• 제목/요약/키워드: Mental health understanding

검색결과 220건 처리시간 0.031초

지역사회 노인의 우울에 영향을 미치는 행동계획과 신체활동의 경로분석 (The Path Analysis of Action Planning and Physical Activity that affect the Depression in the Aged in Community)

  • 황환
    • 한국노년학
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    • 제37권3호
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    • pp.567-582
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    • 2017
  • 본 연구의 목적은 지역사회 노인의 행동계획, 신체활동, 우울로 구성된 경로모형을 분석하여 그 관계에 대한 이해를 증진시키고, 지역사회 노인의 우울관리를 위한 행동계획과 신체활동의 활용에 대해 제안하는 것이다. 이를 위해 선행연구를 고찰하고 신체활동 프로그램을 실시하여 참여노인의 행동계획, 신체활동, 우울 간 관계를 경로모형으로 설정하였다. 수도권 지역의 5개 복지관을 이용하면서 우울증상을 호소하는 노인 116명을 대상으로 행동계획이 포함된 신체활동 프로그램을 실시하고 설정된 경로모형을 검증하였다. 연구결과, 첫째, 설정된 경로모형은 실제 자료에 부합한 것으로 나타났다. 둘째, 행동계획이 증가할수록 신체활동도 증가하였다. 셋째, 행동계획이 사후우울에 부적 영향을 미쳤다. 넷째, 신체활동이 사후우울에 부적인 영향을 미쳤다. 다섯째, 행동계획이 사후우울에 대해 신체활동보다 상대적으로 더 큰 영향을 미쳤고, 우울과 행동계획과의 관계에서 신체활동이 매개효과를 나타냄을 확인하였다. 이러한 결과를 바탕으로 국가적 차원의 신체활동증진전략에 행동계획 지침의 포함, 지역사회 정신보건 관련 기관에 행동계획을 포함한 신체활동 프로그램의 보급과 전달체계 구축, 행동계획 수행의 질적 향상을 위한 내러티브 접근의 활용 등을 제언하였다.

Inferring Pedestrians' Emotional States through Physiological Responses to Measure Subjective Walkability Indices

  • Kim, Taeeun;Lee, Meesung;Hwang, Sungjoo
    • 국제학술발표논문집
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    • The 9th International Conference on Construction Engineering and Project Management
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    • pp.1245-1246
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    • 2022
  • Walkability is an indicator of how much pedestrians are willing to walk and how well a walking environment is created. As walking can promote pedestrians' mental and physical health, there has been increasing focus on improving walkability in different ways. Thus, plenty of research has been undertaken to measure walkability. When measuring walkability, there are many objective and subjective variables. Subjective variables include a feeling of safety, pleasure, or comfort, which can significantly affect perceived walkability. However, these subjective factors are difficult to measure by making the walkability index more reliant on objective and physical factors. Because many subjective variables are associated with human emotional states, understanding pedestrians' emotional states provides an opportunity to measure the subjective walkability variables more quantitatively. Pedestrians' emotions can be examined through surveys, but there are social and economic difficulties involved when conducting surveys. Recently, an increasing number of studies have employed physiological data to measure pedestrians' stress responses when navigating unpleasant environmental barriers on their walking paths. However, studies investigating the emotional states of pedestrians in the walking environment, including assessing their positive emotions felt, such as pleasure, have rarely been conducted. Using wearable devices, this study examined the various emotional states of pedestrians affected by the walking environment. Specifically, this study aimed to demonstrate the feasibility of monitoring biometric data, such as electrodermal activity (EDA) and heart rate variability (HRV), using wearable devices as an indicator of pedestrians' emotional states-both pleasant-unpleasant and aroused-relaxed states. To this end, various walking environments with different characteristics were set up to collect and analyze the pedestrians' biometric data. Subsequently, the subjects wearing the wearable devices were allowed to walk on the experimental paths as usual. After the experiment, the valence (i.e., pleasant or unpleasant) and arousal (i.e., activated or relaxed) scale of the pedestrians was identified through a bipolar dimension survey. The survey results were compared with many potentially relevant EDA and HRV signal features. The research results revealed the potential for physiological responses to indicate the pedestrians' emotional states, but further investigation is warranted. The research results were expected to provide a method to measure the subjective factors of walkability by measuring emotions and monitoring pedestrians' positive or negative feelings when walking to improve the walking environment. However, due to the lack of samples and other internal and external factors influencing emotions (which need to be studied further), it cannot be comprehensively concluded that the pedestrians' emotional states were affected by the walking environment.

