• 제목/요약/키워드: Integrated Nursing Care

검색결과 199건 처리시간 0.027초

통합적 완화 돌봄 중재가 말기암환자의 삶의 질에 미치는 효과: 메타분석 (Effects of Integrated Palliative Care Intervention on Quality of Life in Terminal Cancer Patients: A Meta-analysis)

  • 조계화;박애란;이진주
    • Journal of Hospice and Palliative Care
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    • 제18권2호
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    • pp.136-147
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    • 2015
  • 목적: 본 연구는 통합적 완화 돌봄 중재연구가 말기 암환자의 삶의 질에 미치는 효과 크기를 분석하기 위한 메타분석 연구이다. 방법: 말기 환자와 통합적 완화 돌봄 중재 및 연구 설계를 나타내는 용어들을 병합하여 PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL 및 국내 데이터 베이스에서 검색하였다. 논문의 질평가는 RCT 연구인 경우 RoB 도구를 사용하였으며, Non-RCT 연구인 경우는 RoBANS를 사용하였다. 중재의 효과크기는 Stata 10 프로그램으로 메타분석 하였다. 결과: 8편의 연구가 최종선정 되었으며, 총 대상자의 수는 356명이었다. 통합적 완화 돌봄 중재는 평균 6.5주, 5.6 세션으로 이루어졌으며, 한 세션당 평균 47.8분이 소요되었다. 효과는 동질성 및 하위그룹 분석을 실시하였다. 통합적 완화 돌봄 중재의 효과는 삶의 질(ES=1.83, P=0.018, $l^2=92%$), 영적 안녕(ES=0.78, P=0.040, $l^2=0$), 우울(ES=0.86, P<0.001, $l^2=32$) 및 불안(ES=0.69, P=0.041, $l^2=71.1$)에서 효과가 있었다. 그러나 말기암환자의 통증(ES=0.365, P=0.230, $l^2=69.8$)에는 효과가 없었다. 결론: 이상의 결과로 통합적 완화 돌봄 중재는 비록 통증은 완화시키지는 못했으나 우울과 불안을 감소시키고 영적 안녕과 삶의 질을 높이는 것으로 나타나, 통합적 완화 돌봄 중재는 말기암환자의 사회심리영적 차원의 삶의 질을 증진시킬 수 있다고 본다.

임상간호사의 역할갈등과 모호성 및 피로가 자아탄력성에 미치는 영향: 메르스 사태 이후 (Effects of Role Conflict and Ambiguity, and Fatigue on Self-Resilience in Clinical Nurses: After the MERS outbreak)

  • 이도영;오승은;이혜진
    • 한국직업건강간호학회지
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    • 제27권2호
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    • pp.77-88
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    • 2018
  • Purpose: This study aimed to investigate the degree of role conflict and its ambiguity, and fatigue in clinical nurses and to analyze the effect of these on their self-resilience in order to provide fundamental data for improving their working environment after the Middle East Respiratory Syndrome outbreak. Methods: After the collection of data from 258 clinical nurses in five general hospitals, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression were performed using IBM SPSS Statistics 20.0. Results: A significant positive correlation was found between nurses' role conflict and ambiguity and fatigue; while a negative correlation was found between nurses' role conflict and ambiguity and self-resilience. A significant negative correlation was found between fatigue and self-resilience. According to the study results, the factor that affected clinical nurses' self-resilience the most was role conflict and its ambiguity, followed by marital status, fatigue, educational level, religion, and related tasks, which together accounted for 38% of self-resilience in clinical nurses. Conclusion: To improve weaknesses in nursing care after the Middle East Respiratory Syndrome outbreak, the scope of nursing care was changed upon the expansion of integrated nursing and care-giving services. Therefore, in the rapidly changing environment of nursing, policies to improve nursing performance, as well as successful reaction capability, are suggested.

