• 지역사회간호학회지
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• 제6권2호
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• pp.173-182
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• 1995

Primary health care(PHC) has been established since A Health Law for rural residents has been legislated in 1980 following the WHO declaration, 'Health for All 2000'. in 1978. PHC services are presently assumed to be provided by 2038 Community Health Practitioners(CHP) to about 28% out of rural population in Korea. Most CHPs have confronted the adaptation process to the community being practiced although a CHP's role is to evoke community participation for the improvement of their health by themselves. So the purpose of this study is to describe and explain of the commitment of CHPs into the community. Data were collected by direct interview and tape-recording under subjects' permission till theoretical saturation were occured from 6 CHPs. The subjects were 41 years old and have served in the community for 9 years in average. Main questions and concepts were explored from data according to the procedure of the grounded theory methodology. The results are as follows. 1) The number of the main concepts were twenty four that identified Motive, Desire, Personal characteristics, Unfamiliarity, Denial, Feeling of isolation, Self-sacrifice, Kindness, Patience, Assimilation, Respect for the residents, Support by the family, Support by the residents, Achievement, Acceptance of realities, Use of resources, Inducement of cooperation from the residents, Changes of the difference from time orientation between CHP and residents, Attitude as a official, Technical support, Cost management, Satisfaction level, Acknowledgement by the residents and discrepancy. 2) The twenty four concepts were categorized to seven groups such as Motivation, Feeling of Heterogeneity, Self-discipline, Social support, Induced changes in the attitudes of residents, Familarity and Persistent discrepancy. 3) The categorized groups were analyzed on the base of the Causal Conditions, Central Phenomena, Contexts, Intervening Conditions, Action / Interaction Strategies, and Consequences. Central phenomenon in this study was identified to be the feeling of heterogeneity. Community health practitioners experienced unfamiliarity and denial from the community and felt themselves isolated in the first. In time, they won the trust of residents by their efforts including self-sacrifice, kindness, patience, and assimilation. Afterward, practitioners got self-confidence and familiarity with lesser feeling of heterogeneity. Nevertheless, practitioners could not commit themselves completely because of the persistent discrepancy between CHP and residents. 4) On the commitment process, the CHPs' feeling of heterogeneity were decresed and social support increesed and newly evolved induced change of residents through the continuous interaction between CHP and them The contribution of this study would be concluded as follows. 1) It is expected that effective strategies for more rapid committment into the community can be developed based on this study. 2) More easy committment would be possible for the newly appointed CHP through understanding of the committment process identified on this study.

• 한국콘텐츠학회논문지
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• 제21권8호
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• pp.651-661
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• 2021

본 연구는 일 지방 간호대학생이 수도권 대학병원에서 임상실습을 하면서 어떤 경험을 하는가를 간호대학생의 시각에서 살펴보고자 수행되었다. 연구대상은 J시에 소재하는 간호대학 4학년 12명이었고 자료 수집은 면담 질문지를 사용하여 2017년 9월 29일부터 10월 12일까지였다. 수집된 자료는 Colaizzi의 현상학적 분석방법을 사용하여 분석하였다. 본 연구의 결과, 3개의 범주와 9개의 주제묶음으로 나타났다. '질 높은 실습교육'의 범주에는 '수도권 대학병원 실습에 대한 기대감', '체계적인 실습교육에 대한 만족감', '진로결정에 구체적 기준설정 기회'로 나타났다. '독립된 사회생활의 경험'은 '일상에서 벗어난 자유로움', '혼자 해결해야 함', '주위 인간관계의 소중함을 깨달음'이며 '체계적 실습생 지원 부족'은 '정보부족으로 인한 실습준비의 어려움', '경제적 지원 부족', '안전이 보장되지 않은 생활환경에 대한 두려움'으로 나타났다. 본 연구 결과는 일 지방 간호대학생이 수도권 대학병원에서 어떤 임상실습을 경험하는가를 파악하여 양질의 임상실습 교육환경을 모색할 수 있는 기초자료로 활용할 수 있을 것이다.

