목적 : 우리나라의 주된 사망원인인 암은 최근 들어 진단기술의 발전과 치료방법의 개선으로 전점 만성화되고 있어 결과적으로 집에서 치료받고 있는 재가암환자의 수가 증가추세에 있다. 그러나 지속적이고 체계적인 암환자 관리체계의 미비로 많은 환자들이 적정한 보건의료서비스를 받지 못하고 방치되고 있는 실정이다. 본 연구는 재가암환자의 삶의 질을 높이고 가족의 부담을 줄여주기 위한 지역사회 재가암환자 관리체계를 개발하기 위한 전단계로서 재가암환자의 서비스 요구를 파악하고자 한다. 방법 : 본 연구는 재가 암환자와 환자를 주로 돌보고 있는 가족을 대상으로 그들이 겪고 있는 어려움과 보건의료 분야의 도움을 필요로 하는 요구를 직접 면접 조사를 실시하여 조사하였다(연구대상, 중앙암등록본부 등록 환자, 455명). 결과 : 1) 암환자의 가장 중요한 증상인 통증조절에 대한 만족도는 경증 환자에서는 25.5%, 중증환자의 경우에는 46.5%가 불만이라고 응답하여 만족스러운 통증조절이 안되고 있었다. 2) 재가 암환자 및 보호자에 대한 요구도 조사결과를 보면 가장 필요한 도움으로는 경제적인 도움, 통증 및 증상조절 의료에 대한 정보제공 및 상담이었다. 3) 기본간호에 대해서는 간호필요율에 대한 충족율이 대부분 $20{\sim}30%$ 대로 낮았다. 특수간호의 경우에는 요구도가 있는 재가암환자가 많지 않았으며(5% 이내), 기본간호에 비해 간호충족율이 높았으나, 여전히 50% 정도로 낮아, 충분한 서비스가 충족되고 있지 않았다. 결론 : 재가암환자들의 서비스 요구도를 분석한 결과 암환자들이 충분한 통증 및 증상조절이 이루어지지 않고 있으며, 기본 및 특수간호의 충족률이 매우 낮은 실정이다. 향후에 재가암환자의 삶의 질을 높이고 가족의 부담을 줄여주기 위한 재가암환자 관리체계를 개발이 필요하다.
Author Studied on a few as Pacts of clinical psychology of 274 patients with chronic pulmonary tuberculosis by simple question are, who had been admitted in national Maison for a long time Feb. 1971, Hospital. The results obtained were Summarized as follows: 1. The attitude and state of understanding to their diseases were somewhat different between males and females, That is, rather scientific and intellectual in males but rather unscientific and despairing in females. 2. The attitude to their doctors and nurses were rather more discontent in males and younger age group. 3. Attitude to hospital life what was some different between males and females, that is, more agreeable and obedient to their circumstances in females and older age group than in males and younger age group. 4. The most anxious problem and the Persons who Eave best consolation during hospital life were family members in their home. 5. The home visiting of the nurses seemed under whole net welcomed.
Today the occurrence and world-wide transfusion of the AIDS has brought about new problems related to family relations. The AIDS is more threatening than any other disease because of the special processes of infection trough sex and intravenous injections high care cost and terminal death. The AIDS causes conflicts among family members economic destitution and family dissolution. In the U.S Marriage without noticing of the AIDS may lead to divorce like injuries abandonment and misfeasance during marriage. But the AIDS victims should not be rejected from the rights of parental decision divorce beneficiaries and visiting rights. More discussion is needed about such issues as the pregnancy rights rongful birth action and selective nontreatment by doctors. The AIDS may influence the every party involved and interdisplinary studies should be required to solve the problem including family science laws psychology sociology and medical research as well.