간호·간병통합서비스 병동 신규간호사 대상 핵심기본간호술기향상 교육프로그램 개발 및 적용 (The Development and Application of Core Fundamental Nursing Skills Improvement Education Program for New Nurses in Comprehensive Nursing Care Ward)

  • 최은영;안금희;오인옥;박애희;박민현;손재이;홍나숙;윤호순
    • 한국간호교육학회지
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    • 제23권4호
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    • pp.419-429
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    • 2017
  • Purpose: The purpose of this study was to investigate the effect of the development and application of the new nurses' core skill program on the clinical skill, confidence, knowledge and performance of new nurses. Methods: This study was a nonequivalent control group post-test design on 46 new nurses with 3 to 6 months work experience in a general hospital. Data were collected from August 2015 to August 2016. A training program of core fundamental nursing skills was applied on 23 new nurses from 2016 in the experiment group, and an existing training method was applied on 23 new nurses from 2015 in the comparison group. The collected data were analyzed using SPSS/WIN 23.0. Results: The experimental group ($89{\pm}4.29$) showed higher score in practical skill assessment compared to the control group ($85.09{\pm}3.99$) and showed a statistically significant difference (p<001). Conclusion: A training program of core fundamental nursing skills for new nurses proved effective in improving practical skills. Further research on the development of a systemic training program that can improve clinical nursing knowledge and work ability for new nurses according to the extended enforcement of a Nursing Care Integrated Service ward is needed.

입원환자의 낙상 실태 및 위험요인 조사연구 (Incidence of Falls and Risk Factors of Falls in Inpatients)

  • 윤수진;이천균;진인선;강중구
    • 한국의료질향상학회지
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    • 제24권2호
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    • pp.2-14
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    • 2018
  • Purpose: The objective of this study was to report the incidence of falls in hospitals and analyze the risk factors for falls. Methods: This study used data on 1,216 patients who experienced falls from 2015 to 2017 during their hospitalization. The data was collected from the falls incident reports and patient' electronic medical record of hospital. Data were analyzed with descriptive statistics using Chi-square test, Fisher's exact test and multiple Poisson regression analysis with the SAS 9.4 Results: The incidence of falls was 1.38 per 1,000 patients days (2015), 1.81 per 1,000patients days (2016) and 1.99 per 1,000patients days (2017). The incidence of injury caused by falls (level III~V) was 0.05 per 1,000patients days (2015), 0.04 per 1,000patients days (2016) and 0.06 per 1,000patients days (2017). The largest number of falls occurred during night shift (42.5%), specifically in the patients' room (70.8%), and medical unit (66.0%). Average age of fallers was 69.1 years and 61.7% of them were older than 71 years. CCI and the patient's department have statistically significant differences in injury or injury levels from falls, but the integrated nursing care services had no significant difference in injury or injury levels from falls. Conclusion: The result of this study can be used as a reference for establishing a fall prevention strategy for hospitalized patients by presenting index values such as the fall rate.

일 간호대학의 간호환경시스템 통합실습방안 적용;간호관리학과 지역사회간호학의 통합 (Curriculum Model in Integrated Practicum of Nursing Management and Community Health Nursing)

  • 이경자;김의숙;이정렬;김인숙;이태화;조윤희;정제인;이현정;배선형;김은현;김광숙
    • 간호행정학회지
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    • 제14권1호
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    • pp.51-62
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    • 2008
  • Purpose: Integrated curriculum has been considered as a desirable method in health related school course. The present study was conducted to develop practice curriculum which integrates nursing management and community health nursing and measure the education effect. Method: Literature review and scores of professional meeting were carried out to generate main educational goals, contents, operating principle, and evaluation item. Student evaluation was done by survey and in-dept interview in right after practicum and three months respectively. Results: Six concepts were derived as main component of the integrated curriculum. From 2 to 3 sub-categories were matched to each main component as well. Subsequently, practice contents were suggested on the basis of sub-categories. Attainment of practicum goal scores ranged from 2.82 to 3.54 in four points index. Students expressed that they found nursing manager's role in the community setting. Conclusion: This new approach encouraged students to ascertain relationship between hospital oriented and community based practice. Additionally, they can be prepared to comprehend diverse health care environment.