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코로나19 감염과 그 이후의 정신신체증상 (Psychosomatic Symptoms Following COVID-19 Infection)

  • 박선영;류신혜;임우영
    • 정신신체의학
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    • 제31권2호
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    • pp.72-78
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    • 2023
  • 연구목적 코로나19 감염으로 인한 다양한 정신과적 증상, 정신신체증상을 파악하고 장기적 영향을 조사하였다. 방 법 체계적 문헌고찰을 통해 국내외 데이터베이스에서 논문을 선정하고, "COVID-19", "psychosomatic" 등의 검색어를 활용하였다. 정신신체증상에 대한 구조화된 측정도구를 사용한 연구를 포함하여, 총 16편의 논문이 최종 분석 대상으로 포함되었다. 결 과 코로나19 급성 감염과 관련된 정신증상으로는 불안, 우울, 신체증상 등이 보고되고 있다. 장기간 지속되는 포스트 코로나증후군의 증상으로는 흉통, 피로 등이 보고되었고, 이와 관련된 정신신체증상의 발생 빈도는 10%-20%로 파악되었다. 감염병으로 인한 심리사회적 스트레스, 여성, 노인, 정신과적 기왕력이나 동반 정신질환 등의 요인이 관련을 미친다. 전신염증, 자가면역, 자율신경계의 이상반응 등이 관련이 있을 것으로 생각되고 있다. 결 론 코로나19 감염 이후 발생하는 정신신체증상은 삶의 질과 심리사회적 기능에 부정적인 영향을 미칠 뿐 아니라 증상에 대한 정신과적 이해와 접근은 예방과 치료에도 중요하다.

한국 사회와 교육적 성취 (V): 교육적 성취를 통한 미래 한국 사회의 모색 (Korean society and educational achievement (V): The contribution of educational achievement for the future of Korean society)

  • 박영신;김의철
    • 한국심리학회지 : 문화 및 사회문제
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    • 제14권1호_spc
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    • pp.427-468
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    • 2008
  • 이 글에서는 교육적 성취를 통한 미래 한국 사회의 모습을 탐색해 보고자 하였다. 이를 위해 기존의 선행연구들에서 밝혀진 경험과학적 결과들을 기초로 하여, 크게 네 가지 주제 즉 신뢰, 효능감, 삶의 질, 사회적 비전을 중심으로 살펴보았다. 첫째, 교육적 성취를 통해 신뢰에 기반하는 사회를 형성하는 것의 중요성을 논의하였다. 한국 사람들의 한국 사회에 대한 인식을 검토하고, 한국 사회의 다양한 기관들에 대한 신뢰 수준을 살펴본 결과, 한국 사회에서 신뢰의식의 구축이 필요한 것으로 확인되었다. 교육기관으로서 학교, 교육자로서 교사에 대한 신뢰도 마찬가지로 강화되어야 할 것이다. 둘째, 교육적 성취를 통해 효능감 있는 사회의 형성과 관련하여 논의하였다. 집단효능감의 개념을 탐색하고, 청소년기 집단효능감 및 성인들의 정치효능감에 대한 검토를 통해, 집단효능감 향상의 필요성이 시사되었다. 더불어 개인효능감의 측면에서는 교사효능감 및 자녀양육효능감의 개념구성과 영향에 대해 살펴보았다. 셋째, 교육적 성취를 통해 삶의 질을 지향하는 사회로 나아가야함을 지적하였다. 한국 사회 구성원들이 추구하는 삶의 질의 현주소를 확인하고, 교육적 성취가 삶의 질에 어떻게 관련되어 있는지를 살펴보았다. 학교생활에서의 삶의 질을 검토하고, 학생들의 스트레스 등 개인의 정신건강에 대한 배려가 필요함을 확인하였다. 넷째, 교육적 성취를 통해 비전을 가진 사회로 발전해야 함을 논의하였다. 세대집단별 통일에 대한 견해와 남한 및 북한에 대한 의식 등을 검토함으로써, 국민적으로 합의된 비전의 필요성이 제기되었다. 이외에도 교육적 성취의 맥락에서 미래 한국 사회가 해결해야할 기타 과제들을 검토해 보았다. 이러한 논의들을 종합해 볼 때, 교육적 성취를 통해 미래 한국 사회를 구축해 나가는 과정에서 한국 사회의 현상들에 대한 토착심리적 접근과 이해의 필요성이 확인되었다.