Purpose: The study examined the psychometric properties of the Korean Geriatric Depression Scale Informant-15 (KGDSI-15), an instrument measuring geriatric depression through their primary caregivers. Methods: The participants were 370 Korean older adults $\geqq$65-years-of-age registered in a visiting health center in S city. The Korean version of Geriatric Depression Scale-Short Form (GDSSF-K) was used for comparison. Internal consistency measured tool reliability and Pearson correlation coefficient measured validity. One-way ANOVA was used to determine the clinical usability of the instrument: depression levels were classified as normal, mild depression, and severe using GDSSF-K, and the depression scores of these three groups were comparatively measured by KGDSI-15. Results: The Cronbach's alpha coefficient was .831. The correlation coefficient with GDSSF-K was r=.616 (p<.001). KGDSI-15 results showed the depression level of older adults with severe depression was highest followed by those with mild depression and normal. The group differences were also statistically significant, which indicated the clinical usability of the instrument. Conclusion: KGDSI-15 is suggested to be reliable and valid to measure the geriatric depression through the primary caregivers of older adult.
Purpose: This study was aimed at identifying the factors influencing the practice of taegyo in pregnant women. Methods: A descriptive survey-based study design was used. The study included 210 married pregnant women aged 19 years or higher, excluding pregnant women from multicultural families, who attended the outpatient obstetrics and gynecology departments of a general hospital and a tertiary hospital in C City, from June 29, 2022, to September 8, 2022. Independent t-test, analysis of variance, and multiple regression analysis were used to determine the factors influencing the practice of taegyo. Results: The mean of the subjects' practice of taegyo was 3.49 ± 0.47. The factors influencing the practice of taegyo among pregnant women were perception of taegyo and spousal support. The higher the perceptions of taegyo and the greater the spousal support, the higher the practice of taegyo. The explanatory power of the regression model was approximately 49.2%. Conclusion: The factors influencing the practice of taegyo among pregnant women were confirmed to be the perception of taegyo followed by spousal support. The findings of the study confirmed that efforts to improve the perception of taegyo and spousal support are necessary to improve the adoption of the practice of taegyo among pregnant women.
This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of aerobic walking exercise program on the physical & psychological functions of home stayed stroke patients. The data were collected during the period of May 20th to August 15th, 2001. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b)suffering from stroke for 6 months to 5 years, (c)without recognition disorder with the MMSE-K score above 25, (d)below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease (f)able to walk beyond 15 minutes for themselves. The aerobic walking exercise program for the experimental group was aerobic exercise and education and supportive care. The aerobic exercise was 8 weeks' period, three times a week, 35 to 50 minutes a day. And the education and supportive care was consisted of one home visiting and 2 times telephoning a week. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. There was significant difference in the gait speed between the two groups. 2. There was significant difference in the dynamic valance between the two groups. 3. There was significant difference in ADL score between the two groups. 4. There was no significant difference in the depression between the two groups. As shown above, the results of 8 weeks' the aerobic walking exercise program for home stayed stroke patients produced positive effects on gait speed, dynamic valance, ADL score. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.
The impact of childhood experience has lifelong significance on subsequent health and development. Especially, the experience of infant is mostly affected by the quality of parental care and rearing environment. But the new mothers usually do not know what to do because of the lack of experience in these days. Therefore, an educational program regarding maternal role would be necessary. This study was conducted to evaluate the effectiveness of the maternal role education program for mother-infant interaction, child-rearing environment, and infant development. Non-equivalent control group time-series design was used, and Barnard's mother-infant interaction model was used as a conceptual framework of this study. The subjects were the healthy infants weighing over 2,500gm at birth, whose gestational age was more than 37 weeks, and their mothers. The final sample consisted of 19 mother-infant dyads for intervention group and 18 dyads for control group. Data were collected from March 15th to September 3rd in 1999. For the intervention group, programmed education which focused on mother-infant interaction, breast feeding, and infant care was provided before discharge. Telephone counselling was provided within one week after discharge. Home visiting for maternal role education was provided twice, one month and three months postpartum. For the control group, home visiting was also conducted but only for data collection. The data were analyzed using chi-square test and t-test to test the equivalence of two groups, and the effectiveness of intervention program was determined with repeated measure ANCOVA and t-test. The results were as follows: 1. Significant differences were found in mother-infant interaction between two groups(p=.000). It indicates that intervention program was effective in improving mother- infant interaction. In subscale analysis, four out of six subscale showed significant differences between the groups: sensitivity to cues (p=.000), social-emotional growth fostering (p=.000), cognitive growth fostering(p=.000) in mothers, and responsiveness to caregiver (p=.019) in infants. 2. The difference in the mean score of childrearing environment (HOME) between the intervention group and control group was significant(p=.003). When each subscale of HOME was examined individually, intervention group showed significantly higher scores in the diversity of stimulation(p=.000), and mother's involvement(p=.001). 3. Three-month-Infants of the intervention group showed higher GQ in the Griffiths mental development scale(p=.026). In subscale analysis, significant differences were found in the personal-social(p=.005), and the hearing and speech(p=.003). In conclusion, the maternal role education program proved to be effective in promoting the mother-infant interaction, organizing the childrearing environment, and fostering the infant development. These results are very meaningful that we found maternal role education necessary for normal infants' mothers, and that nurses can make a great contribution in promoting health of infants and mothers.
