• 한국보건간호학회지
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• 제16권2호
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• pp.454-468
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• 2002

Historically, women's health needs have been viewed primarily as reproductive, and all other health needs have been dealth with without considering their responses to disease and treatment(Strickland & Giger, 1994). It has mostly been through the efforts of women's group, especially health care team, that more recognition has been given to the overall health of women worker in recent years. The purpose of this study was to examine the depression, self-esteem and health practice in order to identify health care strategies to improve health promotion among women workers in small workplace. The consisted of 94 women workers who work at small manufacturing industry. The data were collected from January to February, 2002. The instruments for this study was Rogenburgs self-esteem scale, Zung s depression self-reporting scale and Breslow & Enstrom s health habits scale. The analysis of data were performed with frequency, percentage, t-test, ANOVA. $\chi^2$ test, pearson correlation and multiple regression using SPSS Win 10.1 program. 1. The average depression score was 1.87 which is relatively low and the average self-esteem score was 2.75 which is relatively moderate. The total mean score for health practice was 4. 10(range 0-7) which is relatively high moderately. 2. Health practice had not a statistically significant correlation with depression and self-esteem, but the depression had a statistically significant correlation with self-esteem(r=-.401, p=.000). 3. There was not a significant difference In depression, self-esteem and health practice according to the general characteristics 4. There was a significant difference in sub category of health practice according to the status of living with family and status of marriage. As far as the health practice of women workers living with family practiced better health than women workers no living with family concerning breakfast(p=.03) and as far as the health practice of women workers no living with family practiced better health than women workers living with family concerning sleeping time(p=.04). There was a significant difference in breakfast(p=.04), smoking(p=.00), and BMI(p=.05) according to the status of marriage. 5. The major factor was age and explained for $7\%$ of health practice. The repeated study should be carried out to figure out the health practice and its related factors of female workers at small manufacturing industry.

• 대한간호
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• 제36권2호
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• pp.73-83
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• 1997

Bed rest is recommended to prevent postlumbar puncture headaches(PLPHA), but the period of bed rest varies in the literature from 6 hours to 24 hours. In clinical practice the period of bed rest varies but nursing methods for adults and children have little difference. In Seoul National University Hospital, children have been given at least 6 hours bed rest after a lumbar puncture. Pediatric oncology patients require a lumbar puncture for an initial diagnosis, follow up treatment or administration of chemotherapeutic agent. But it is difficult for young children to lie supine or to refrain from their usual activities in any way, and unpleasant problems related to a shortage of beds often occurs during discharge or in an outpatient setting. The purpose of this study is to substantiate the preventive effect of PLPHA by the period of bed rest, to identify the other factors that influence PLPHA, and to use the nursing methods proper to children. The subjects were 65 children, ages 1-17, undergoing treatment in the children's cancer center at SNUCH during the period June 1, 1995, to Aug. 31, 1995. The team nurses asked questions about PLPHA of the parents and children in order to fill out a questionnaire. The data were evaluated by percent, t-test, Chi-square test and Mann-Whitney U test. Result; 1. There was no significant difference relating the bed rest time spent to the occurrence of postspinal headaches (t-test). 2. There was a significant risk of PLPHA in the children who were irritable before procedure and/or had experienced previous PLPHA(p<0.05, ${x^2}-test$). 3. The following factors were not found to be associated with increased risk of PLPHA: previous puncture experience, giving analgesics, the choice of puncturist, inpatient/outpatient status, gauge of needle, purpose, the amount of CSF removed, gender, diagnosis, the number of peripheral WBCs, previous lumbago experience after LP, position after bed rest, age, the number of aural puncture at the time. A longer period of bed rest is unlikely to be more effective to prevent PLPHA and seems impractical. A shorter period will save time and effort. Perhaps it will also allay some of the fears which surround LP. So 1 hour bed rest after LP is suggested and nursing methods for emotional support should be investigated to reduce PLPH.

• 대한간호학회지
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• 제11권1호
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• pp.45-63
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• 1981