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문화속의 인간심성과 문화를 넘어선 인간심성 - 동과 서의 보다 나은 만남을 위하여 - (Human Mind Within and Beyond the Culture - Toward a Better Encounter between East and West -)

  • 李符永
    • 심성연구
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    • 제28권2호
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    • pp.107-138
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    • 2013
  • 현대 임상정신의학이 그동안 잊어버렸거나 소홀히 해온 문화와 심성의 관계를 다음과 같은 내용으로 살펴보았다. 1. 문화 :01) 문화정신의학의 공적과 한계 및 그 해결책 ; 2) C.G. 융의 비 서구문화의 경험 ; 3) 융의 분석심리학적 입장에서 본 문화 ; 4) 문화스펙트럼 모델 2. 심성 :01) 원시시대 및 고대의 심(心) 신(身)관 ; 2) 동양적 심성론 ; 3) 자기Self와 동양사상 문화정신의학은 정신건강문제의 문화적 요인을 규명함으로써 정신의학에 큰 기여를 해왔으나 문화적 차이에만 관심을 집중한 나머지 인류보편의 공통된 심성을 도외시하는 경향이 있었고, 인간의 건강한 심성을 등한시하고 문화의 역사적 측면을 간과하였으며 문화 상호간의 역동적 상호관계의 무의식적 심층적 측면을 보지 못했다. C.G. 융의 여행을 통한 이異 문화 체험 양식과 C.G. 융의 분석심리학설은 이 점에서 문화정신의학의 한계를 넘을 수 있는 가능성을 제시했다. 이에 따르면 인류학자들의 문화에 대한 다양한 개념 속에는 집단적 의식collective consciousness뿐 아니라 집단적 무의식에 뿌리박은 내용이 발견된다. 저자는 이를 효孝를 예로 설명했다. 저자는 또한 문화 스펙트럼cultural spectrum이라는 설명모형을 제창하였는데 한국인의 경우 샤머니즘, 불교, 도교, 유고, 기독교 문화가 한 개체의 인격을 여러 가지 스펙트럼으로 구성됨을 제시하였다. 주로 네 가지 유형을 분류하였는데 그것은 1) 주로 불교문화가 우세한 사람, 2) 주로 유교문화가 우세한 사람, 3) 주로 샤머니즘문화가 우세한 사람, 4) 주로 기독교문화가 우세한 사람이다. 비록 의식표면은 하나의 종교문화가 우세하지만 내면에는 다른 종교문화가 섞이게 되며 가장 심층에 샤머니즘 문화를 공유하고 있다고 보았다. 문화와 정신건강의 관계를 이해하고 치유의 접근을 할 때 이러한 스펙트럼 시각이 필요하다. 저자는 인간심성에 대한 고대중국의 개념과 동양종교의 관념, 그리고 C.G. 융의 자기개념에 대한 이해를 소개하고 이에 비길 수 있는 전체정신의 중심에 관한 한국의 선사, 원효의 생각, 대승기승론의 일심(一心), 노자의 도(道), 이퇴계의 천명도(天命圖), 이기설(理氣說)을 융의 분석심리학적 입장에서 해석하였다. 궁극적으로 정신요법의 목적은 분석심리학적 입장에서는 '하나가 되는 것' 이며 '하나'가 됨은 문화에 제약된 인간으로서가 아니라 문화를 포함하나 이를 넘어선 인간 심성 전체가 되도록 하는 것이다.

한국의 베이비부머세대 중년여성이 삶에서 추구하는 가치에 대한 질적연구 - 서울 거주 중산층을 중심으로 - (Qualitative Research on Korean Baby-Boomer Generation Middle-Aged Women's Attitude Toward Their Lives - Based on Middle-Class Seoul Residents -)

  • 이지현;김선우
    • Asia Marketing Journal
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    • 제14권2호
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    • pp.127-156
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    • 2012
  • 본 연구에서는 가족 내 높은 의사결정권을 가진 베이비부머세대 중년여성을 연구대상으로 선정하여 이 소비자에 대한 이해를 높이기 위해 이들이 삶에서 추구하는 가치를 질적연구방법을 통해 알아보았다. 그 결과, 시간, 관계, 젊음과 건강, 자아실현, 의식의 총 5개의 핵심가치를 도출했다. 상위범주들의 맥락적 관계를 구축하여 모형을 도출한 결과, 베이비부머세대 중년여성은 시간적 여유의 증가와 이전/이후세대와는 다른 의식을 인과적 조건으로 하여 자아실현과 타인과의 관계맺기 현상을 나타내며 이 과정에서 스트레스를 받고 있었다. 이들은 이와 같은 현상을 대처하기 위해 건강과 젊음을 위해 다양한 노력을 취하고 있었으며, 이를 통해 최종적으로 시간적 여유가 있고 경제적으로 크게 고통 받지 않는 현재의 삶에 감사하고 있다는 결론을 도출하였다. 모형을 보다 추상적인 중심현상으로 축약화하여 베이비부머세대 중년여성의 삶에 대한 이야기를 구성하였으며, 이를 통해 베이비부머 중년여성이 여러 가지 활동과 노력을 통해 추구하고자 하는 것은 '건강하고 젊고 행복한 삶'이라는 결론을 내렸다. 본 연구를 통해 도출된 실무적 시사점은 다음과 같다. 첫째, 베이비부머세대 중년여성의 삶에 가장 큰 영향을 미치는 시간을 잘 활용하도록 도와주는 상품, 서비스가 필요하다. 둘째, 자아실현 욕구가 높은 베이비부머세대 중년여성이 자아효능감을 느낄 수 있도록 이들의 감각, 능력, 인맥을 활용할 수 있는 기회를 제공해야 한다. 셋째, 이들의 집안과 외모 가꾸기는 자아실현의 방법이므로 이 시장에 대한 세분화가 필요하다. 질적인 방법으로 진행된 본 연구의 한계점을 보완하기 위해서는 다양한 지역과 소득계층을 포함하는 후속연구가 진행되어야 한다. 그리고 이상의 결과를 확인하고 보완하는 차원의 양적연구가 후속으로 진행되어야할 것이며, 이들 삶의 한 부분을 집중적으로 조명하여 더욱 깊이 있는 결과를 도출하는 후속연구가 필요하다.

