• 제목/요약/키워드: PC3

검색결과 5,180건 처리시간 0.048초

가정 호스피스케어환자 방문간호 조사분석 (A Study on Home Visiting Hospice Care of the Terminally Ill Patients)

  • 이소우;이은옥;박현애;오효숙;안효섭;허대석;윤영호;김달숙;노유자
    • Journal of Hospice and Palliative Care
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    • 제1권1호
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    • pp.39-46
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    • 1998
  • 목적 : 오늘날 호스피스 운동은 만성질환자가 급격히 증가함에 따라 인간의 삶을 추구하여 이루어낸 가장 완벽한 대답의 하나가 되고 있다. 우리의 1996년, 1997년의 연구에서 말기환자와 그 가족들에 대한 조사를 통해 한국 호스피스의 현재 상황을 파악하였다. 또한 호스피스케어 팀과 자원봉사자와 호스피스환자 관리를 위한 정보서비스 시스템을 개발하였다. 본 연구는 호스피스 정보서비스 시스템를 통한 간호사의 가정방문 호스피스케어와 그 문제점을 분석하였다. 방법 : 1997년 10월 1일부터 1998년 3월 31일까지 서울대학교병원 등에서 의뢰받은 26명의 말기암환자를 대상으로 하였다. 데이터 베이스와 홈페이지를 통해 호스피스케어에 필요한 정보를 갖춘 호스피스 정보서비스 시스템을 인터넷을 통해 방문간호사에게 제공하였고 방문간호사들은 이 시스템을 교육받고 환자 방문시 노트북 컴퓨터를 소지하여 호스피스 정보서비스 시스템을 통해 호스피스케어를 제공하였으며 첫 방문시와 호스피스케어동안에 환자들의 신체적 심리적 사회적 자료를 수집하였다. 결과 : 연구기간동안 26명중 16명이 사망하였으며 사망자의 평균 생존기간은 20.7일이었다. 첫 방문시 식욕부진(96.2%), 거동장애(88.5%), 통증(84.6%)이 주요한 증상이었으며 226개의 간호진단 중 영양부족과 통증이 가장 흔한 진단이었다. 가족은 환자보다 호스피스케어를 더 잘 이해하고 더 요구하였다. 대부분의 환자와 가족들은 간호사에게 영적 사회적 간호를 요구하지 않았다. 결론 : 시범사업을 통해 환자와 방문 호스피스 간호사에게 통증과 영양 관리에 대한 보다 많은 정보를 제공하여야 하여야 함을 알 수 있었다. 호스피스 정보서비스 시스템은 영적 사회적 케어에 대한 정보와 인력을 보안되어질 필요가 있다.

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화학요법을 받는 부인암환자의 구강불편감에 관한 연구 (A study on oral discomfort in gynecological cancer patients undergoing chemotherapy)

  • 정재원
    • 대한간호학회지
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    • 제25권2호
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    • pp.372-389
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    • 1995
  • The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

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질소 동위 원소 분석을 이용한 경기도 지역 지하수 중 질산태 질소 오염원 구명 (An Investigation of the Sources of Nitrate Contamination in the Kyonggi Province Groundwater by Isotope Ratios Analysis of Nitrogen)

  • 류순호;최우정;한광현
    • 한국토양비료학회지
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    • 제32권1호
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    • pp.47-56
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    • 1999
  • 경기도 군포시 및 수원시에서 축산지역과 영농지역 및 주거지역의 토지이용방식을 반영하는 14곳의 지하수 과측정을 대상으로 1997년 1원부터 12월까지 지하수 시료를 채취하여 지하수질의 화학성과 질산태 질소농도를 소사한 결과 지하수의 양이온 조성은 토지이용방식에 따라 큰 차이가 없었지만, 음이온 조성에서는 축산지역 소재 지하수의 $NO{_3}^-$의 비율이 상대적으로 높았다. 영농지역 지하수의 질산태질소 농도는 영농활동의 영향으로 4월과 7월사이에서 증가하는 것으로 나타났으며, 축산지역 지하수는 강우유형에 영향을 받는 것으로 판단할 수 있었고 주거지역의 질산태질소농도는 시기에 상관없이 일정한 수준을 유지했다. 질산태 질소의 오염원을 구명하기 위해 Urea, Ammonium sulfate, 축산 폐수, 청정지역 지하수 중에 포함된 질소의 동위원소비를 측정한 결과 각각 +1.4, -2.7, +27.2, +5.5% 로 나타나 이 ${\delta}^{15}N$ 값을 근거로 지하수중 질산태질소의 ${\delta}^{15}N$ 값이 +5% 이하인 경우 화학비료영향 +5~+10‰은 토양 질소, +10‰ 이상은 축산폐수 또는 생활하수 영향으로 오염원 구분기준을 설정할 수 있었다. 관측정 지하수중 질산태 질소의 ${\delta}^{15}N$ 값은 대부분 토지이용방식에 따른 오염원을 반영했지만, 영농과 축산이 복합적으로 운영되는 농촌지역의 특성상 단일 오염원보다는 두 종류 이상의 오염원이 공동으로 지하수질에 영향을 미치는 것으로 판단할 수 있었다. 또한 각 오염원의 오염 기여도는 관측정 주위의 토지이용방식에 따라 차이가 있었지만, 같은 관측정 내에서도 시기에 따라 그 기여도가 변함을 알 수 있었다.

