• 대한간호학회지
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• 제41권4호
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• pp.433-443
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• 2011

Purpose: Clinical training for nursing students is limited to rudimentary skills to avoid potential risks. Simulation-Based Training (SBT) can overcome the shortcomings of clinical training. We evaluated the educational effect of SBT for obstetrical nursing students using high-fidelity simulation courses. Methods: We developed a simulation program for obstetrical nursing students to practice nursing skills that are necessary to provide quality care. The program consisted of four sessions. 1st: An orientation and a preliminary test. 2nd: Learning core skills required in obstetrical nursing. 3rd: Testing each student with scenario. 4th: Providing a debriefing session. At the beginning of the program, students were surveyed about their self-confidence in obstetrical nursing care, and at the end of the program, they were surveyed about the adequacy of SBT as well as self-confidence. Results: Students' self-confidence showed a significant difference before and after simulation. Mean adequacy of SBT was $7.15{\pm}1.35$ (out of 10). Most students became more interested in Women's Health Nursing after SBT. Conclusion: The results from evaluating the effects of simulation-based obstetrical nursing training show that SBT provides invaluable clinical experience for obstetrical nursing students by overcoming the lack of actual clinical involvement in clinical training programs.

• 여성건강간호학회지
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• 제18권3호
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• pp.180-189
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• 2012

Purpose: The purpose of this study was to evaluate the effects of clinical practice and simulation-based practice for obstetrical nursing in terms of self-efficacy, practice satisfaction, and practice stress. Methods: A non-equivalent control group post test design was used. The participants were 171 junior nursing students, 103 in the experimental group, and 68 in the control group. Simulation-based practice consisted of nursing assessment during labor, nursing assessment and intervention for normal and high risk mother, nursing education for mother and family during labor, and open lab. The experimental group participated in simulation-based practice for two days and the control group participated in clinical practice at delivery room for two weeks. Results: The experimental group showed higher level of self-efficacy (p= .043), practice satisfaction (p<.001) and practice stress (p=.003) compared to the control group. Conclusion: Simulation-based practice is an effective learning method for obstetrical nursing and can be used as the alternative for clinical practice. However, stress management strategies are needed for simulation-based practice.

• 디지털융복합연구
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• 제13권9호
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• pp.377-386
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• 2015

본 연구는 분만간호에 대한 융복합 기반 시뮬레이션 실습의 효과 및 요구도를 파악하기 위해 실시하였다. 연구대상은 충남 소재 일개 대학 간호학과에 재학 중인 3학년 학생 47명을 대상으로 하였다. 자료수집은 2012년 2월 13일에서 25일까지 실시하였으며, 자가보고형 설문지를 이용하였다. 분만간호에 대한 융복합 기반 시뮬레이션 실습은 1일 8시간씩 총 2일 동안 4개 영역으로 나누어 실시하였다. 시뮬레이션 실습 후 분만간호에 대한 자기효능감(t=-14.74, p<.001) 및 임상술기능력(t=-17.51, p<.001)이 유의하게 증가하였으며, 실습만족도가 실습스트레스에 비해 높게 나타났다. 시뮬레이션 실습필요도는 10점 만점에 7.96점이었으며, 실습만족도가 높을수록 실습필요도가 높게 나타났고, 임상실습 전에 시뮬레이션 실습을 실시하는 것에 대한 요구도가 임상실습 후 시뮬레이션 실습을 실시하는 것에 비해 높게 나타났다. 따라서 분만간호에 대한 임상실습을 보완하는 방안으로 시뮬레이션 실습을 활용하는 것이 필요하며, 시뮬레이션 실습은 임상실습 전에 실시하고, 시뮬레이션 실습필요도에 대한 학생들의 인식을 증가시키기 위한 전략 수립이 필요하다고 할 수 있다.

• 성인간호학회지
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• 제24권4호
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• pp.358-369
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• 2012

Purpose: This study was performed to compare the costs of nursing interventions implemented for the obstetrical and gynecological patients using Korean Reimbursement System and ABC codes system developed in the US for costing out interventions performed by health care professional. Methods: First, the narrative data on nursing interventions were extracted from electronic medical record system of a tertiary university and mapped with Nursing Intervention Classification (NIC) by two researchers until 100% consent was reached. Narrative nursing interventions mapped with NIC were then remapped with ABC codes system using the electronic program developed in the research. The mapping data were analyzed with real numbers, frequency, percentage, mean, and standard deviation. Results: More nursing interventions were mapped with ABC codes than Korean reimbursement system. Total of 97 different types of narrative interventions could be mapped with NIC, 43 NIC interventions could be reimbursed by ABC code but only 16 NIC interventions were reimbursed by Korea Reimbursement System. Conclusion: Korean medical insurance fee system needs amendment to include more comprehensively interventions performed by nurses which are very important to patient outcomes. Further study is needed to develop strategies to costing out nursing interventions.

