• Title/Summary/Keyword: In-school clinical practice

검색결과 1,094건 처리시간 0.036초

간호 교육에 대한 일 연구 -2년제 초급대학 과정 중심으로- (A Study of The Nursing Education Concerning Two Years Associate Degree Nursing Program)

  • 변창자
    • 대한간호학회지
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    • 제4권3호
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    • pp.63-79
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    • 1974
  • 1. The purpose of this study. The purpose of this study is to plan and investigate short-term nursing education of two-years associate degree program to produce middle-level professional nurses which are needed by-society and nation. Current nursing education in Korea is divided into four years degree program, three years diploma program Even (though) there are differences in the aims of their education, the curriculums are not much different between the education for producing leaders which is its basic purpose and training middle-level professional nurses. Therefore the purpose of associate degree program lies in minimizing the waste of time and finance which are invested for long-term education for middle-level professional nurses. And also this coincide with the policy of national technical training and definite supply of nurse manpower according to health policy for effective role and ability of nurse. 2. The method of study. This is based on the study of literature, research on the actual condition and investigation of opinion- through questionnaire. L) The study of literature: Domestic and foreign literatures for two years associate degree program were studied and investigated. 2) Research on the actual condition : Current three years nursing education program was collected and analysed. 3) Investigation of opinion. The problem of curried nursing education system and the possibility of two years associate degree program were investigated through questionnaire. 3. The result of the study. 1) The trend of recent nursing education. a. The aims of nursing in past chiefly taking care of physical disease of patient has recently changed to nursing of character including physical, mental, socio-economic, educational and psychological condition. b. For the performing systematic and effective nurse's duty according to her role, the-change of educational system which is classified as a range of education the period of education and certificate after graduation has been enforced or fulfilled. c. Nursing education also has a trend to become a collage or two years associate degree program which can get same legal protection as other educational institutions whose basic purpose is education. Attached nursing school to hospital is getting disappeared because of disadvantage of educational system. 2) Problems. Depending upon research on actual condition of current 3 years nursing education program. a. There are too many subjects. b. Contents of education could be doubled because major subjects are subdivided in detail. c. The credits for graduation are too heavy comparing to the period of study or the ability of students. (The necessary credits are 150.8 for three years according to actual investigation 4. There is no certain standard in organizing curriculum therefore there are too much differences between schools. 4. Basic Plan. The plan for two years associate degree program in nursing education depending on demand of professional nursing field of society is based on following items. 1) Training middle-level professional nurse lay emphasis on liberal arts and basic major field. 2) Liberal arts are divided into required and optional subjects and students could take courses by choice. 3) Major subjects are compound together by fields and they become the sciences of nursing Ⅰ,Ⅱ,Ⅲ,Ⅳ and every items has its educational purposes and contents major study includes laboratory practice and clinical experience. 4) The required credits for graduation are to which means 17-18 credits a semester. The above has been planned to solve the problems of current three years nursing education program. In conclusion for the achievement of this system, following items are needed. 1) It is necessary to change educational administration and system such as amendment of educational law or order of educational application of law. 2) Qualified professors should be available to understand and develope the idea or purpose of this educational system. 3) Local medical institutions should be opened widely and educational for clinical training. 4) The job after graduation should he secured positively.

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경화액의 농도와 온도가 인산칼슘시멘트의 유변학적 성질에 미치는 영향에 관한 연구 (The Effect of Temperature and Concentration of Setting Solution on the Rheological Properties of Injectable Calcium Phosphate)