This study was done to determine the relationship between the anxiety levels of hospitalized psychiatric patients and various influencing variables. The purpose of this study was to determine factors that may help hospitalized psychiatric patients to experience lower levels of anxiety in relation to changing situations and provide the basic data for a dynamic approach which is important in the field of modern psychiatric nursing that understands and analyses the meaning of patients behavior. The anxiety may produce stress, which is a common experience among all human beings. Patients may merely feel uncomfortable in the state of mild anxiety, however, the severe state could be an obstacle to treatment and recovery from disease. The anxiety of the psychiatric patient is a factor which greatly influencing the patient's behavior, so his disorderd behavior is an expression of defence or pathologically fixed behavior. According the psychiatric patient's anxiety at the time of admission is the concern of the health team. The nurse's special concern has to do with understanding and supporting the patient and meeting his individual needs by frequent close contact during the entire hospitalization period, compared to other teamembers the nurse's responsibility in this regard is greated. So this study emphasizes the necessity of creating conditions these, but above all the psychiatric nurse should create a therapeutic environment by not only regarding the patient's behavior or symptoms but understanding the meaning of them. The subjects of this study were 57 psychiatric patients selected from the K neuropsychiatric hospital located in Kunsan city. Data were collected twice from the same patients within a 24 hour period after admission and 10 days after admission. (September 18th to November 8th, 1980). The data collected method was through direct interview, and the interview time was 20 minutes for each patient. Data analysis included Item Analysis & Internal Consistency Reliability Tests, Percentages, t-test, analysis of variance and stepwise multiple regression analysis. The findings of this study were as follows. A. Test of Hypothesis a. Hypothesis 1 :“The anxiety level of psychiatric patients within 24 hours after admission will be higher than those of the same patients 10 days after admission,”was accepted. (t = 3. 15 ; p < 0.005) b. Hypothesi 2:“The more the number of admissions the higher the level of anxiety related to two categories”, was accepted. (affective anxiety: F = 5.50, p < 0.005, Somatic anxiety: F = 9.12, p <.

• Child Health Nursing Research
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• 제5권2호
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• pp.211-234
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• 1999

The purpose of this article was to get hold of adolescent's needs for sex knowledge and to reveal their understanding of sex. These results may be applied to the sex education and counselling for adolescent. The participants of study were 267 students (females, 144 ; males, 123) who were the first and second grade form 1 middle and 2 high schools. They were asked to describe 3 questions that they wanted to know or to learn about sex. Their questions about sex were total 779(girls, subtotal 456, mean 3.2, boys, subtotal 323, mean, 2.6). These questions categorized to 9 items by content analysis. The items were ‘sexual drive, behavior and tendency(229, 29.4%)’ , ‘anatomy and physiology of reproductive system(140, 18.0%)’, ‘reproduction(131, 16.8%)’, ‘concept of sex(31, 4.0%)’, ‘acquaintance between the other sexes(17, 2.2%)’, and ‘the others(9, 1.2%)’ in order of frequency. The most frequent item that the student want to know or team about sex was ‘sexual drive, behavior and tendency’ except girls of sophomore in middle school. There were several features in participants' needs for sex knowledge as respects of the understanding of sex- biological sex, gender, and sexuality. The prominent feature in knowledge need of bio logical sex was that the participants had the interests according to their biological sex. They had the negative attitude to the phenomenons (ex, menstruation and pregnancy, phimosiectomy, etc) that they experienced or would experience due to their biological sex. A part of them asked the questions based the misconceptions and used the slangs or ‘××’, ect. to name the male or female genitalia. The male students wanted to know the female genitalia. The participants' understanding of gender reflected the sexism of our society, but they didn't accept and had doubts about the dual, hierarchical structure of that. The students, especially female seemed to be powerless to the harms of the sexual violence. Girls had much interest in their appearances and complained to our sexual culture that women comforted and served men. The participants had the dual perspective that the sexuality as respects of physiologic phenomenon was considered as natural but that as related to heterosexuals was as negative. And they deemed that men's sexual drive was stronger than women's and was difficult or was not able to be inhibited. They had much interests in homosexuality but reflected the negative attitude to that in our society. Adolescent felt wonder why the expressions of sexuality of adult were permitted but theirs were not. Lastly, a part of boys substituted querying the sexuality of animals for asking that of human. Maybe it was because of the embarrassment to talk about human's sexuality directly. The teenaged participants understood that the sex had not only the biological meanings but also the sociocultural meanings. They regarded the sex as natural and wanted to know it, but they had conceptions that it was difficult and embarrass to talk about it openly and directly.