• 대한간호학회지
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• 제10권1호
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• pp.41-55
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• 1980

The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 ％. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ￦22,650 while its daily average was ￦2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(￦10,880) and next in neurologic cases(￦ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (￦5,200) and integrated (￦5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

• 기본간호학회지
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• 제8권1호
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• pp.7-23
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• 2001

This study was done to provide basic data on prevention of breast cancer by identifying and analyzing risk factors for breast cancer in Korean women. The data were collected from three hospitals. The data from Jan. 1995 to Dec. 1997 was based on the patient recordings and personal contacts if possible. Data from 1998 to 1999 was collected from 280 inpatients and outpatients diagnosed as breast cancer. From this data, information about the risk factors of breast cancer could be acquired. The factors are scaled according to the degree of risk. Menstrual history, obstetrical history, family history. lactation period, life style were given 5 point, and body mass index was given 4 point. Using one-way ANOVA. the most important risk factors were identified and analyzed by multiple regression. The conclusion of this study are as follows : General factors which would show an effect on the results of the multiple regression included risk factors such as menstrual history, obstetrical history, lactation period, family history, and life style factors including mortal state, monthly income, educational level, job and age. Family history(R=0.481) was found to be the highest risk factor(23.1%) affecting breast cancer risk. The next factors were dying hair(R=0.603), drinking(R=0.846), body mass index(R=0.885), smoking(R=0.916), age of menopause(R=0.937), pregnancy age of first full-term(R=0.957), eating vegetable(R=0.980) and the number of full term pregnancies in that order. The sum total(R=0.986) of all the above factors accounted for 97.3% of the risk of breast cancer for Korean women. In conclusion, it was found that family history and dyeing hair were the highest risk factors for breast cancer. It is recommended that those with a family history of breast cancer should have regular breast examinations, and those who often dye their hair should reconsider this practice.

• 여성건강간호학회지
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• 제7권4호
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• pp.536-546
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• 2001

The purposes of this descriptive study were to identify the prevalence rate of urinary incontinence(UI) and the differences in frequency of incontinent and normal women by general characteristics, obstetrical history, and the conditional events for urinary incontinence of the elderly women in a community. By the results of this study, it is intended to provide nursing practice guidelines for incontinent women. The research design of this study was a preliminary descriptive study. The 173 subjects were 55 years old and over, and resided in a small city area. Data were collected from June 20 to July 20, 2001, by an interview or a self-report with questionaire. The questionaire was composed of items of general characteristics, obstetrical characteristics, and conditions of UI by the modified Henderickon's Stress Incontinence Scale(1981). The results were summariezed as follows: 1. The UI prevalence rate of the sample was 64.2%. Of the incontinent women, 31.5% had experienced UI for a period of three to five years, and 84.7% had never treated or managed their UI. Frequency of UI was once or twice times per month(46.8%). 2. The total mean of UI on the scale in the incontinent women was 25.50 of 85, ranging from 18 to 41. 3. The most frequent condition of UI was coughing, followed by laughing, sneezing, heavy exercise, and preparation of urination in descending order. 4. There were significant differences in age, education, social activity, and urinary difficulty between the incontinent women and the normal women. 5. There were significant differences in frequency of spontaneous abortion, age of menopause between the incontinent women and the normal women. 6. There were no significant differences in number of delivery, frequency of artificial abortion, age of the last delivery, and postal health management between the incontinent women and the normal women. In conclusion, the incidence of UI in this study was high, but there were no effective treatments or management. It is suggested to provide the adult women with knowledge about UI, and to educate preventive behavior and control skill of urinary incontinence. Also episodes of urinary incontinence were high in the situation of sudden increase of abdominal pressure. This data can be used for the prevention strategy of urinary incontinence, In future research it is recommended to identify comprehensive factors related to urinary incontinence including psychosocial factors, and effective strategies of urinary incontinence.

• 여성건강간호학회지
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• 제5권1호
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• pp.80-95
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• 1999