  • 유현미;장석우;박동성
    • 구강회복응용과학지
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    • 제25권1호
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    • pp.73-82
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    • 2009
  • 인산칼슘시멘트(calcium phosphate cement)는 우수한 생체친화성 및 골전도성을 가지고 있어 골이식재로 많이 사용되어 왔다. 인산칼슘시멘트의 중요한 물성 중 하나인 흐름성은 유변학적 성질을 측정하여 확인할 수 있지만, 인산칼슘시멘트의 유변학적 성질에 관한 연구는 많이 진행되어 있지 않다. 이 실험의 목적은 인산칼슘시멘트를 hydroxyprophyl methylcellulose (HPMC) 수용액 및 polyacrylic acid (PAA) 수용액과 각각 혼합하여 주사용 인산칼슘시멘트를 만들고, 각각의 용액의 농도(35%와 17.5%의 HPMC, 2%와 1%의 PAA)와 온도($25^{\circ}C$ and $37^{\circ}C$)가 유변학적 성질에 미치는 영향을 연구하기 위한 것이다. 실험에 사용된 인산칼슘시멘트는 dicalcium phosphate dihydrate (DCPD)이며 유변학적 성질은 자동화된 rheometer를 사용하여 측정하였다. 통계분석은 Mann-whitney test를 사용하였다. 높은 농도의 경화액과 혼합된 인산칼슘시멘트는 (35% HPMC와 2% PAA)는 낮은 농도의 경화액과 혼합된 인산칼슘시멘트 (17.5% HPMC와 1% PAA)보다 각각 유의성 있게 높은 점도를 보였다. HPMC 수용액과 혼합된 인산칼슘시멘트는 $37^{\circ}C$에서 $25^{\circ}C$보다 유의성 있게 높은 점도를 보였다. PAA 수용액과 혼합된 인산칼슘시멘트는 $37^{\circ}C$에서 $25^{\circ}C$보다 낮은 점도를 보였으나 통계적 유의성은 없었다. 또한 실험에 사용된 모든 종류의 인산칼슘시멘트는 의사가소성(pseudoplastic)을 보였다.

수면장애 아동을 위한 사회적 이야기 중재 효과: 체계적 고찰 (A Systematic Study of the Intervention Effect of Social Stories in Children with Sleep Disorders)

  • 김지호;유은영
    • 대한감각통합치료학회지
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    • 제21권2호
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    • pp.69-83
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    • 2023
  • 목적 : 본 연구는 수면장애 아동을 대상으로 사회적 이야기(social story)를 적용한 연구를 대상으로 중재효과를 체계적으로 고찰하고자 하였다. 연구방법 : 본 연구는 2001년에서 2022년까지 데이터베이스 Scopus, ScienceDirect, psycArticles, Pubmed에 게재된 문헌들을 대상으로 하였다. 검색어는 'social story' OR 'social stories' AND 'sleep' OR 'sleep disorders' OR 'sleep wake disorder bedtimes' OR 'sleep initiation' and 'maintenance disorders' OR 'sleep wake disorder' OR 'sleep arousal disorder'을 사용하였다. 선정 기준에 따라 최종적으로 6편의 실험연구를 선정하여 분석을 실시하였다. 결과 : 분석 대상 문헌은 무작위 대조 실험연구는 2편, 개별 실험연구가 3편, 사례연구가 1편이었다. 대상자는 진단별로는 자폐스펙트럼 아동, 연령별로는 학령기와 청소년기가 가장 많았다. 중재유형은 사회적 이야기와 다른 중재를 함께 포함한 복합중재가 많았고, 중재 기간은 1일부터 40일 이상으로 다양하였다. 중재 효과로는 수면의 질에 긍정적인 효과를 보였으며, 그중에서도 야간 각성(night walking), 수면 시작 지연(sleep onset delay), 수면 불안(sleep anxiety)이 개선되었다. 사회적 이야기의 효과를 평가하는 도구로는 표준화된 평가에서는 아동 수면 습관 설문지(children's sleep habits questionnaire)와 아동 행동 체크리스트(child behavior checklist)를 가장 많이 사용하였고, 비표준화된 평가로는 인터뷰(interview), 수면일기 (Sleep diary)를 사용한 연구가 많았다. 결론 : 본 연구는 수면장애가 있는 아동 및 청소년에게 사회적 이야기를 적용함으로써 임상에서 적용할 수 있는 수면 중재 방향을 모색하는 것에 의의가 있다. 사회적 이야기의 중재 효과로는 야간 각성(night wakings), 수면 시작 지연(sleep onset delay), 수면 불안(sleep anxiety) 영역이 개선된 연구들이 큰 비중을 차지하였다. 수면의 질의 세부 효과 영역은 대부분의 연구에서 중재 전후 유의한 개선을 나타냈으며, 본 연구에서 분석한 6편의 연구에서는 추적검사를 통해서 중재 효과에 대한 지속을 확인할 수 있었다. 따라서 본 연구는 사회적 이야기(social story)를 적용한 수면장애 아동의 중재 효과, 결과 평가 도구, 중재 기간을 제시함으로써 수면장애 아동을 대상으로 사회적 이야기(social story)를 임상에서 적용할 때 도움이 될 것으로 판단된다.