• 대한간호학회지
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• 제1권1호
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• pp.27-43
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• 1970

This study is designed to find out proper nursing activities for the needs of the colostomy patients, i.e., mental and psychological as well as physical needs for rapid recovery, and to help them build up the follow-up care for proper social adjustment. The study is based on 268 cases out of 381 colostomy patient's records kept in Ewha Womans University Hospital, Yonsei Medical Center, and National Medical Center in between the period from Jan. 1953 to Jan. 1970. The items of study are mainly on etiology, sex, age, duration of hospitalization, mortality rate, seasonal frequency, time from the onset of illness to the admission of the hospital, signs and symptoms. 1. Frequency of onset by etiology: Neoplastic disease 112 cases (42%), Inflammatory disease 33 cases (12%), Congenital malformation 30 cases (11%), Intussusception 25 cases (9.3%), Trauma 24 cases (9%), Volvulus 17 cases (6.3%), and Crohn's disease 6 cases (2.2%). 2. By sex: male 167 cases (62.9%), and female 101 cases (37.1%). So the ratio of portion of male and female 2:1. 3. By age: under 1·year·old 27 cases (10.1%) highest, 41-50 yrs 54 cases (20.2%), 51-60 yrs 42 cases (15.5%), above 71 yrs 5 cases (1.9%). 4. Duration of hospitalization: the shortest is 2-days and the longest is 470 days. 1-20-days 52%, 40-60 days 14%. 5. Mortality rate: Under the 10-days-admission 19.5%, and the beyond 30-days-admission 3.9%. 6. Seasonal frequency: Higher in summer (32% ). 7. Signs and symptoms: abdominal pain (56%), abdominal distention (54%), vomiting (40%), bloody mucoid diarrhea (38%) , pain of anal region (18%), abdominal tenderness, anorexia, indigestion, constipation, disuria, tenesmus, high fever and chilling sensation, bile tingled vomiting. Nursing activities for the patient's physical needs are as follows: Skin care for colostomy region, Prevention of colostomy constriction and depression, Removal of an offensive odor, The use of colostomy bag-selection for, and demonstration of the use of inexpensive colostomy irrigation equipment, Personal hygiene, general skin care, care of hair, finger nails and toe-nails, Oral hygiene, sleep and rest, aquate, Daily activities, etc. Measures for regulation of bowl movement. Keeping the instruction of taking food, Preparing the meal and help for anorexia, Constipation and it's solution, Prevention of diarrhea, helping the removal of mucous, and stretch constricted steam as needed. Nursing activities for pt's socio-psychological needs are as follows; Help the patient to make decision for the operation, Remove pt's anxiety toward operation and anesthesia, To meet the pt's spiritual needs at his death bed, Help to establish family and friends cooperation, Help to reduce anxiety at the time of admission and it's solution, Help to meet religious need, Help to remove pt's anxiety for loosing his job and family maintenance, Follow-up studies for 7 cases have been done to implement the present thesis. The items of the personal interviews with the patients are as follows: Acceptability for artificial anus, The most anxious thing they had in mind at the time of discharge, The most anxious thing they hat·e in mind at present, Their friends and family's attitudes toward the patient after operation, Relations with other colostomy patients, Emotional damage from the operation, Physical problem of enema, irrigation, Control of diet, Skin care, Control of offensive odor, Patient's suggestions to nurses during hospital stay and after discharge. In conclusion, the follow-up care for colostomy patients shares equal weight or perhaps more than the post-operative care. The follow-up care should include the spiritual care for moral support of the patient, to drag him out of isolation and estrangement, and make him fully participate in social activities. It is suggested that the following measures would help to rehabilitate the colostomy patients (1) mutual acquaintance with other colostomy patients if possible form a sort of club for the colostomy patient to exchange their experiences in care (2) through the team work of doctor, nurse and rehabilitation specialists, to have a sort of concerted effort for betterment of the patient.

• Journal of Hospice and Palliative Care
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• 제22권4호
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• pp.185-197
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• 2019

목적: 호스피스 자원봉사자는 환자와 가족의 곁에서 보이지 않는 손의 역할을 하며 호스피스 완화의료팀 내에서 중추적인 역할을 수행하고 있다. 본 연구는 호스피스 자원봉사자 역량강화를 위한 지속교육과정의 효과를 혼합연구방법을 통해 파악하고자 하였다. 방법: 본 연구는 G도 J시에 소재한 G대학교의 매주 4시간씩 총 20시간의 호스피스 자원봉사자 지속교육 과정에 참여한 호스피스 자원봉사자 30명을 대상으로 하였다. 자료의 양적연구를 위해 대상자의 교육 전후 호스피스 태도, 의미 있는 삶, 자기효능감, 자원봉사활동 만족도를 조사하였다. 자료는 SPSS Window 20.0을 사용하여 기술통계, paired t-test, Wilcoxon signed-rank test로 분석하였다. 질적 연구를 위해 교육 참여자들에게 포커스그룹 인터뷰를 시행하였으며, 수집된 자료는 내용분석하였다. 결과: 호스피스 자원봉사자 지속교육 과정의 효과에 대한 양적연구 결과, 호스피스 자원봉사자의 호스피스 태도(t=-2.52, P=0.018)와 자기효능감(z=-2.06, P=0.40)을 향상시키는 것으로 나타났다. 질적 연구 결과, 참여자들은 자신의 신체를 다치지 않으면서 효과적으로 환자들을 돌볼 수 있는 방법과 영적 돌봄을 제공할 수 있는 실제적인 방법을 알기 원하였다. 참여자들은 삶의 마무리를 돕는 봉사에 대한 자부심과 베푸는 기쁨이 나의 삶에 감사로 돌아오기 때문에 지속적으로 봉사활동을 하고 있었으며, 개인시간 할애가 많음에도 불구하고 환자를 잘 돌보고 싶은 열정으로 지속적 배움에 대한 열의를 나타냈다. 결론: 호스피스 자원봉사자들은 지속교육 과정을 통해 환자와 가족을 돌보기 위한 역량 강화를 원하였으며, 이러한 교육은 호스피스 태도와 자기효능감을 높이는 것으로 나타났다. 자원봉사자들의 역량강화를 위해서는 대상자들의 신체적·사회적·영적인 접근을 모두 강화시키는 지속교육이 필요하다. 효율적이고 체계화된 지속교육을 위해서는 웹기반 교육과정 개발 및 지역별 컨소시엄 형성이 도움이 될 수 있다.