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간호학 교과과정 개선을 위한 조사 연구 (A Study on improvement of curriculum in Nursing)

  • 김애실
    • 대한간호학회지
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    • 제4권2호
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    • pp.1-16
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    • 1974
  • This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

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병원종사자의 직업성 스트레스에 관한 연구 - 서울시내 500병상 이상 병원종사자를 중심으로 - (Occupational Stress of Hospital Workers)

  • 이우천
    • 한국병원경영학회지
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    • 제3권1호
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    • pp.1-33
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    • 1998
  • The purpose of this thesis is to study theoretical access to the methods that have been used for the research of occupational stress, thereby providing management methods of occupational stress of hospital workers. With a stress model of hospital workers set up from the viewpoint of organization management, 929 sets of questionnaires were collected from intern doctors, resident doctors, nurses, nursing aides, pharmacists, medical technicians, workers in patient affairs(reception and medical insurance workers), administrators and clerks from the 8 hospitals in Seoul with more than 500 beds. Upon variance analysis, correlation analysis and regression analysis of the collected questionnaires, this work examined how differences in stress caused by specific occupations and formulated a method of stress management for the hospital workers. The results are as follows. 1) If some duties of the nurses suffering from role-overloaded stress are transferred to the nursing aides dissatisfied with insufficient role, the two grunting groups can be satisfied at the same time. It is also necessary to transfer some jobs of the overloaded workers in patient affairs to the administrators, or the other way around. To reduce stress of conflict and ambiguity of role caused by the obscure division of roles between the workers, the role of each occupation should be delineated and the clear division of roles should be translated into action strictly according to that delineated. 2) Stress of inefficiency of organization from which the student doctors suffer can be relieved by management of participation. If they have access to the process of decision-making in general hospital affairs and consequently their understanding and the autonomy of job performance are promoted, such stress will be reduced. 3) To cope with stress of career development from which nurses, medical technicians, administrators, workers in patient affairs suffer, it is necessary to establish whether they have a chance to revive their careers, whether there are any ways of remotivation for less contributive workers, and whether they encourage each other to develope their careers. If they are given a chance to develope their careers, such stress will be relieved. 4) Pharmacists, suffering from stresses of living and personal relations, have strong cohesive power among themselves and organize a well-integrated team; thereby reducing the stress of personal relations and increasing productivity. 5) For administrators and student doctors confined to lesser social supports and for nurses and workers in patient affairs whose recognition of stress and job satisfaction are affected by social supports, emotional and informational supports for job performance help alleviate an individual's mental, and physical stress. 6) In addition to the above-mentioned stress-management methods, if an organizational coping strategy is provided according to the types of stress from the general viewpoint of the whole group of hospital workers, it would be of great help to managing stress. For example, the redesign of jobs, the management of objective, the improvement of working environment, the formation of an autonomous working group and various working plans can be set up for those who suffer from stress related to inappropriate role, while career counseling and development of career process can be provided for those dissatisfied with career development. Participation in the process of decision-making and the restructuring of the organization are needed for those who suffer from stress of malfunctioning organization, whereas creation of a supportive organizational atmosphere is desired for those who feel stressed due to personal relations. As well, such organizational coping strategies. as the increase of welfare facilities, seminars and educational programs and provision of health-promotion facilities can be provided.

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병원 간호사의 선호근무시간대에 관한 연구 (A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours)

  • 이경식;정금희
    • 대한간호
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    • 제36권1호
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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간호원의 환자교육 활동에 관한 연구 (Study of Patient Teaching in The Clinical Area)

  • 강규숙
    • 대한간호학회지
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    • 제2권1호
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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