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사례관리를 위한 Critical Pathway 개발 : 요추협착증 환자의 융합술 (Development of Case Management using Critical Pathway of Posterolateral Fusion for Lumbar Spinal Stenosis)

  • 박혜옥;노유자
    • 성인간호학회지
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    • 제12권4호
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    • pp.727-740
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    • 2000
  • It is well recognized that case management is required to survive in the rapidly changing medical environment. One of the case management is the critical pathway(CP) which is assumed to increase the quality of care and at the same time to decrease the length of stay in hospital. The purpose of the study was to develop a CP for the management of patients with postero-lateral fusion for lumbar spinal stenosis. Through review of literature and medical records of patients with spinal stenosis, a pilot CP was designed, including 8 different care components such as medication, laboratory tests, assessment etc., from one day before surgery to 6 days of postoperative care. Every item of the pilot CP was evaluated by a panel of experts to test the content validity. The items not agreed on by more than 4 out of 6 experts were deleted or modified to be integrated in the CP. To apply the modified CP to a clinical environment, the items reflecting treatment, medication and lab work were entered into an order communication system(OCS), and doctors and nurses were taught to use the CP. Finally, the development of CP for the patients with posterolateral lumbar fusion was completed after the application and variance analysis of the CP.

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어린 두 자녀를 둔 3교대 간호사의 양육 갈등 경험: 현상학적 연구 (Experience of Conflict in Three Shift Nurses Rearing more than Two Kids: Phenomenological Study)

  • 김증임;염정원;박선경;정현희;민엄주;박선화;이정미;염영선
    • 여성건강간호학회지
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    • 제24권3호
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    • pp.252-264
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    • 2018
  • Purpose: To understand the essentials of rearing conflict experience by three shift nurses in advanced general hospitals. Methods: The design was a qualitative research of phenomenology. Participants were 7 shift nurses working in advanced general hospitals who were rearing young children. Data were collected individually through in-depth interview on their life experiences. Data were analyzed by Colaizzi's phenomenological methodology. Results: Eighteen themes were drawn from 256 meaningful experiences and these themes were integrated to six theme clusters. The most influencing themes were 'Regret that I cannot satisfy even the slightest wish', 'Fail to care for kids', and 'Mutual feeling to care giver between appreciation and inconvenience'. Other themes were as follows: 'Body and mind are broken', 'The need for a three-shift system to support nurses who are rearing children', 'Doing my best for work and child rearing'. Conclusion: The nature of three-shift nurses working in advanced hospital and caring kids is explained as 'lives with conflict' between work and home. This study suggests it is necessary to establish a 24-hour care center for 3-shift nurses to keep working while rearing their children.

실버케어로봇 프로그램이 시설노인의 인지기능, 우울, 일상생활수행능력에 미치는 효과 (Effects of Silver-Care-Robot Program on Cognitive Function, Depression, and Activities of Daily Living for Institutionalized Elderly People)

  • 오진환;이여진;신철진;박천수;강상승;김재홍;김인숙
    • 대한간호학회지
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    • 제45권3호
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    • pp.388-396
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    • 2015
  • Purpose: The purpose of this study was to identify the effects on cognitive function, depression, and activities of daily living of Silver- Care-Robot Program for institutionalized elders. Methods: This study was a nonequivalent control group pretest-posttest design. The participants were 42 institutionalized elders (17 in the experimental group and 25 in the control group). The Silver-Care-Robot Program was provided as an intervention which was conducted twice a week for 5 weeks. The Silver-Care-Robot Program is an integrated entertainment program to help the mental, emotional, and physical health of elderly people. Pre-test was conducted on the two groups, and, in order to examine the effects of intervention, a post-test was conducted after 5 weeks. Results: There were significant differences in cognitive function and ADL (activities of daily living) between two groups after the program. But the difference in depression in the institutionalized elders was not statistically significant between the two groups. Conclusion: The Silver-Care-Robot Program should be considered as a regular program for cognitive function and activities of daily living for institutionalized elders.

