• 지역사회간호학회지
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• 제30권2호
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• pp.119-129
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• 2019

Purpose: The purpose of this study is to develop and evaluate the effects of a multifaceted cognitive training program on cognitive function, depression, and instrumental activities of daily living (IADL) in community dwelling elders with mild cognitive impairment. Methods: A non-equivalent control group pretest-posttest design was used. The subjects were recruited from a community health center in D metropolitan city and were assigned to the experimental or control group. Weekly 50-minute session intervention was delivered to the experimental group over 12 weeks. 8 weeks and 12weeks after intervention, the changes in cognitive function, depression, and IADL in the groups were measured and compared. Data were analyzed with Mann-Whitney U test, Wilcoxon Signed Rank test, and post-hoc test with Bonferroni correction using SPSS/WIN 23.0. Results: When compared with their counterparts (n=15), the elders in the experimental group (n=12) showed significant improvement in cognitive function and depression at week 12. The mean scores of IADL at week 12 were not significantly different between the groups. Conclusion: The results indicate that this multifaceted cognitive training program is effective in improving cognitive function, depression, and avoiding deterioration of IADL among elders with mild cognitive impairment.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.293-301
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• 2018

본 연구는 다면재활프로그램이 산업재해근로자의 다차원 심리 변화와 역량강화, 직업복귀준비 및 작업능력에 미치는 효과를 알아보고자 하였다. 2017년 3월부터 9월까지 경남 창원에 위치하는 C병원에 입원한 산업재해근로자 12명을 대상으로 실시하였다. 다면재활프로그램으로는 주 2회 2시간씩 8주 동안 희망찾기프로그램과 주 5회 3~4시간씩 8주 동안 작업능력강화프로그램을 병행 실시하였다. 이 때 중재효과를 검증하기 위해서 다차원 심리검사, 역량강화척도, 직업복귀준비도 및 작업능력평가를 실시하여 윌콕슨부호순위검정으로 전 후 검사 결과를 비교하였다. 그 결과, 다차원 심리검사에서 불안, 우울, 신체화, 사회적 지지에서 유의하게 향상된 반면(p<.05), 분노에서는 유의한 차이가 없었다(p>.05). 역량강화척도와 직업복귀준비도에서는 유의미한 차이가 있었다(p<.05). 작업능력평가에서는 바닥에서 허리높이로 들기, 허리에서 어깨높이로 들기, 바닥에서 어깨높이로 들기, 옮기기, 밀기 및 당기기에서 모두 유의한 차이가 있었다(p<.05). 본 연구는 사회심리적 요소와 신체적 측면을 함께 고려한 다면재활프로그램이 산업재해근로자의 직업복귀에 있어서 다차원 심리의 긍정적인 변화, 역량강화, 직업복귀준비 및 작업능력에 효과적임을 알 수 있었고 직업재활의 효과적인 방법임을 제안한다.

• 중환자간호학회지
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• 제16권1호
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• pp.56-70
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• 2023

Purpose : This study aimed to identify the effects of a multifaceted pediatric delirium education program for pediatric intensive care unit (PICU) nurses on their delirium knowledge, confidence in delirium nursing, and delirium evaluation accuracy. Methods : This study used a one-group pretest-posttest design. The participants were 50 nurses in two units of the PICU at S General Hospital in Seoul. All participants took a 1-hour lecture with case-based practice for the first two weeks, and received feedback as they applied the program to clinical practice over the next two weeks. Test measures were completed before and after the four week intervention period for all participants. The delirium evaluation accuracy was measured using the Korean version of the Cornell Assessment of Pediatric Delirium. Data were analyzed using the chi-square and paired t-tests. Results : After the Pediatric Delirium Education Program, nurses' delirium knowledge (x²=11.65, p =.001), confidence in delirium nursing (t=9.71, p<.001), and delirium evaluation accuracy (t=6.07, p<.001) improved significantly. Conclusions : Pediatric delirium education programs for PICU nurses were effective. For active application of the program in clinical practice in the future, various cases of childhood delirium and specific strategies for each subject must be developed. To achieve this, long-term intervention and research for multiple organizations are required.

• 한국의료질향상학회지
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• 제12권2호
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• pp.93-112
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• 2006

This study reviewed published studies on interventions used by hospitals, health insurance programs, or governments to improve use of medicines in foreign countries. Interventions to improve use of medicines are classified into two categories: 1) information strategies-dissemination of educational materials, group education, one-to-one educational outreach, drug utilization review, and feedback; 2) managerial strategies- formularies, prior authorization, and financial incentives. Dissemination of educational materials, which is a common intervention, was unsuccessful in changing physicians' prescribing behaviors. Problem-based small group education was more likely to change behaviors than didactic large group education. One-to-one educational outreach(academic detailing) was among the most effective strategies used to change prescribing behaviors. Prospective drug utilization review (DUR) program was more successful in improving use of medicines than retrospective DUR program. Feedback intervention has been reported to be ineffective to change behaviors. Formularies are frequently used to control medication use by most health insurance programs. Financial incentives provide physicians economic incentives according to appropriateness of prescribing. However, few published studies have assessed the efficacy of formularies or financial incentives. Prior authorization requires physicians to get authorization from health insurers before prescribing a certain group of drugs which is usually of high costs or risk. There is no magic bullet for quality use of medicines. Multifaceted interventions that help to predispose, enable, and reinforce desired behaviors are more likely to be successful.