• 지역사회간호학회지
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• 제13권3호
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• pp.513-522
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• 2002

This study investigated stress and the extent of climacteric symptoms in mid-life men, and examined their relationship in order to better understand the stress and climacteric symptom experiences of mid-life men, and thereby attempted to offer basic materials for the development of a health improvement program that may help increase the quality of life of mid-life men. Three hundred mid-life men whose ages were between 40 and 59 and resided in the Seoul area were subjects of this study. The data were analyzed with the SAS PC program using descriptive statistics to analyze subjects' general characteristics and variables of stress and the extent of climacteric symptoms of the subjects. The relationship between stress and climacteric symptoms were examined by the Pearson Correlation Coefficient, and stress and the extent of climacteric symptoms in relation to the general characteristics were analyzed by T-test and ANOVA. The study conclusions are as follows: 1. Subjects general characteristics The average, age of the subjects was 46 and 47.0% of them reported ages between 40 and 45. Of the subjects, 98% were married. In marriage satisfaction, those who were generally satisfied with their married life comprised 62.0% of the subjects. In terms of level of education, 95.7% were educated above the high school level. In occupational background, 59.7% had occupations related to technologies. As for religion, 42.7% had no religion. In number of children, 67.3% had 2 children. In residential status, 79,3% were living in their own homes. In terms of living arrangements, 87.7% of the subjects were living in the form of nuclear families. 2. Stress and the extent of climacteric symptoms The level of stress was scored as $2.94{\pm}0.74$, and considering that the overall examination score is $27.16{\pm}1.32$, the subjects' stress level was not viewed as particularly high. The average score of the extent of climacteric symptoms was $35.37{\pm}0.27$. The extent of sub-domains of climacteric symptoms included skeleton symptoms ($39.37{\pm}2.81$), joint pain ($39.16{\pm}3.66$), vasomotor symptoms ($35.39{\pm}3.01$), other symptoms ($36.99{\pm}3.02$), psychological symptoms ($34.68{\pm}3.01$), urogenic symptoms ($35.03{\pm}3.27$), and cardiovascular symptoms ($33.70{\pm}2.78$). 3. General characteristics in relation to the stress level The subjects' general characteristics that were significantly related to the level of stress were marriage status (F=4.38, p=.001), marriage satisfaction (F=4.56, p=.001), educational background (F=2.68, p=.012), and age (F=2.48, p=.033). 4. General characteristics in relation to the level of climacteric symptoms The subjects' general characteristics that were significantly related to the level of climacteric symptoms were educational background (F=3.26, p=.007), age (F=2.58, p=.027), marriage status (F=2.62, p=.025), and marriage satisfaction (F=2.78. p=.032). 5. The correlation between stress and climacteric symptoms The subjects' level of stress and climacteric symptoms were significantly related to each other (r=0.578, p=0.000). The subjects' level of stress was correlated with sub-domains of the climacteric symptoms including psychological symptoms (r=0.579, p=0.000), joint pain (r=0.479, p=0.000), skeleton symptoms (r=0.477, p=0.000), other symptoms (r=0.467, p=0.000), vasomotor symptoms (r=0.4615, p=0.000), cardiovascular symptoms (r=0.458, p=0.000), urogenic symptoms (r=0.401. p=0.000). In summary, the climacteric symptoms suffered by mid-life men are positively correlated with their level of stress. In addition, the climacteric symptoms were affected by the level of stress.

• Journal of Hospice and Palliative Care
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• 제13권3호
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• pp.153-160
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• 2010

