여자에게 심층면접을 실시하였다. 연구 결과 문헌연구에서는 장기요양 예방·자립지원은 장기요양급여노인에게도 자신이 삶의 주체가 되어 살아가도록 이용자의 권리를 지원하는 '이용자 중심의 지원체계의 강화'로 전개되어야하는 것으로 분석되었다. 문서분석에서는 보건의료와 관련한 급여제공이 부재한 것으로 나타났고, 예방·자립지원을 위한 사회적지지체계의 미비 등이 나타났으며, 심층면접조사결과에서 장기요양급여이용노인의 예방·자립과 관련된 서비스의 강화가 요구되었으며 예방·자립을 위한 요양급여이용노인의 절실한 욕구는 ①고독감, 외로움, 불안, 공포 ② 자녀와 사람에 대한 그리움과 걱정, ③이동, 외출, ④ 보건·의료서비스·재활프로그램, ⑤ 주간보호이용욕구, ⑥주택구조의 불편, ⑦식사메뉴의 욕구, ⑧폐용증후군(disuse syndrome)의 발생 등이 도출되었다. 따라서 예방·자립지원모형은 ①이용자 중심의 지원체계의 강화, ②보건의료연계지원체계의 강화, ③사회적지지 체계강화의 3가지 축을 중심으로 예방·자립지원모형설계의 기초를 제시하고자 했다.

노인장기요양보험제도에서의 방문물리치료 도입에 대한 노인요양시설 물리치료사의 인식조사연구 (Research for the Inclusion of Home-Based Physical Therapy in Long-Term Care Insurance System of Physical Therapists in Elderly Care Facilities)

  • 이광재;노정석
    • 한국콘텐츠학회논문지
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    • 제11권11호
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    • pp.231-240
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    • 2011
  • 본 연구는 앞으로의 노인장기요양보험 서비스의 확대 시 우선적인으로 방문물리치료 서비스 도입의 기초자료를 제공하는데 그 목적이 있으며 그를 위해 노인장기요양보험 하에서 물리치료 서비스를 제공하고 있는 노인시설 물리치료사들의 제도에 대한 인식조사를 실시하였다. 그 결과 노인장기요양보험에 대한 인지도는 88.1%로 높았으며 필요성에서도 높았지만 40세 이상에서 절대 필요하다는 응답이 60.3%로 더 높았다. 또한 수가는 방문간호를 기준으로 높게 책정해야 한다는 의견이 59.7% 가장 높았다. 방문물리치료서비스 중 가장 중요한 치료접근으로는 일상생활 지도가 40%로 가장 높았고, 서비스 주체로는 방문간호센터처럼 방문재활센터로 해야 한다는 의견이 69.4%를 차지했다. 방문물리치료 시행에 따른 기대효과는 50점 만점에 전체 평균 41.44점으로 나타났으며 특히 40세 이상에서 42.48점으로 나타나 전체적인 기대효과가 높은 것으로 나타났다.

단기 생애회고요법이 말기 암 환자의 영적 안녕, 우울 및 불안에 미치는 효과 (Effects of a Short-term Life Review on Spiritual Well-being, Depression, and Anxiety in Terminally Ill Cancer Patients)

  • 안성희;안영란;유양숙;에이엔도 미치요;윤수진
    • 대한간호학회지
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    • 제42권1호
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    • pp.28-35
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    • 2012
  • Purpose: This study was done to evaluate the effects of a short-term life review on spiritual well-being, depression, and anxiety in patients with terminal cancer. Methods: The study used a pre posttest quasi experimental design with a nonequivalent control group. Measurement instruments included the Functional Assessment of Chronic Illness Therapy-Spiritual scale (FACIT-Sp12) and the Hospital Anxiety and Depression Scale (HADS). Participants were 32 patients with terminal cancer who were receiving chemotherapy or palliative care at hospitals or at home. Eighteen patients were assigned to the experimental group and 14 to the control group. A sixty minute short-term life review session was held twice a week as the intervention with the experimental group. Results: There was a statistically significant increase in spiritual well-being in the experimental group compared to the control group. There were also significant decreases in depression and anxiety in the experimental group compared to the control group. Conclusion: The results indicate that a short-term life review can be used as a nursing intervention for enhancing the spiritual well-being of patients with terminal cancer.

노인요양시설 거주노인의 활동공간 이용행동 및 점유행태 (A Study of the Residents' Use and Occupancy-Behavior in the Activity Areas of the Senior Nursing Facilities)

  • 이민아
    • 가정과삶의질연구
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    • 제27권5호
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    • pp.77-90
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    • 2009
  • The purpose of this study was to investigate the residents' use and occupancy-behavior in the activity areas of the senior nursing facilities, and to provide basic information to establish the appropriate physical elements for planning the activity areas. For the study, the observations in five facilities were conducted for one day, from 10 a.m. to 4 p.m by four researchers. The results of the study are summarized as follows: First, most of the using behaviors in the activity areas were the doing nothing or sleeping. The meals and program services were provided in only one activity area of the floor and it showed that the unit care system was perfunctorily conducted at those facilities. In the representative activity area, its openness was the main physical element influencing the spatial using frequency, while the accessibility and the openness in the sub-activity area were most important. The seating arrangements having comers were helpful for residents' interactions. Second, while facility programs and meals were provided in the specific activity area, there was no residents' occupancy in other activity areas at the same time. There were interactions including residents' conversations and watching/observations in non-designated activity areas such as the nursing stations and near corridors. But the residents' interactions and self-regulations were blocked by absence of territoriality, monotonous spatial compositions and furniture arrangements, insecurity of residents' privacy, wide or narrow areas, and isolated spatial type. Based on the results at the above, basic guidelines for planning the activity areas of senior nursing facilities can be proposed as follows: First, the isolated type and the sight interception should be avoided in representative activity areas. It should be partitioned with couple of areas through the appropriate furniture arrangements, and be prepared semi-private spaces in non-designated areas such as nursing station for the interactions among the residents and the staff. Second, in activity areas for small group, the isolated type is not also good for the residents' accessibility. The residents' privacy should be confirmed through the various spatial compositions, and enough areas need to be sure for the diverse furniture arrangements.