• 가정∙방문간호학회지
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• 제24권2호
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• pp.210-220
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• 2017

Purpose: The study aimed to describe the utilization of home healthcare in patients using home mechanical ventilator(HMV) Method: A descriptive cross-sectional design was used in this study. A Questionnaires were sent to nation wide home healthcare agencies to assess their utilization status of home healthcare. A convenience sample of 158 patients data was reviewed. Result: A total of 88(55.7%) men with the mean age of 51.94(${\pm}19.52$) years were included in the study. Approximately 55.1% of patients at the outpatient department were referred to the home healthcare services after discharge. The underlying diseases were as follows : 129 amyotrophic lateral sclerosis and 27 muscular dystrophies. A total of 155 patients have invasive HMV. Efficient home healthcare nursing activities provided by a highly skilled home healthcare advanced practice nurses(HHCAPN) were tracheotomy and gastrostomy tube management and urinary catheterization. The average frequency of home visit for one patient was 2.52times per month. The duration of home healthcare utilization with >1 year was 82.9%. HHCAPNs have limited knowledge and skill for HMV. Conclusion: The government support is required to provide sufficient home healthcare services to the patients discharged with HMV. HHCAPNs should be properly educated on the effective HMV care.

• 한국의료질향상학회지
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• 제18권1호
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• pp.37-55
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• 2012

Objectives : This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients. Methods : Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients. Result : The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful. Conclusion : Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.

• Archives of Plastic Surgery
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• 제47권1호
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• pp.3-8
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• 2020

Genital lymphedema (GL) is an uncommon and disabling disease that manifests as enlargement of the genital region resulting from the disturbance of lymphatic drainage. Although conservative treatment such as decompression is typically the first-line approach, surgical intervention has been shown to be effective in certain cases. This study aimed to systematically review studies evaluating available surgical alternatives for the treatment of male GL. A systematic search strategy using keyword and subject headings was applied to PubMed, Scopus, EMBASE, and Cochrane Library in May 2019. Studies investigating various surgical techniques to treat penile and scrotal lymphedema were included. The potential risk of bias of included trials was evaluated using the methodological index for non-randomized studies (MINORS). In total, 13 studies met the inclusion criteria, nine of which were determined to be high-quality. The average MINORS score was 12.45 for studies involving excision and 14 for studies involving lymphovenous anastomosis (LVA). The most common reason for a low score was a failure to describe the inclusion criteria. Recurrence of lymphedema during follow-up was reported in four studies involving excision and in no studies involving LVA. In general, the quality of the included literature was considered to be fair. Although surgical intervention might not always prevent the recurrence of lymphedema, all of the studies reported improved quality of life after the procedure. This study could be used as the basis for evidence-based guidelines to be applied in clinical practice for managing male GL.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.384-392
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• 2018

Background: A very low protein diet (VLPD) with ketoacid analogs of essential amino acids (KA/EAA) administration can remarkably influence protein synthesis and metabolic disturbances of patients with advanced chronic kidney disease (CKD), and may also slow the decline in renal function. Methods: A retrospective cohort study was carried out to monitor renal progression and metabolic and nutritional status among 140 patients with CKD stage III or IV. One group (n = 70) was on a low protein diet (LPD) with 0.6 g of protein intake, and another group (n = 70) was on a VLPD with 0.3 g of protein and KA/EAA supplementation of 100 mg/kg/day for 12 months. Results: At 12-month follow-up, estimated glomerular filtration rate (GFR) significantly decreased from $41.6{\pm}10.2$ to $36.4{\pm}8.8mL/min/1.73m^2$ (P < 0.001) and urine protein increased from $0.6{\pm}0.5$ to $0.9{\pm}1.1g/day$ (P = 0.017) in the LPD group, but no significant changes in estimated GFR and urine protein were found in the VLPD plus KA/EAA group. A significant mean difference in rate of change in estimated GFR ($-5.2{\pm}3.6mL/min/1.73m^2$ per year; P < 0.001) was observed between the two groups. After Cox regression analysis, treatment with VLPD plus KA/EAA significantly protected against the incidence of declining GFR > 10% annually (adjusted hazard ratio, 0.42; 95% confidence interval, 0.23-0.79; P = 0.006) and significant correlations were found between using VLPD plus KA/EEA and increased GFR. Conclusion: VLPD supplementation with KA/EAA is associated with delayed renal progression while preserving the nutritional status in the patients with CKD. Co-administration of VLPD and KA/EAA may prove an effective alternative to conservative management of CKD.

