• 대한간호학회지
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• 제26권1호
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• pp.15-32
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• 1996

The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

• 서비스연구
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• 제13권4호
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• pp.70-96
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• 2023

최근 간호인력들의 높은 이직률과 직무스트레스 증가로 인한 문제가 사회적 이슈로 크게 부각되며, 간호 조직 내의 '태움' 문제에 대한 관심이 증가하고 있다. 이에 따라, 본 연구는 간호업무 현장에서의 괴롭힘을 포함한 태움 문제에 대한 해결책 모색이 시급한 상황에서 이 문제에 대한 예방 및 극복방안을 제시하는 것을 목적으로 한다. 이를 위해 S-O-R 프레임워크 및 선행연구를 기반으로 직무스트레스 및 이직의도를 태움의 결과변수로, 커뮤니케이션능력을 선행요인으로 도출하였으며, 이러한 태움의 영향 메커니즘에서 마음챙김과 사회적지지가 문제 극복을 돕는 조절변수 역할을 수행할 것으로 보고 연구모형을 구성하였다. 최근 1년 내 태움을 경험한 간호인력 300명을 대상으로 한 설문조사를 통해 자료를 수집하고, 구조방정식모형을 활용하여 가설을 검증한 결과, 간호인력의 커뮤니케이션능력이 높을수록 태움 피해를 적게 인지하는 것으로 나타났으며, 태움으로 인한 피해는 높은 직무스트레스를 거쳐 이직의도로 이어진다는 사실을 밝혀내었다. 또한, 마음챙김과 사회적지지는 각각 태움이 직무스트레스에, 직무스트레스가 이직의도에 미치는 정(+)의 영향을 유의하게 약화시키는 것으로 나타났다. 본 연구는 기존의 S-O-R 프레임워크에서 사전예방 단계를 추가하여 확장된 P-S-O-R 프레임워크를 제안하였으며, 추가로 마음챙김과 사회적지지 변수의 조절효과를 검증했다는 점에서 연구의 의의가 있다. 본 연구결과를 통해 실무에 적용 가능한 태움 예방 및 극복방안 마련을 위한 구체적인 지침을 제시할 수 있기를 기대한다.

• 한국의료질향상학회지
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• 제9권2호
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• 한국융합학회논문지
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• 제7권3호
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• pp.149-157
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• 2016

산재 발생은 근로자의 노동력 상실과 생산성 그리고 삶의 질에 영향을 준다. 본 논문은 산재 발생 후 직업 복귀자의 업무수행능력에 영향을 미치는 요인을 융합적으로 파악하고자 한다. 본 연구 자료는 2013년과 2014년 산재보험패널 자료를 활용한 단면연구이며, 독립변수인 일반적 특성과 종속변수인 업무수행능력의 관련성을 파악하기 위해 로지스틱 회귀분석을 실시하였다. 연구 결과, 업무수행능력 감소에 큰 영향을 미치는 요인으로 장해등급 1 - 7급과 요양기간이 12개월 이상과 6 - 9개월인 것으로 나타났다. 즉, 직업복귀자의 장애 정도가 중증일수록, 요양기간이 증가할수록 업무수행능력이 큰 폭으로 감소하는 것을 확인할 수 있었다. 업무수행능력은 산재자의 성공적인 직업복귀를 간접적으로 파악할 수 있고 산재 이후 직업복귀자에 대한 사후적 관리가 중요하다는 점에서 의의가 있다. 직업복귀자의 안정된 업무수행은 근로자의 생활 안정과 삶의 질을 유지하고 기업의 생산력을 확보하는데 중요하다.

• 한국의료질향상학회지
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• 제23권2호
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• pp.23-34
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• 2017

Purpose: Nurse's second victim experiences could influence organizational negative work-related outcome. The purpose of this study was to investigate the casual relationship between nurses' second victim experience and third victim experience and multiple mediation effects of second victim supports. Methods: A cross-sectional, self-report survey (the Second Victim Experience and Support Tool) was conducted with 305 nurses working in a general hospital. Data were collected from October 20 to November 25, 2016 and analyzed using SPSS Win version 23.0. Results: The nurses' perceived second victim experience was $3.24{\pm}0.61$ and the third victim experience was $3.12{\pm}0.92$. Nurses' second victim experience was found to have a direct effect on increasing third victim experience and indirect effect of colleague support as mediator (p<.05). However, institutional support and supervisor support had not a partial and indirect effect on third victim experience. Conclusion:This study is one of the first to connect second victim experience to third victim experience in South Korea. This study broadens the understanding of the negative effects of a second victim experience influence third victim experience. When involvement in patient safety events, the important role of colleague support in limiting nurse's third victim experience have been acknowledged. This study reinforces the efforts health care leaders are making to develop interventional programs to colleague support their staff as they recover from adverse event involvement.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.179-183
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• 2016

Breast cancer is the most prevalent type of cancer among women around the world, and mortality is primarily caused by micro-metastatic disease. The complex mechanisms of breast cancer invasion and metastasis are intrinsically related to the malignant cell type so that early detection of micro-metastases can help prolongation of survival for patient. The aim of the present research work was evaluation of the expression status of mammoglobin protein as a candidate molecular marker in the negative sentinel lymph node (SLN). Fifty tumor specimens, and 50 normal adjacent breast tissue samples from the same patients were selected on the basis of having more than 10% tumor content for RNA extraction from SLNs. Tumor samples and normal adjacent breast tissue were archived in the form of frozen fresh tissue in liquid nitrogen. Real-time PCR was performed on a Bioner life express gradient thermal cycler system. Mammoglobin gene overexpression in breast cancer metastasis was investigated. Single marker results were mammaglobin 66.7% and CK19 50.0%, with 58.3% for the two in combination. Due to improved outcome with at least 3 genes (83.3%), it seems, triple marker evaluation will be most likely useful for detecting micro-metastases instead of studying separate genes.