The purpose of this study was to investigate the characteristics of low birth-weight infants and their's mothers, and to identify the factors which influenced to delivery of L.B.W infants. The data derived from K. General Hospital and J. obs & gyn clinic in pusan from January, 1998 to August, 1998, which were from mothers of having B. W infants. The factors used for this study were characteristics of general, obstetrical, environmental aspects and physical and psychological life experiences during pregnancy. Analysis of data obtained were computerized statistically by using SPSS 7.5 WIN program. the data were analysed as number, frequency, percentage, t-test and ANOVA. The major results obtained of this study were as follows : 1) Gender that L.B.W infants were male in 47.2% and female in 52.8%, body weight of 2001~2500gm was above 8 in 68.5%, and below 5 in 1.8%. The L.B.W infants with complications were 7, which were 6.5%. The kinds of malformations were the Cleft palate & lip, Hyper-kalemia, Hypoglycemia, Meningocele, CHD, Down syndrome and each of them marked 0.9%. 2) In the general characteristics of pregnant women, the age group of 25~29 years was the most common as 46.3%. Over 35 years of age, elderly gravidas were in 7.5%. the height of 156~160cm was the most common as 52.8%. pregnant women of below 150cm height was in 3.7%. body weight of 51~55kg was the most common as 38%. pregnant women of below 45kg were in 19.4%. The women with smoking and drinking episodes during pregnancy were 1.9% and 25%. In the status of marriage, married women were in 95.4%, unmarried ones were in 1.9%, and unmarried couples were in 2.8%. Iin he obstetrical characteristics of pregnant women, pregnant women with gestational age under 37wks were in 45.4%, and the ones over 38wks were 54.6%. At the methods of delivery, normal spontaneous vaginal deliveries were in 51.9%, which were the most common, cesarian section deliveries were in 47.2%, and breech deliveries were in 0.9%. In the environmental characteristics of pregnant women, 40.8% of pregnant women lived in house or apartments with stairs, 23.1% of them lived in the high altitude. the pregnant women who ran a household without a helper were in 65.7%. In the pregnant women who had underwent life experiences of physical and psychological stress during pregnancy. life experiences of physical stresses were described as persistent fatigue due to lifestyle, traumatic experience, illness, move away with an effort, physical impact caused by discord. life experiments of psychological stresses were describeded as trouble with their husbands, discord with one's husband family, family problems, and conflicts due to environmental factors, etc. The number of the pregnant women who had complications during pregnancy was 32, which was 29.6% totally. Among them, pre-eclampsia was in 12.1% and the premature rupture of membrane in 7.4%. 3) In the analysis of the general, obstetrical, and circumstantial characteristics and L.B.W infants. There were statistical difference significantly between the gestational age of pregnant women(F=12.035, P=.000), and the status of marriage(F=3.207, P=.044), and maternal complication(t=2.344, P=.021) etc.

• 기본간호학회지
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• 제5권2호
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• pp.353-361
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• 1998

The purpose of this study was to determine the predictors of health promoting behavior in postpartal $4{\sim}6$ week women. The sample consisted of 104 postpartal women who experienced a vaginal delivery at four obstetrical clinics located in Kwangju city. Data were collected for two months from June 1 to July 30, 1997. Analysis of the data was done by use of percentage, t-test, ANOVA, Pearson's Correlation Coeficients, and Stepwise Multiple Regression. The results of this study were summarized as follows : 1. The range of total HPLP score was from 93 to 182 and the mean score of that was 142.28. In comparison of mean scores defending on each item of six demensions, self-actualization demension tended to showed hightest score(3.33) and exercise & rest demension, the lowest score(2.47). 2. The HPLP score was not significantly different defending on the general characteristics. 3. The HPLP score showed a positive correlation with family-support(r=.51) and self-efficacy(r=.41), but a inverse correlation with perceived barriers(r=-.27). 4. By using stepwise multiple regression analysis it was determined that the main influencing factors on the HPLP score were family-support(26%) and self-efficacy (8%). These variables made it possible to explain 34% of variance in HPLP score.

• 여성건강간호학회지
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• 제6권3호
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• pp.358-371
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• 2000

The purpose of this study was to provide the basic, data for developing a program for effective prevention for Postpartum Depression (PPD) by investigating the level of PPD in postpartum 2 weeks women. The subjects were 384 women who visited obstetrical clinics for postnatal care. The data were collected from June 29. 1999 to April. 2000, using a 46-item questionnaire related to PPD, and analyzed by SAS program for t-test, ANOVA, Scheffe test, stepwise multiple regressions. The results were as follows : 1. The level of PPD according to general characteristics Women had mild PPD (Min score; 46.0, Max score; 124.0). The PPD levels were significantly differences according to religion and marital satisfaction (p<0.05). 2. The level of PPD according to obstetrical characteristics 1) Characteristics related to pregnancy The PPD levels were significantly differences according to mood change, confidence of body weight recovery, depression related to appearance change, husband's help to housework, and husband's emotional support (p<0.05). 2) Stressful events during pregnancy The PPD levels were significantly differences according to financial problem, conflict between partners, conflict between family, and husband's job change (p<0.05). 3) Characteristics related to delivery and post natal period The PPD levels were significantly differences according to baby's health state, parenting confidence, and difficulties related to postpartum care (p<0.05). 3. The variables to predict postpartum depression in postpartum women are depression related to appearance change (10.4%), parenting confidence (8.8%), husband's help to housework (2.7%), confidence of body weight recovery (2.4%), husband's job change (1.9%), baby's health state (1.9%), difficulties related to postpartum care (1.6%), mood change (1.2%), conflict between partners (0.6%), marital satisfaction (0.5%), financial problem (0.4%). The sum total of all the above variables can account for 32.4% of postpartum depression. 4. The level of PPD according to PPD factors. Women had the highest degree of PPD in biophysiological phenomena-disturbance of physical functioning factor. The factors of relationship to baby-negative feeling and cognitive phenomena-self concept disturbance were showed the lowest degree of PPD. As a result of the above findings, a systemic and individualized program is strongly recommended for PPD prevention, diagnosis, and care for PPD in postpartum women. In near future, this study should be expanded to investigate the coping skills according to the PPD levels in postpartum women.