• 디지털융복합연구
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• 제19권9호
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• pp.401-409
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• 2021

본 연구의 목적은 간호대학생의 가상현실 시뮬레이션 교육 전후의 간호과정 수행능력, 비판적사고성향과 자기효능감의 차이를 파악하여 효과적인 실습교육의 기초자료를 마련하고자 함이다. 2021년 2월부터 4월까지 간호대학생 31명에게 URL설문지를 이용하여 자료를 수집하였고, 수집된 자료는 SPSS 22.0으로 분석하였다. 연구결과, 가상현실 시뮬레이션 교육 후 간호대학생의 간호과정 수행능력(t=-3.776, p=.001), 비판적사고성향(t=-3.608, p=.001), 자기효능감(t=-3.580, p=.001)이 교육 전보다 유의하게 높아졌다. 또한 전공만족도, 임상실습만족도가 높은 집단과 임상실습만족도가 보통인 집단과 학업스트레스가 높은 집단에서도 가상현실 시뮬레이션 교육 후 간호과정 수행능력, 비판적사고성향, 자기효능감이 교육전보다 유의하게 높아졌다. 가상현실 시뮬레이션 교육이 간호대학생의 간호과정 수행능력 향상에 효과적임이 확인되었다. 따라서, 가상현실 시뮬레이션 교육이 간호과정 수행능력 향상을 위한 임상실습 전략으로 활용될 수 있으며, 이를 위해 다양한 시나리오 개발과 후속연구가 이루어져야 할 것이다.

• 한국콘텐츠학회논문지
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• 제21권9호
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• pp.714-722
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• 2021

본 연구에서는 가상현실을 이용한 VR 기본간호술 교육 콘텐츠를 제안하고자 하였다. 핵심기본간호술 20가지 중 간이혈당검사와 인슐린피하주사 항목은 간호술 항목에서 빈번히 수행하는 기본간호술 중 하나이며, 당뇨환자들에게 자가관리 교육을 할 때도 사용할 수 있는 항목이다. 본 연구는 이 항목을 가지고 학습자의 체험을 중심으로 가이드, 미션, 피드백의 3단계로 나누어 몰입형 VR기반 핵심기본간호술 콘텐츠를 설계하였다. 이 콘텐츠에서는 실제 간호술처럼 콘트롤러를 사용하지 않고 손가락 관절인식을 통해 손의 움직임을 트랙킹하여 몰입하며 훈련할 수 있다. 이 연구는 임상 수행 능력 향상을 도울 수 있는 VR 간호술 교육 콘텐츠 개발에 도움이 될 것이다.

• 디지털융복합연구
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• 제17권2호
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• pp.329-338
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• 2019

본 연구는 간호대학생의 대학캠퍼스 환경인식과 건강지각이 스트레스에 미치는 영향을 파악하여 스트레스를 감소하기 위한 프로그램 개발의 기초자료를 제공하기 위해 시행되었다. 자료수집은 2016년 12월 01일부터 12월 30일까지 G시의 3개 간호학과 학생을 대상으로 편의 추출하였으며 223명의 수집된 자료를 SPSS/WIN 21.0 프로그램을 이용하여 위계적 다중 회귀분석으로 분석하였다. 연구결과, 스트레스에 차이를 나타내는 일반적 특성은 연령, 실습경험, 성별, 주거형태, 성격과 식습관형태 및 학교보건실 이용경험이었다. 스트레스는 대학캠퍼스 환경인식과 건강지각 간에 부적상관관계를 나타내었다. 스트레스에 영향을 주는 요인은 식습관, 성별, 대학캠퍼스 환경인식과 건강지각이었으며, 스트레스에 대한 이들의 설명력은 23.1%로 나타났다. 따라서 간호대학생의 스트레스를 감소시키기 위해서 대학캠퍼스 환경을 개선하고 건강에 대한 지각을 높일 수 있는 다양한 프로그램을 개발하여 운영해야 할 것이다.