의료기관 QI 담당자의 목표추구몰입에 관한 연구 (A Study on the Goal-Orientation of QI Performers in the Medical Centers)

  • 김미숙;박재성
    • 보건의료산업학회지
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    • 제2권1호
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    • pp.105-124
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    • 2008
  • The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

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농촌 일차 보건사업에 있어서 마을건강원 업무량 및 업적에 관한 연구 (A Study on Performance and Achievement of Village Health Workers in Rural Primary Health Care Program)

  • 허달영;이명숙;염용태;김순덕
    • 농촌의학ㆍ지역보건
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    • 제12권1호
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    • pp.36-53
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    • 1987
  • It is utmostly important to establish the efficient fitable way of peoples' active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass- root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programmes and survey record on the VHWs activity from correspondent people. 1 hose data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for conveniance. The summarized results were as follows; 1) General characteristics of VHWs. Among a total of 28 VHWs in the area, about 39.3g of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others. The age of majority (75.0%) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also entiled "chief of women club" of corresponding villages. 2) Work-load of VHWs. Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule. 3) Work performance analysis. Informations collected through VHWs were compared with data from official vital registration at local administration center "Myon Office" in 1985. VHWs collected 100.8 of new born, 116.2 of death, 58.3 of move in and 74.8 of move out in comparison with 100.0 of official registration each. Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. All(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother's home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women. 4) Attitude of VHW on the roles and functions. Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 44.0% of them had passive attitude of working saying they followed direction regardlessly. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves. Still, 64.0% of them thought visiting unfamilier house to be awful and 40.0% complained forms of activity to be difficult and hard. It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic diseaes of the aged. Regular on-the-job basic trainings were said to be needed twice a year.

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신라 시조 혁거세왕 신화에 대한 분석심리학적 연구 (A Study of Myth of King Heokgeose, the Founder of Shilla Dynasty from a Perspective of Analytical Psychology)

  • 한상익
    • 심성연구
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    • 제28권1호
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    • pp.50-87
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    • 2013
  • C. G. Jung은 일찍이 신화(神話)나 민담(民譚, Märchen)에서 인간 무의식의 보편적, 원초적 조건이 발견된다고 하였다. 우리의 일상에서 이러한 인간심성의 보편성을 흔히 체험할 수 있는 것은 꿈이다. 그러므로 꿈에 나오는 인간 심성에 있는 보편적인 원형상들을 이해하기 위해서 신화소(神話素)들이 등장하는 신화나 민담들에 대한 분석심리학적 해석을 시도해 보는 것은 실제 임상에서 마주치게 되는 이런 '큰 꿈'들을 충실히 이해하기 위해 매우 중요한 과정이다. 저자는 신화에 대한 분석심리학적 해석에 관심을 가지면서 그 대상에 대한 탐색을 하면서 신화소에 나타나는 '원형'의 보편성을 우리 민족 전래의 신화 속에서 찾아보기 위해 삼국유사를 살펴보던 중 기이편(紀異篇)에 나오는 신라(新羅)의 건국신화인 혁거세왕(赫居世王) 신화에 주목을 하게 되었다. 신라는 일찍 건국이 되긴 하였지만 한반도 남부 끝자락에 위치한 제일 작은 나라로서 고구려, 백제에 비해 정치, 군사적으로나 문화적으로 가장 늦게 발전한 나라였음에도 결국 삼국을 통일하고 우리나라 역사상 가장 긴 거의 1000년(BC57~AD935)의 역사를 이어온 나라라는 점에서 건국과 관련된 남다른 바탕이 있었는지 그들의 건국신화에 있는 원형상(原型像)들을 살펴보고자 하였다. 한반도의 남쪽 작은 나라였던 신라의 건국시조의 탄생신화가 탄생전의 상태에서부터 탄생, 배필의 탄생, 성장, 결혼, 즉위, 다스림, 죽음, 죽음 이후, 계승까지 거의 완전한 줄거리를 갖고 있다는 것은 매우 주목되는 점이다. 이 신화에 나오는 1, 3, 5, 6, 7, 13, 61 등 다양한 숫자 상징, 동, 서, 남, 북과 중심을 포함한 모든 방위, 호랑이, 백마, 닭, 용, 봉(鳳) 뱀 등 많은 동물상징, 중심적인 상징인 알을 비롯한 바위, 박(瓢), 전광(電光), 샘물, 내(川), 나무, 숲, 산, 쇠 등 자연의 상징과 선도성모 같은 신상(神像) 등 점차 이야기가 전개되면서 등장하는 온갖 상징들은 이 짧은 신화 속에 온 인류가 경험해온 의식의 탄생, 부성과 모성의 합일을 통한 성장과 발전, 소멸, 재생의 이야기가 펼쳐지고 그런 과정이 다음 세대로 영원히 계승되는 웅대한 이야기가 재현되고 있음을 볼 수 있다. 신화의 한 단어, 한 문장 또는 별로 의미를 찾을 수 없어 보이던 내용들이 점차 그 뜻을 드러내고 있었고, 무의식과 의식의 상호 작용이 그 모습을 달리 하며 계속 반복되며, 중층적으로 표현되고 있음을 확인할 수 있었다.

