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호스피스간호가 말기암환자의 통증에 미치는 효과에 관한 연구 (The Study on the Effects of Hospice Care on the Pain Management of the Terminal Cancer Patients)

  • 윤매옥
    • Journal of Hospice and Palliative Care
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    • 제6권1호
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    • pp.34-44
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    • 2003
  • 목적 : 본 연구는 호스피스 간호가 말기암환자의 통증정도에 미치는 효과를 파악하고 분석함으로써, 말기암환자의 안위를 도모하여 전인적이고 개별화된 간호를 제공하는데 도움을 주기 위하여 시도된 단일군 전후설계(one group pre-post test)이다. 방법 : 2000년 7월부터 11월까지 전주시에 소재하는 1개 종합병원의 호스피스에 의뢰되어 연구참여에 동의한 말기암환자 37명을 대상으로 하였다. 호스피스 간호는 1주일에 $5{\sim}6$회를 조주 동안 제공하였으며, 자료분석은 실수, 백분율, 평균, 표준편차 등의 서술통계와 paired t-test로 분석하였다. 결과 : 1) 통증정도의 중증도는 통증정도가 24시간 동안 가장 심했을 때 통증점수는 중재전이 6.35점, 중재후가 4.76점이었다. 통증으로 인한 지장정도는 중재전에는 인생을 즐김(8.22점), 통상적인 일(7.46점), 보행(7.08점), 일반적인 활동(7.08점)순이었으며, 중재후에는 인생을 즐김(6.62점), 통상적인 일(6.43점), 보행(6.11점), 일반적인 활동(5.78점)순으로 중재전과 후가 동일한 순위를 보였다. 2) 통증의 중증도는 중재전보다 중재후에서 각각 유의하게 감소하였다. 영역별로 분석하였을 때 24시간 동안 가장 심했을 때 통증(t=4.085, P=0.000), 24시간 동안 가장 약했을 때 통증(t=4.020, P=0.000), 평균통증(t=4.254, P=0.000), 조사당시 바로 지금 느끼는 통증(t=5.017, P=0.000)영역에서 중재후 통증이 중재전보다 유의하게 감소하였다. 3) 통증으로 인한 지장정도는 중재전보다 중재후에서 각각 유의하게 감소하였다. 영역별로 분석하였을 때 일반적인 활동(t=3.137, P=0.003), 기분(t=6.713, P=0.000), 보행능력(t=2.027, P=0.050), 통상적인 일(t=20.132, P=0.040), 대인관계(t=4.143, P=0.000), 수면(t=4.071, P=0.000), 인생을 즐김(t=3.881, P=0.000)에서 통계적으로 유의한 차이가 나타났다. 결론 : 호스피스 간호를 제공받은 말기암환자는 제공받지 않은 말기암환자에 비해 통증정도와 삶의 치장 정도에서 모두 낮아짐이 확인되었으며, 유의한 차이를 보였다. 이상과 같이 말기암환자에 대한 호스피스 간호는 통증감소와 통증이 생활에 지장을 주는 정도를 감소하는데 효과적인 것으로 확인되었으므로 앞으로 말기암환자를 위해 적극적인 활용을 권장한다.

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질소시용, 예초 및 재식밀도가 한국잔디(Zoysia Japonica Steud)의 생육에 미치는 영향 (Studies on the growth of Korea Lawn Grass (Zoysia japonica Steud.)in Reponse to Nitrogen Application, Clipping Treatment and Plant Density)