• 한국산학기술학회논문지
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• 제18권12호
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• pp.300-309
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• 2017

본 연구는 병원간호사를 대상으로 의료진 간 의사소통 능력과 이직의도 관계에서 자기효능감의 매개효과를 규명하기 위해 실시된 서술적 조사연구이다. 본 연구의 대상자는 일 지역 두 개 대학병원에 근무하는 간호사 208명이었다. 수집된 자료는 SPSS 23.0을 이용하여 분석하였으며 기술통계, t-test, one-way ANOVA, Pearson correlation coefficients correlation을 확인하였다. 또한 자기효능감의 매개효과를 확인하기 위해 Baron & Kenny의 3단계절차를 이용한 multiple regression으로 분석하여 Sobel test로 간접효과를 확인하였다. 연구결과 의사소통 능력과 이직의도 간에 부적상관(r=-.22, p=.001)이 있었으며, 의사소통 능력과 자기효능감 간에는 정적상관(r=.61, p<.001), 자기효능감과 이직의도 간에는 부적상관(r=-.25, <.001)이 있었다. 의사소통 능력과 이직의도의 관계에서 자기효능감의 매개효과는 1단계에서의 의사소통 능력이 이직의도에 미치는 영향은 유의하였지만(${\beta}=-0.22$, p<.001), 3단계에서의 의사소통 능력은 이직의도에 유의한 영향을 미치지 않아(${\beta}=-0.11$, p=.194) 의사소통 능력과 이직의도의 관계에서 자기효능감이 유의하게 완전 매개함을 확인하였다(z=-2.15, p=.032). 따라서 본 연구결과 의사소통 능력을 향상시켜 자기효능감을 높여주는 것이 병원 간호사의 이직의도를 줄이는데 기여할 수 있을 것으로 보인다.

• 한국의료질향상학회지
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• 제18권1호
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• pp.27-36
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• 2012

Objectives : A protocol called "critical pathway" was developed to standardize the management of hospital patients the day after they underwent gamma knife radiosurgery. The quality of improvement in patient outcomes was evaluated. Methods : Critical pathway was developed, according to the regulations of the I hospital, by analyzing the medical records of 22 inpatients who underwent gamma knife surgery within the period from January to April 2011 on the day of the surgery. The study included a group of 22 patients admitted to the hospital the day after they underwent gamma knife radiosurgery, between July and September 2011. The control group included 22 patients who had surgery employing the same method within the period from May to June 2011. To measure the effects on quality improvement, the average length of stay, the execution rate of the hospital discharge notice system, daily hospital revenue, and the satisfaction of the patients and the medical team were assessed. The patient questionnaire employed a four-point Likert scale while the medical-staff questionnaire employed a five-point Likert scale. Result : The average length of stay was significantly shorter in the study group compared to the control group (2.3 days vs. 3.8 days, P<0.05). The execution rate of the hospital discharge notice system was higher in the study group (100% vs. 72%) than in the control group. Daily hospital revenues were higher by 264,178 Korean won in the study group when compared to the control group. The study group showed greater satisfaction of patients compared to the control group based on a four-point Likert scale (P<0.05). The study group showed greater satisfaction in medical team compared to the control group based on a five-point Likert scale (P<0.05). Conclusion : The development and implementation of a critical pathway protocol for hospital admission the day after gamma knife radiosurgery is an effective care process that improves the clinical quality.

• 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.

• 보건행정학회지
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• 제9권1호
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.