• 디지털융복합연구
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• 제17권2호
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• pp.265-273
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• 2019

본 연구는 보건의료전공 대학생을 대상으로 환자안전에 대한 태도와 수행자신감을 조사하여 응급환자관리를 위한 다학제적 환자안전 교육컨텐츠를 개발하기 위한 기초자료를 제공하고자 시도된 서술적 상관관계 연구이다. 2016년 06월 01일부터 06월 30일까지 J도 H 대학교와 C 대학교의 간호학과와 응급구조학과에 재학생 중 응급실실습을 경험한 3,4학년을 대상으로 편의 추출하였으며 145명을 대상으로 수집된 자료를 SPSS 21.0을 사용하여 분석하였다. 연구결과, 환자안전에 대한 태도는 간호학과 학생이 더 긍정적이었으나, 환자안전 수행자신감 및 환자안전교육 경험에서 차이가 없었으며 의료오류를 목격한 경험이 있는 학생이 환자안전에 대한 긍정적 태도와 수행자신감을 보여주었다. 연구결과를 통해 환자안전사고를 예방하고 적절하게 대처할 수 있는 응급전문인력을 양성하기 위하여 사례 기반의 다학제적 융복합 교육컨텐츠 개발 및 효과 검증 연구를 제안한다.

• 지역사회간호학회지
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• 제29권4호
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• pp.467-475
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• 2018

Purpose: The purpose of this study is to investigate adherence to the clean intermittent catheterization (CIC) and influencing factors on the adherence following a customized intensive education program (CIEP). Methods: This work is a retrospective descriptive study. The subjects were 226 emptying failure patients who learned in a CIEP from January 2012 to July 2014. The program developed in 2011 and consisted of 1) customized theoretical education; based on the results of urologic tests, underlying disease, or surgery of the patients, 2) hands-on practice until the trainees were able to master the techniques, 3) questions about the process of catheterization and what he/she needs to know. 4) at follow-up, the survey about adherence and barrier to CIC. Clinical characteristics; the level of satisfaction, understanding, and self-confidence; the barrier in medical records were reviewed. Results: The short-term adherence rate (median 22 days) is 87.6% and the long-term adherence rate (median 112 days) is 50.4%. The biggest obstacle is time management. The levels of satisfaction, understanding, and self-confidence are very high. The variable of Income is the only factor that has influence on adherence. Conclusion: Despite the CIEP, the adherence rate is relatively low. In addition to the education, emotional and psychological supports and regular follow-up are needed to improve long-term adherence.

• 산업융합연구
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• 제17권1호
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• pp.17-24
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• 2019

본 연구는 간호대학생을 대상으로 강의자동녹화시스템을 통해 발생한 녹화강의콘텐츠를 학습관리시스템에 연계하여 반복학습하도록 제시한 수업설계를 적용한 후 아동간호학 교과목의 학습성과에 미치는 효과를 확인하기 위한 것이다. 본 연구는 비동등성 대조군 전후 유사실험 연구로 D광역시 일 대학 간호대학생을 대상으로 하였으며, 실험군과 대조군 각각 52명으로 총 104명이었다. 자료는 SPSS 22.0을 이용하여 ${\chi}^2$ test와 independent t-test로 분석하였다. 강의 자동녹화시스템을 사용한 수업설계를 적용받은 실험군의 제1학습성과(다양한 교양지식과 전공지식에 근거한 간호술을 통합적으로 실무에 적용한다)의 효과는 확인되지 않았으나, 제5학습성과(비판적 사고에 근거한 간호과정을 적용하고 임상적 추론을 실행한다)의 효과는 대조군에 비해 통계적으로 유의하게 높았다. 본 연구는 핵심역량을 갖춘 간호 인재를 양성을 위한 학습성과 기반 교육과정을 운영하고 있는 현 시점에서 간호대학생의 학습성과를 향상시키기 위한 수업설계방안을 발전시키기 위한 자료를 제시하였다는데 의의가 있다.