목적: 본 연구는 제주지역에 거주하는 암환자의 요구도와 만족도를 파악하기 위한 조사연구이다. 방법: 2009년 7월 13일부터 7월 30일까지 제주대학교 병원에 내원한 암환자 174명의 의료서비스에 대한 요구도와 만족도를 분석하였다. 보건복지부에서 재가암환자 관리사업 시행 시 제시한 서비스 요구도 및 충족도 조사 항목을 이용하여 조사하였으며, 수집된 자료는 SPSS 12.0 for Windows program을 이용하여 분석하였다. 결과: 대상자는 위암과 대장직장암 등 위장관계 암환자가 33.3%로 가장 많았으며, 52.3%가 진단 후 경과 기간이 1년 이하였으며, 진단 후 5년 이상 경과한 대상자는 5.2%로, 최장기간은 12년이었다. 전체의 60.9%가 암으로 인한 수술 경험이 있었으며, 28.2%가 항암화학요법 경험이 있었다. 요구도가 가장 높았던 항목은 경제적지원(3.38점)이었으며, 치료 계획에 대한 상담(3.22점), 질병에 대한 정보(3.07점), 암 이외의 다른 질병 관리(2.97점) 순이었다. 만족도가 가장 높았던 항목은 종교상담(3.41점)이었으며, 간병보조(3.39점), 직업상담(3.26점), 가족 및 대인관계 상담(3.26점), 물리치료 및 재활치료(3.20점), 보험 상담(3.18점) 순이었으며, 만족도가 가장 낮은 항목은 경제적 지원(1.98점)이었다. 남성의 서비스 만족도는 3.1점으로 여성(2.8점)보다 높았으며, 자녀와 사는 경우 서비스 요구도가 가장 높았으며, 홀로 살거나 자녀와 사는 경우 서비스 만족도가 가장 낮았다. 의료보호 환자 및 암보험에 가입하지 않은 경우 서비스 요구도가 더 높은 것으로 나타났다. 대상자의 연령, 직업, 학력수준, 결혼여부, 종교, 수입에 따른 차이는 없었으나, 60대 및 수입이 높은 그룹에서 서비스 만족도는 가장 높고, 요구도는 가장 낮은 것으로 나타났다. 의학적 진단 및 치료 방법에 따른 서비스 요구도 및 만족도의 차이는 없었으나, 갑상샘암 환자에서 서비스 만족도가 다소 낮았으며, 방사선 치료 및 색전술을 받은 경우 만족도가 다소 낮은 것으로 나타났다. 결론: 암환자들은 경제적 지원 및 치료계획이나 질병에 대한 정보를 얻고자 하는 요구도가 높으며, 실제 경험하는 증상에 대한 관리는 잘 이루어지지 않는 것으로 보인다. 또한, 환자의 지지체계 및 경제적 지원 체계의 확보 여부에 따라 의료서비스에 대한 요구도도 다양하고, 주요 5대암 이외의 암환자에 대한 지원이 다소 부족한 것으로 보인다. 따라서, 의료기관에 내원 중인 암환자 및 재가암환자 모두를 대상으로, 대상자 특성 및 요구도를 고려한 지속적인 정책적 노력이 필요할 것이다.

• 농촌의학ㆍ지역보건
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• 제48권1호
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• pp.28-40
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• 2023

본 연구에서는 2016년 KPS 자료를 이용하여 우리나라 임상의사의 삶의 만족도 자가 평가 수준과 이와 관련된 요인을 파악하였다. KPS는 우리나라 전체 의사를 대상으로 근무 현황 및 환경, 보건의료체계·정책 인식 및 평가수준, 보건의료정보시스템 가용 현황 및 활용 정도, 직업 및 직무만족도, 활동 계획 및 진로, 생활습관 및 건강상태, 특정 직역(개원의, 은퇴자) 문항 등을 조사하였다. 설문지는 온라인 설문조사 방식으로 E-mail을 통해 발송되었고 최종 응답자는 8,564명으로 응답률은 13.8%였다. 본 연구에서는 현재 환자를 직접 진료하고 있는 임상의사 중에서 수련의와 공보의를 제외한 총 7,228명을 연구대상으로 하였다. 본 연구결과 임상의사의 삶의 만족도는 만족 36.1%(2,609명), 보통 42.8%(3,095명), 불만족 21.1%(1,524명)이었다. 임상의사의 삶의 만족도에 긍정적인 영향을 미치는 요인들은 신체적 요인으로는 60대이며, 여성이고, 평소 건강상태를 좋다고 평가하는 경우였다. 심리적 요인으로는 스트레스가 적었다. 사회적 요인으로는 가족과 함께 거주하며, 가족과 보낼 수 있는 시간에 대해 만족하는 것으로 나타났다. 또한 의사로서 받게 되는 사회적인 존경에 대해 만족하고 있었다. 조직적 요인은 교수이며, 16년 이상 근무 경력을 가진 경우였다. 직업적 요인으로는 근무시간 및 업무량, 의료자원 지원, 동료 및 직원과의 관계에 만족하는 경우였다. 경제적 요인으로는 소득에 대한 만족도가 높았다. 건강행태 요인으로는 현재 흡연을 하지 않으며, 음주횟수는 한 달에 1번 미만이었다. 임상의사의 삶의 만족도는 단순히 개인의 삶을 떠나 의사를 만나는 환자의 진료행위에까지 영향을 미칠 수 있음을 감안할 때 임상의사의 삶의 만족도를 높이기 위한 다각도의 접근이 필요하다고 생각한다. 이를 통해 임상의사들은 우리 사회 구성원 중 하나로 균형 있는 삶을 영위하고, 나아가 우리 사회 구성원들에게 보다 질 높은 보건의료서비스를 제공할 수 있기를 기대한다.