산모와 간호원이 본 선택된 산욕기 간호활동의 중요도에 관한 탐색적 연구 (An Exploratory Study about the Importance of Selected Nursing Activities during the Puerperal Period, as Viewed by Women in the Puerperal Period and by Nurses Caring for Them)

  • 박주봉
    • 대한간호학회지
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    • 제8권1호
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    • pp.152-162
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    • 1978
  • The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

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한국과 중국 간호대학생의 죽음에 대한 의식 (The Death Orientation of nursing students in Korea and China)

  • 이진숙;최화숙
    • 호스피스학술지
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    • 제8권1호
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    • pp.1-12
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    • 2008
  • 목적: 한국과 중국 간호대학생의 죽음의식을 조사하여 죽음교육과정설계에 간호대학생의 특성을 고려한 내용이 반영되도록 기여하고 간호교육 및 임상간호의 질적 향상에 도움이 되는 자료를 제공하고자 하였다. 방법: 본 연구는 2007년 3월19일부터 3월23일 사이에 한국 E대학교 간호대학생 248명과 중국 Y대학교 간호대학생 244명 총 492명을 대상으로 하였으며 측정도구는 Thorson과 Powell(1988)의 죽음의식도구를 박석춘(1992)이 번안하여 사용했던 도구를 이용하였다. 수집된 자료는 SPSS(12.0)통계 프로그램을 이용하여 전산처리 하였으며, 실수, 백분율, 평균, 표준편차는 기술통계 방법을 사용하고, Cronbach Alpha Coefficient, 요인분석, t-test, ANOVA 및 회귀분석 등을 통하여 분석하였다. 결과: 1. 한국 간호대학생은 반수이상(58.5%)이 종교가 있는데 비해 중국 간호대학생은 거의 종교를 가지고 있지 않았다(93.9%). 죽음경험이 한국 간호대학생(66.9%)보다는 중국 간호대학생이 많았다(76.6%). 사후세계유형에서 한국 간호대학생은 '사람이 죽으면 천국이나 지옥중의 한곳으로 간다'고 생각하는 경우가 제일 많았고(27.3%), '사람이 죽으면 어떻게 될 것인지 통 모르겠다'가 2위로 나타났다(22.9%). 중국 간호대학생은 '사람이 죽으면 어떻게 될 것인지 통 모르겠다'가 제일 많고(30.3%), '사람이 죽으면 그것으로 끝이고 사후세계는 존재하지 않는다'가 그 다음으로 많았다(29.5%). 2. 죽음의식은 한국 간호대학생이 평균 2.36점, 중국 간호대학생이 평균 2.50점으로 죽음에 대한 염려, 불안, 두려움이 중간수준이었으며 중국 간호대학생이 한국 간호대학생보다 높았다(t=3.51,p=.000). 3. 한국 간호대학생의 죽음의식은 연령(t=3.20, p=.002), 종교(t=2.56, p=.011), 사후세계(F=4.64, p=.000)에 대한 태도에 따라 유의한 차이가 나타났으며, 죽음의식에 대한 기여도는 사후세계변수가 수량화범위 0.735(p=.000)로 나타났다. 중국 간호대학생의 죽음의식은 모든 변수에서 유의한 차이가 없는 것으로 나타났다. 결론: 본 연구의 결과, 내세에 대한 믿음을 가지고 있는 대상자의 죽음의식이 제일 긍정적이므로 영적간호의 필요성이 강조된다. 한편 중국 간호대학생은 한국 간호대학생보다 죽음을 더 의식하고 죽음에 대한 염려, 불안, 두려움이 더 높게 나타났으므로 간호교육과정의 비교검토를 통해 한국의 죽음교육내용을 참고하고 중국의 정치, 문화와 사회제도에 알맞은 죽음교육을 해야 된다고 하겠다. 죽음의식은 사후세계에 대한 태도가 가장 크게 영향을 미치고 있으므로 이에 대한 지속적인 연구와 교육 및 실무에 적용을 제언한다.