This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.
In this study the levels and influencing characteristics of maternal identity and self confidence for caring the baby were identified during the immediate postpartum period. 114 primiparous women who delivered vaginally normal baby participated in the survey from August 1 to October 31, 1996. SD scale was to measure maternal identity which consisted of 11 items for mother and 6 items for baby. Likert scale was to measure self confidence for caring the baby (38 items). Cronbach's alphas for evaluating internal consistency as follows : .86 for maternal identity and .96 for self confidence scale for caring the baby. The study showed these results : 1. Mean score of maternal identity(82.03 : 52.65 for mother, 29.38 for baby) was considered relatively low. 2. Mean score of self confidence for caring the baby(113.91) was considered relatively low. 3. There were significant influencing characteristics of primiparous to maternal identity : age(total ; F=3.53, p=.0329, for mother ; F=2.60, p=.0719, for baby ; F=3.12, p=.0481), prenatal infant care preparation(total ; t=2.31, p=.0306, for mother ; F=2.62, p=.0160), knowledge about infant care during the hospitalization(for baby ; F=3.94, p=.02222), colostrum feeding(total ; t=1.95, p=.0541, for baby ; t=2.71, p=.0080), frequency of breast feeding during the hospitalization(for baby ; F=3.91, p=.0228)and feeding type after discharge(for baby ; F=3.18, p=.0456). 4. There were significant influencing characteristics of primiparous to self confidence for caring the baby : routine husband support(F=6.09, p=.0031), prenatal infant care preparation(t=2.04, p=.0574), knowledge about infant care during the hospitalization(F=3.15, p=.0467), education of breast feeding during the hospitalization(t=-1.79, p=.0850). 5. Correlation between maternal identity and self confidence for caring the baby was r=.37608(p=.0001). This study implies that special education programs for primipara are needed. For the future, this study suggest that maternal role variables need to be monitored through the home visiting follow up. Also intervention programs related to prenatal care, discharge education, home visiting follow up need to be developed and then evaluated their effectiveness.
Purpose: This study conducted a job analysis of visiting nurses in the process of change. Methods: Participants were the visiting nurses working for the Seoul Metropolitan city. On the basis of the Public Health Intervention Wheel model, two times of the focus group interview (FGI) with seven visiting nurses and one time of the Developing a Curriculum (DACUM) with 34 visiting nurses were performed. A questionnaire survey of 380 visiting nurses was conducted to examine the frequency, importance and difficulty levels of the tasks created by using the FGI and DACUM. Results: Visiting nurses' job was derived as the theme of present versus transitional roles. The present role was categorized as 'providing individual- and group-focused services' and 'conducting organization management', while the transitional role was categorized as 'providing district-focused services' and 'responding to new health issues'. The job generated 13 duties, 28 tasks, and 73task elements. The tasks showed the levels of frequency (3.65 scores), importance (4.27 scores), and difficulty (3.81 scores). All the tasks were determined as important, exceeding the average 4.00 scores. The group- and district-focused services of the tasks were recognized as more difficult but less frequent tasks. Conclusion: The visiting nurses exert both present and transitional roles. The transitional roles identified in the present study should be recognized as an extended role of visiting nurses in accordance with the current changing healthcare needs in South Korea. Finally, the educational curriculum for visiting nurses that reflects the transitional roles from the present study is needed.
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