• 한국산학기술학회논문지
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• 제13권10호
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• pp.4660-4668
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• 2012

본 연구는 여자 고등학생의 스트레스와 자아탄력성, 그리고 학교적응유연성 정도를 파악하고, 그 상관관계를 확인하기 위하여 시도되었다. 대상자는 I시에 소재한 3개 인문계 고등학교에 재학 중인 여자 고등학생 250명으로, 구조화된 설문지를 이용하여 2010년 9월 한 달 간 자료를 수집하였다. 대상자의 스트레스는 학교생활 만족도와 선생님과의 관계에 따라 유의한 차이가 있었으며, 학교적응유연성은 학교생활 만족도와 선생님과의 관계, 학교 성적, 음주 경험, 이성 친구 유무에 따라 유의한 차이가 있었다. 학교적응유연성은 학교 관련, 가족 관련, 친구 관련 스트레스와 유의한 상관관계가 있었으나, 자아탄력성과는 상관관계가 없었다. 결론적으로 여자 고등학생들의 학교적응에 있어 스트레스의 중재가 중요하다고 볼 수 있으며, 또한 학교에서의 생활, 선생님과 친구들과의 관계가 매우 중요하다는 것을 확인할 수 있었다. 따라서 여자 고등학생의 학교적응을 위한 중재 프로그램 개발 시 학교 관련 스트레스 요인을 감소시킬 수 있는 방안을 신중히 고려해 볼 필요가 있다.

• 한국산학기술학회논문지
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• 제21권6호
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• pp.116-126
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• 2020

본 연구의 목적은 이압요법이 60세 이상 노인의 수면장애 개선에 미치는 효과를 분석하기 위함이다. 자료수집은 국내외 컴퓨터 데이터베이스를 기반으로 하였다. 검색어는 'auricular', 'sleep', 'insomnia' 등을 조합하였다. 선정한 문헌의 비뚤림 위험평가는 RoB와 RoBANS도구를 사용하였고, 메타분석은 Cochrane Library의 RevMan 5.3 Program을 이용하였다. 총 386개의 문헌 중 7개 문헌이 선정되었다. 이압요법 중재 평균 횟수는 4.1회, 총 적용 기간은 평균 2.8주, 이압요법 1회 적용 시 유지 기간은 평균 4일이었다. 수면 장애 개선을 위해 자주 사용한 부위는 신문, 뒷머리, 심장으로 4편의 문헌에서 모두 사용되었다. 수면 정도는 총 중재 기간이 4주 미만인 문헌에서 WMD 25.66 (95% CI 20.18 to 31.14)로 대조군보다 유의하게 높았으며, 4주 이상인 문헌에서는 WMD 8.59 (95% CI 6.26 to 10.92)로 대조군보다 유의하게 높았다. 수면 만족도는 이압요법 1회 적용 시, 유지 기간이 3일 이하인 문헌에서 SMD 13.37 (95% CI 5.29 to 21.45)로 대조군보다 유의하게 높았으며, 4일 이상인 문헌에서 SMD 2.27 (95% CI 1.82 to 2.72) 대조군보다 유의하게 높았다. 이압요법은 수면 정도와 수면 만족도에 효과가 있어 노인의 수면 장애 개선에 효과가 있었다. 그럼에도 불구하고, 본 연구의 메타분석에 이용된 문헌은 모두 비 무작위 대조군 연구이며, 대조군에 아무런 조치도 취하지 않았으며, 주관적 도구만 사용하였다. 또한, 총 중재 기간, 1회 적용 시, 유지 기간에 따라 효과 크기가 다른 것으로 나타났으나, 문헌의 수가 적어 해석에 제한점이 있다.

• 대한간호학회지
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• 제26권4호
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• pp.833-852
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• 1996