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전인적 호스피스간호중재 프로그램이 입원한 호스피스환자의 통증과 불안에 미치는 효과 (Effects of Wholistic Hospice Nursing Intervention Program on Pain and Anxiety for In-patient of Hospice Palliative Care Unit)

  • 최성은;강은실;최화숙
    • 호스피스학술지
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    • 제8권1호
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    • pp.55-67
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    • 2008
  • 목적: 말기환자와 그 가족들은 신체적인 고통뿐 아니라 심리·사회적, 영적 측면에서 전인적인 고통을 겪고 있으므로 이러한 고통을 완화시켜주기 위해서는 간호사, 의사, 성직자, 사회복지사 등의 다학제(multi- discipline) 전문가들과 자원봉사자로 구성된 호스피스 팀에 의해 제공되는 호스피스 간호중재 프로그램의 개발이 필요한 현실이다. 본 연구는 단일군 전․후 유사실험 연구설계로 전인적 호스피스 간호중재 프로그램이 호스피스 병동에 입원한 호스피스 환자의 통증과 상태불안에 미치는 효과를 알아보고자 하였다. 방법: 자료수집은 P시 소재 S병원의 호스피스 병동에 입원한 18세 이상의 환자 27명을 대상으로 2004년 4월 6일부터 2005년 4월 20일까지 구조화된 설문지를 통해 수집하였다. 제공된 전인적 호스피스간호중재 프로그램은 전인적, 다학제적, 개별 및 집단적인 중재형태로 구성되어 있고, 상호협동적인 다학제 전문가팀(간호사, 의사, 성직자, 사회복지사, 무용치료사, 미술치료사, 자원봉사자)이 호스피스 대상자 병실이나 병동에서 매회 120분씩, 총 10회(총1,200분)에 걸쳐 실시한 프로그램이었다. 프로그램 효과를 측정하기 위한 도구로서 통증 척도는 윤영호(1998) 등이 한국형 간이통증 조사지(Korean Version of Brief Pain Inventory, BPI-K)로 개발한 도구 중 일부를 윤매옥(2000)이 사용한 도구, 상태불안 척도로는 Spielberger (1975)의 상태불안 측정도구(State-Anxiety Inventory)를 김정택과 신동균(1978)이 번역하여 사용한 도구를 사용하였다. 자료분석은 수집된 자료를 SPSS/WIN 12.0 프로그램을 이용하여 실수, 백분율, 최대값, 최소값, 평균, 표준편차, Paired t-test로 분석하였다. 결과: 본 연구의 결과는 다음과 같다. (1) 가설 1 ‘전인적 호스피스 간호중재 프로그램을 제공받은 입원 호스피스 환자(이하 실험군)는 실험 전보다 실험 후의 통증 정도가 낮을 것이다’ 를 검증한 결과 실험군은 실험 후의 통증 점수가 유의하게 낮아 가설이 지지되었다(t=-10.585, P= .000). (2) 가설 2 ‘전인적 호스피스 간호중재 프로그램을 제공받은 실험군은 실험 전보다 실험 후의 상태불안 정도가 낮을 것이다’ 를 검증한 결과 실험군은 실험 후의 상태불안 정도가 유의하게 낮아 가설이 지지되었다(t=-8.234, P= .000). 결론: 본 연구의 결과, 전인적 호스피스 간호중재 프로그램은 호스피스 대상자의 통증 및 상태불안을 완화시키고 향상시켜 신체 및 정서적 차원에서 그 효과가 확인되었으므로 호스피스 임상 실무에 적극적으로 활용할 수 있을 것이며, 그로 인해 호스피스 대상자의 통증을 조절하고 불안을 감소시켜 삶의 질을 총체적으로 높일 수 있는 데 기여하리라 사료된다.