  • 심재성
    • 자연과학논문집
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    • 제1권
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    • pp.61-113
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    • 1987
  • The increasing emphasis placed on the production of fine turf for lawns, golf courses, parks, and other recreational sites has led to many unsolved problems as to how such turf could be best established and mainteined. For this purpose, a series of experiments were conducted under con ditions of pot and field. The results obtained were as follows EXPERIMENT I. The effect of nitrogen fertilizer and clipping interval on Zoysia japonica. 1. Increasing the rate of nitrogen and frequent clipping increased tiller number of Zoysis japonica and the maximum number of tillers were obtained from 700 kg N application and freqnent clippings (10 days interval ) in October. Treatment of 350kg N with 10 days clipping interval increased tillers much more than those of 700 kgN with 20 and 30 days clipping intervals. 2. The average number of green leaves occurred during the growth period maximized by applying 700 kg N and clipping 10 days interval. 3. Increasing tiller numbers significantly decreased tops DM weight per tiller by clipping plants at interval of 10 and 20 days, irrespective of nitrogen applied, and with nil N, at the interval of 30 days. By applying 700 kg N, however, top DM weight per tiller increased as the number of tillers increased consistently. 4. The highest top DM weight was achieved from late August to early September by applying 350 and 700kgN. 5. During the growth period, differences in unders ( stolon + root ) DM weight occurred bynitrogen application were found between nil N and two applied nitrogen levels, whereas, at the same level of nitrogen applied, the increase in stolon DM weight enhanced by lengthening the clipping interval to 30 days. 6. Nitrogen efficiency to green leaves, stolon nodes and DM weight of root with high nitrogen was achieved as clipping interval was shortened. 7. By increasing fertilizer nitrogen rate applied, N content n the leaves and stems of Zoysiajaponica was increased. On the other hand, N content in root and stolon had little effect onfertilizer nitrogen, resulting in the lowest content among plant fractions. The largest content of N was recorded in leaves. Lengthening the clipping interval from 10 or 20 to 30 days tends to decrease the N content in the leaves and stems, whereas this trend did not appeared in stolon androot. 8. A positive correlations between N and K contents in tops and stolon were established andthus K content increased as N content in tops and stolon increased. Meanwhile, P content was not affected by N and clipping treatments. 9. Total soluble carbohydrate content in Zoysia japonica was largest in stolon and stem, and was reduced by increasing fertilizer nitrogen rate. Reduction in total soluble carbohydrate due to increased nitrogen rate was severer in the stolons and stems than in the leaves. 10. Increasing the rate of nitrogen applied increased the number of small and large vascular bundles in leaf blade, but shortened distance among the large vascular bundles. Shortening the clipping interval resulted in increase of the number of large vascular bundles but decrease ofdistance between large vascular bundles.EXPERIMENT II. Growth response of Zoysia japonica imposed by different plant densities. 1. Tiller numbers per unit area increased as plant density heightened. Differences in num ber between densities at higher densities than 120 D were of no significance. 2. Tiller numbers per clone attained by 110 days after transplanting were 126 at 40D,77 at 80D, 67 at 120D, 54 at 160D, and 41 at 200D. A decreasing trend of tiller numbers per clone with increasing density was noticable from 100 days after transplanting onwards. 3. During the growth period, the greatest number of green leaves per unit area were attainedin 90days after transplanting at 160D and 200D, and 100 days after transplanting at 40D, 80Dand 120D. Thus the period to reach the maximum green leaf number with the high plantdensity was likely to be earlier that with the low plant density. 4. Stolon growth up to 80 days after transplaning was relatively slow, but from 80 daysonwards, the growth quickened to range from 1.9 m/clone at 40D to 0.6m/clone at 200Din 200 days after transplanting, these followed by the stolon node produced. 5. Plant density did not affect stolon weight/clone and root weight/clone until 80 daysafter transplanting. 6. DM weight of root was heavier in the early period of growth than that of stolon, butthis trend was reversed in the late period of growth : DM weight of stolon was much higherthan that of root.EXPERIMENT Ill. Vegetative growth of Zoysia japonica and Zoysia matrella as affected by nitrogen and clipping height. 1. When no nitrogen was applied to Zoysia japonica, leaf blade which appeared during theAugust-early September period remained green for a perid of about 10 weeks and even leavesemerged in rate September lived for 42 days. However, leaf longevity did not exceed 8 weeks asnitrogen was applied. In contrast the leaf longevity of Zoysia matrella which emerged during the mid August-earlySeptember period was 11 weeks and, under the nitrogen applied, 9 weeks, indicating that thelife-spen of individual leaf of Zoysia matrella may be longer than that of Zoysia japorica. Clipping height had no effect on the leaf longevity in both grasses. 2. During the July-August period, tiller number, green leaf number and DM weightof Zoysia japonica were increased significantly with fertilizer nitrogen, but were not with twolevel of clipping height. This trend was reversed after late September ; no effect of nitrogen wasappeared. Instead, lax clipping increased tiller number, green leaf number and DM weight. Greenleaves stimulated by lax clipping resulted in the occurrance of more dead leaves in late October. 3. Among the stolons outgrown until early September, the primary stolon was not influencedby nitrogen and clipping treatments to produce only 2-3 stolons. However, 1st branch stoIon asaffected by nitrogen increased significantly, so most of stolons which occurred consisted of 1st branch stolons. 4. Until early September, stolon length obtained at nil nitrogen level was chiefly caused bythe primary stolons. By applying nitrogen, the primary stolons of Zoysia japonica waslonger than 1st branch stolons when severe clipping was involved and in turn, shorter than 1stbranch stolons when lax clipping was concerned. In Zoysia matrella, 1st branch stolons were muchlonger than the primary stolon when turf was clipped severely but in conditions of lax clippingthere was little difference in length between primary and 1st branch stolons. 5. Stolon nodes of both Zoysia japonica and Z. matrella were positively influenced by nit rogen, but no particular increase by imposing clipping height treatment was marked in Zoysiamatrella. Although the stolon of Zoysia japonica grew until late October, the growthstimulated by nitrogen was not so remarkable as to exceed that by nil N.

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