가족 간 생체 간이식 환자 가족의 돌봄 경험 (The Caring Experience of Family Caregivers for Patients of Living Donor Liver Transplantation from the Family Members)

  • 방미선;권수혜
    • 대한간호학회지
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    • 제52권4호
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    • pp.435-450
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    • 2022
  • Purpose: The purpose of the study was to understand the care experiences of the family of living donor liver transplantation (LDLT) patients where the donation had occurred within the family. Methods: Participants were eight family caregivers who cared for recipients and donors of LDLT. Data were collected through individual in-depth interviews from November, 2020 to April, 2021. Data analysis was performed through a cyclical process of data collection and analysis by applying Giorgi's phenomenological research method. Results: The five main components extracted from the experiences of the family caregivers were: "A double-edged choice to save the family", "The harsh daily life of liver transplantation care", "The yoke of double care on both shoulders", "The power to withstand the adversity of caring", and "The recovery and growth of life pursued by trusting each other". Conclusion: The participants tried to do their best in their daily lives, while providing reassurance and care to the LDLT patients in the family; however, they expressed some worry and hardship while doing so. The results of this study provide a deeper understanding of the caring experience of the family caregivers, which may contribute to the development of nursing interventions that will aid these caregivers in providing care to their LDLT family members. Furthermore, the development and application of an integrated management program for LDLT patients in the family is required.

문제기반학습 연계 시뮬레이션 교육이 간호대학생의 임상수행능력 및 자기 효능감에 미치는 효과 (Effectiveness of Simulation Integrated with Problem Based Learning on Clinical Competency and Self-efficacy in Nursing Students)

  • 이미진;안영미;조인숙;손민
    • Child Health Nursing Research
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    • 제20권2호
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    • pp.123-131
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    • 2014
  • 목적 본 연구의 목적은 아동대상자의 수술 후 간호를 주제로 문제기반학습 연계 시뮬레이션 교육 프로그램(simulation integrated with problem based learning, SIM-PBL) 개발과정을 기술하고, 교육 프로그램이 간호대학생의 임상간호 수행능력과 자아 효능감에 미치는 효과를 파악하기 위함이다. 방법 본 연구는 대조군 중재군 전후 시차 설계를 통한 유사 실험 연구이다. 자료수집 기간은 2012년 4월 23일부터 5월 18일까지 총 4주간이었다. 연구대상은 4년제 간호학과의 3학년에 재학 중인 학생을 대상으로 아동간호학 임상실습 중인 학생을 편의표집 하였고, 시차를 이용하여 대조군 18명, 중재군 18명으로 구성하였다. 대조군에게는 기존 임상실습교육이 제공되고, 중재군에게는 임상실습 시간 중 150분을 SIM-PBL로 대체하였다. SIM-PBL의 효과 평가를 위해 시뮬이션을 기반으로 한 임상간호 수행능력 평가(simulation based clinical examination, SCE)와 자아효능감이 이용되었다. 결과 SIM-PBL 교육을 받은 중재군은 대조군과 비교하여, 교육 후 임상간호 수행능력의 향상 정도가 일부 영역에서 통계적으로 유의한 차이를 보였다(신체검진: 3.019, p =.005; 수술 후 교육: t=2.428, p =.021). 그러나 자아효능감은 두 군 사이에 통계적으로 유의한 어떤 차이도 보여주지 못하였다. 결론 본 연구에서 사용된 SIM-PBL은 간호대학생들의 아동대상자를 위한 수술 후 간호 및 투약수행에 대한 임상간호 수행능력의 일부 영역을 향상시키는데 효과적이었다. 본 연구는 시뮬레이션 기반 교육과 문제기반학습의 두 가지 교육방법을 혼합하여 교육 프로그램을 구성하였고, 구조화된 체크리스트 도구를 통해 객관적으로 임상간호 수행능력을 평가하였다는 점에 의의가 있으며, 추후 이러한 교육 프로그램의 적극적 활용 및 중재의 크기에 따라 효과를 다양하게 입증하는 연구가 수행될 것을 제언한다.