Regular long term dance movement could be one of ways to induce improvement of psychophysiological variables, resulting in improvement of quality of life. However, there have been few studies to evaluate the effect of dance movement training on both physiological and psychological variables in the elderly. This study was focused to determine the effect of Korean traditional dance movement training on psychophysiological variables-body weight, body fat, lean body mass, muscle strength, muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satisfaction-in Korean elderly women. Thirty four subjects, aged between 65 and 75years who have normal cognition, sensory function, cerebellum function, cardiovascular function, participated in this study. Seventeen experimental group subjects were selected from E-elderly university in Kyung Gi province, and Seventeen control group subjects were selected from N-welfare facility in Seoul City. Seventeen experimental group subjects participated for 12weeks dance movement program. Korean traditional dance movement program was developed on the basis of Korean traditional dance and music by the author. The program consisted of approximately 50minutes of dance, 3times a week for 12weeks. During 50minutes workout, there were 15minutes of warm-up dancing, 25minutes of conditioning dance and 10minutes of cool-down dancing. The intensity for the conditioning phase was at between 60% and 65% of age-adjusted maximum heart rates. The body weight, body fat, lean body mass, muscle strength(grip strength, leg strength), muscle endurance, flexibility, agility, resting heart rate and blood pressure, depression and life satis-faction were measured prior to and following the experimental treatment. The participants in dance movement were interviewed focusing on subjective feeling following 12 week's regular dance movement. Data were analyzed with mean, standard deviation, percentage of change, X²-test, t-test, and ANCOVA test using SPSS PC/sup +/ program. Subjective feeling was categorized into cognitopsy-chological and physiological responses. Results were obtained as follows : 1) The body weight (F=15.52, p=.000), body fat (F=18.33, p=.000) and lean body mass (F=7.28, p=.011) of the experimental group were significantly lower than those of the control group following the dance movement training. 2) The leg strength (F=30.96, p=.000), muscle endurance (F=9.06, p=.005), agility(F=44.92, 000), flexibility(F=6.84, p=.014) of the experimental group were significantly higher than those of the control group following the dance movement training. There was no significant difference of grip strength(F=.43, p=.515) between experimental and control groups. 3) The heart rate(F=26.96, p=.000), systolic (F=10.40, p=.000) and diastolic(F=3.99, p=.005) blood pressure at rest of the experimental group were significantly lower than those of the control group following the dance movement training. 4) No significant difference of score of depression (F=3.49, p=.071) was observed between experimental and control groups. 5) Score of life satisfaction of experimental group was remarkably higher than that of control group following 12weeks of dance movement training (p<0.05). 6) Thematic responses about the dance movement following the training were positive. "I feel good" was the most frequent among cognitopsychological responses and "I feel lightness of body" was the most frequent among physiological responses. The results suggest that Korean traditional dance movement training can improve psychophysiological variables of Korean elderly.

• 보건행정학회지
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• 제27권1호
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• pp.39-46
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• 2017

Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

• 재활간호학회지
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• 제5권1호
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• pp.71-85
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• 2002

The purpose of study was to find out the relation ship between health perception and health status of clinical nurses. It also identified factors that related to health perception and health status of clinical nurses. The research design was descriptive correlational study. The subjects were consisted of 289 clinical nurses at the university hospital in Pusan. The data were collected from Feb. 12th to Feb. 28th, 2001 by self reporting structured questionnaires. The instruments used for this study were health perception questionnaire developed by Ware and Cornell Medical Index modified by Nam Ho-Chang (1965) for measuring health status. The data were analyzed by SPSS/PC+ program using frequency, percentage, mean, mean mark, standard deviation, t-test, ANOVA, Scheffe test, and Pearson's correlation coefficient. The results of this study were as follows. 1. The mean score of the health perception was $94.70{\pm}8.93$(range : 29-145), which the item mean mark score was $3.27{\pm}$0.31(range 1-5). The score of subarea of the health perception was the highest score in health concern ($4.57{\pm}0.58$) and the lowest score in rejection of sick role($2.94{\pm}0.32$). 2. The mean score of the health status was $102.83{\pm}7.61$(range: 57-114), which the item mean mark score was $1.80{\pm}0.13$ (range : 1-2). The mean mark score of the physical health status was $62.55{\pm}5.35$($1.69{\pm}0.14$) and the mental health status was $40.28{\pm}3.51$($1.83{\pm}0.16$). 3. There were statistically significant difference in the score of health perception according to the presence of disease(F=4.607, P=.011), job satisfaction (F=12.242, P=.000), and job place(F=2.838, P=.038). 4. There were statistically significant difference in the score of health status according to the age(F=3.164, P=.007), presence of leisure time(F=4.308, P=.039), presence of diseases(F=3.215, P=.042), job experience(F=9.064, P=.000), job satisfaction(F=7.182, P=.001), job place (F=5.638, P=.001), job position (F=3.900, P=.021). 5. Health perception of clinical nurse was shown to be positively related to health status(r=.543, p=.000). In conclusion, health perception of clinical nurse working at the university hospital was relatively high, and health status was fine. And the more health perception was high, the more health status was high. Therefore, the health promotion program for clinical nurses, should included health perception.