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암화학요법을 받는 유방암 환자의 불안, 절망감 및 가족지지와의 관계 (The Relationship of Anxiety, Hopelessness, and Family Suppoort of Breast Cancer Patients Undergoing Chemotherapy)

  • 박점희;이현주;김현미;류은경
    • 기본간호학회지
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    • 제4권1호
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    • pp.147-162
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    • 1997
  • This study was attempted to provide the basic data for nursing intervention to improve the psychosociological adaptation of patients receiving chemotherapy for breast cancer by examining relationship between anxiety and hopelessness that they are experiencing and family support, in order to help them successfully cope with various psychological problems. This study was carried out with 93 breast cancer patients who are receiving chemotherapy in the injection treatment room of K University Hospital located in the downtown of Taegu after having underwent mastectomy in the hospital between December 1995 and August 1996. This study used the systematized questionnaires which contain 7 questions about general characteristics, Spielberger's trait anxiety & state anxiety scale, the tool that WON(1987) modified the hopelessness scale which was developed by Beck et al.(1967) and the family support tool made by TAE(1985). By using the SPSS/PC program, this study obtained the real number and percentage for the general characteristics of the subjects, and mean and standard variation for the degrees of trait anxiety, state anxiety, hopelessness and family support. The correlation between each variables was identified on the basis of the Pearson Correlation, and the degrees of trait anxiety, state anxiety, hopelessness and family support in the general characteristics of the subjects were analyzed by using the t-test, ANOVA, and Duncan test. The results of this study were summarized as follows. In the general characteristics of the subjects, most of each group were 51 years old or more and the middle class in income, had educational background under elementary school, no job, Buddhism in religion and spouse, and were receiving chemotherapy using MTX and 5FU. It was shown that the degree of the subjects' trait anxiety is, on an average, 50. 29, state anxiety 49. 68, hopelessness 51. 46 and family support 34. 28. Both trait anxiety and hopelessness showed normal correlation ; the higher the degree of trait anxiety is, the higher the degree of hopelessness is, while trait anxiety and family support showed reverse correlation ; the higher the degree of trait anxiety, the lower the degree of family support that the subjects perceive is. State anxiety and hopelessness also showed normal correlation ; the higher the degree of state anxiety is, the higher the degree of hopelessness is. Family support and hopelessness showed reverse correlation ; the higher the degree of family support is, the lower the degree of hopelessness that the subjects perceive is. And family support and state anxiety showed reverse correlation but there was a statistically significant difference. The degree of trait anxiety in the general characteristics of the subjects showed a significant difference by age, job and religion, the degree of state anxiety a signigicant difference by job and religion, the degree of hopelessness a signigicant difference by age, educational background and existence or not of spouse. In conclusion, the breast cancer patients receiving chemotherapy perceive anxiety and hopelessness due to several causes such as diagnosis itself or side effects of chemotherapy, so that it is required not only to develop specific nursing interventions including family support to alleviate anxiety and hopelessness but also to apply such interventions to clinical practice.

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