• 대한간호학회지
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• 제45권4호
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• pp.469-482
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• 2015

Purpose: The purpose of this study was to identify which nursing interventions are the most effective in fall prevention for hospitalized patients. Methods: From 3,675 papers searched, 34 were selected for inclusion in the meta-analysis. Number of fallers, falls, falls per 1,000 hospital-days, and injurious falls, fall protection activity, knowledge related to falls, and self-efficacy about falls were evaluated as outcome variables. Data were analyzed using the Comprehensive Meta Analysis (CMA) 2.2 Version program and the effect sizes were shown as the Odd Ratio (OR) and Hedges's g. Results: Overall effect size of nursing interventions for fall prevention was OR=0.64 (95% CI: 0.57~0.73, p <.05) and Hedges's g= - 0.24. The effect sizes (OR) of each intervention ranged from 0.34 to 0.93, and the most effective nursing intervention was the education & environment intervention (OR=0.34, 95% CI: 0.28~0.42, p<.001), followed by education intervention (OR=0.57, 95% CI: 0.50~0.67, p=.001). Subgroup analyses showed that multifaceted interventions (OR=0.76, 95% CI: 0.73~0.79, p<.001) were more effective than unifactorial interventions, and that activities for prevention of falls (OR=0.08, 95% CI: 0.05~0.15, p<.001) showed the largest effect size among outcome variables. Conclusion: Falls in hospitalized patients can be effectively prevented using the nursing interventions identified in this study. These findings provide scientific evidence for developing and using effective nursing interventions to improve the safety of hospitalized patients.

• 디지털융복합연구
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• 제19권11호
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• pp.615-623
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• 2021

본 연구는 루푸스 환자의 극복력에 영향을 미치는 요인을 파악하기 위해 수행되었다. 연구대상자(N=118)는 D시 소재의 E병원을 내원한 루푸스 환자를 대상으로 하였다. 수집된 자료는 기술통계, t-tset, ANOVA, pearson correlation, multiple regression으로 분석하였다. 연구결과, 극복력에 영향을 미치는 요인은 불확실성의 질병의 영향 영역, 피로, 불확실성의 자기관리 영역과 의사에 대한 신뢰영역 이었다. 본 연구를 토대로 루푸스 환자의 극복력을 향상시키기 위해서는 환자가 인지하는 불확실성을 줄이고 피로 조절을 위한 다각적인 접근이 필요하다. 또한 영향요인을 반영한 루푸스 환자의 극복력 증진을 위한 효과적인 간호중재 프로그램의 개발이 요구된다.

• 디지털융복합연구
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• 제17권6호
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• pp.417-426
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• 2019

본 연구는 가출 후 청소년의 거리생활 경험에 관하여 조사하고, 거리생활로 인한 범죄의 영향력 등에 대해서 살펴봄으로써 효과적인 융복합적 지원정책에 대해서 탐색하였다. 본 연구조사는 청소년쉼터 이용청소년과 아웃리치 사업에서 만난 거리청소년을 대상으로 설문조사하였으며, 최종적으로 259부를 분석하였다. 연구결과는 다음과 같다. 첫째, 청소년가출 연령과 거리생활 연령을 비교해 볼 때에 가출 후에 적절한 서비스를 통한 개입과 지원이 이루어지지 못할 때에 가출청소년은 거리생활로 이어질 수 있다. 둘째, 거리청소년에 대한 정책은 청소년쉼터에 찾아온 아이들을 대상으로 서비스를 지원하였다. 그러나 이제는 청소년 지원 정책이 청소년 삶의 현장을 찾아가는 서비스와 욕구를 기반으로 문제해결을 돕는 융복합적 정책의 필요하다. 셋째, 거리생활 후에 비행행동이 높아짐을 알 수 있다. 거리청소년은 거리생활을 위해서는 비행에 가담할 수밖에 없는 상황에 놓이게 된다. 마지막으로 거리생활 청소년은 생활비, 주거시설, 일자리 소개, 취업기술 훈련 등의 자립지원에 관한 서비스 욕구가 높게 나타났다. 결과적으로 거리생활 경험 청소년의 개입은 주거, 노동, 교육, 복지 등의 융복합적 지원이 필요하다.