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달맞이꽃 종자 추출물의 생리활성 (Biological Activity of Oenothera Biennis Seed Extracts)

  • 조현동;김두현;김민근;이용석;서권일
    • 생명과학회지
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    • 제28권9호
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    • pp.1048-1055
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    • 2018
  • 본 연구에서는 달맞이꽃 종자 물, 에탄올, 메탄올 및 70% 에탄올 추출물의 총 폴리페놀 및 플라보노이드 함량, 항산화, 신경세포 손상 억제, 항암, 대식세포 면역조절 활성 및 에 대하여 비교하였다. 달맞이꽃 종자 추출물 중 메탄올 추출물에서 각각 31.90 mg GAE/g 및 20.66 mg QE/g의 총 폴리페놀 및 총 플라보노이드 함량을 나타내었으며 나머지 추출물과 비교하여 가장 활성이 높았다. 라디칼 소거능 및 환원력 활성은 달맞이꽃 종자 추출물의 처리에 따라 농도의존적으로 증가하였다. 또한 물, 에탄올 및 메탄올 추출물을 $25-100{\mu}g/ml$의 농도로 전처리 하였을 때 글루탐산에 의해 유도되는 신경세포 손상 효과를 감소시키는 것으로 확인되었다. 암세포의 경우 메탄올 추출물이 간암, 폐암, 유방암 및 흑색종 피부암의 세포 생존율을 효과적으로 감소시켜 낮은 $IC_{50}$ 값을 보였으며 대장암과 전립선암에서는 물 추출물과 에탄올 추출물이 가장 낮은 $IC_{50}$ 값을 나타내었다. 또한, 달맞이꽃 종자 70% 에탄올 추출물은 RAW 264.7 마우스 대식세포의 생존율에 영향을 미치지 않는 농도에서 유의적으로 산화질소(nitric oxide, NO)의 생성을 통해 대식세포의 면역활성을 유도하였다. 따라서, 달맞이꽃 종자 추출물은 풍부한 폴리페놀 함량과 다양한 생리활성 효능을 나타내며 이를 통해 달맞이꽃 종자 추출물을 기능성 식품 원료 및 천연물 의약품으로 이용할 수 있을 것으로 사료된다.

상호교류분석으로 본 간호학생의 자아상태와 스트레스 대처방법 및 건강상태에 관한 연구 (Study on Ego states in the view of Transactional analysis, Coping style and Health states of Nursing Students)

  • 원정숙;김정화
    • 동서간호학연구지
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    • 제7권1호
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    • pp.68-81
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    • 2002
  • The purpose of this study is to analyze the type of ego states and stress coping style on female college students who are in the course of nursing study. This study is performed in the view of Transactional Analysis and designed to scrutinize descriptive correlations between the type of ego states and stress coping style. The subject is consists of 144 freshmen and sophomore, 138 junior and senior students group, who are students of K nursing college located in Seoul. The sampling investigation period is on Sept. 14, 2002 to Oct. 26, 2002. The measuring instrument used for Transactional Analysis ego state is 50 items Ego-gram research paper devised by Dusay(1997). For studying coping style, Folkman & Lazarus's measurement(1984) was adopted, which is translated and modified by Han, and Oh,(1990). Health states is adopted by standardized health inspecting instrumental table (Cornell Medical Index:CMI) which is designed for Korean people by Ko and Park(1980) Statistic average and standard deviation were generated by using SPSS PC+, t=test and Pearson correlation. The results were as follows: 1) In the type of ego states on both groups indicated the arithmetic apex NP(maximum value), then the point A was high and the data made a down slope to point AC. In the comparison to type of ego states between two groups, only at point CP, the data value of upper year students represented higher than that of lower year ones by c(t=2.28, p=.023). 2) Stress coping style of whole students were highly and affirmatively dedicated to research. Especially hopeful aspect(t=.67, p=.05), relaxation of tension(t=-2.16, p=.03) made significant difference each other in the view of arithmetic calculation. 3) In view of nursing students' physical health states, there is significant difference in past history(t=2.50, p=.013) and in case of mental health states, there are considerable discrepancies between lower group(73.52) and upper group(75.11)(p<.05). In view of all field, state of tension(t=2.13, p=.048) has difference. 4) While verifying coping style in terms of ego states level between lower and upper students group, In type CP, high level ego states group indicated significant difference on stress coping style area than low leveled group and made such sequences as the central point of problem, In type NP, sequences such as the central point of problem, In type A, the central point of problem, In type FC, hopeful aspect and In type AC, hopeful aspect and indifference were derived significantly different (p<.05). 5) While verifying health state differences in the level of lower and upper ego states, In type FC, low level group(150.29) marked higher point than upper group(145.19), there is remarkable discrepancy and so did whole health state(p=.014), In type AC both mental state(p=.000) and whole health state (p=.015) showed differences. 6) When analyzing correlations between whole students' ego states, copying style and health state, all type of ego state showed differences(p<.001). In correlations between ego state and health state, in type FC physical state had an apex and there are inverse correlations among the other types. Especially, type FC showed inverse correlations with great discrepancies(p<.05). In mental state, type NP(${\gamma}=.198$, p<.001) and type A(${\gamma}=.166$, p<.05) represented straight correlations with remarkable differences. Especially, In type AC showed inverse correlations(${\gamma}=.282$, p<.001). In case of correlations between copying style and health state, indifference(${\gamma}=-.157$) and relaxation of tension(${\gamma}=-.158$) presented great difference(p<.05). In mental state, central point of problem and search for social support showed straight correlations with great discrepancies(p<.05), hopeful aspect and indifference showed inverse correlations with considerable differences(p<.001).

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3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구 (Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital)

  • 유호신
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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중금속이 토양용액 중 화학종 변화에 미치는 영향 (Changes of Chemical Species in Soil Solution Induced by Heavy Metals)

  • 양재의;이기원;김정제;임형식
    • 한국환경농학회지
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    • 제14권3호
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    • pp.263-271
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    • 1995
  • 중금속에 의한 토양오염을 화학적으로 평가하기 위한 일환으로 토양을 중금속으로 오염시킨 후 토양용액을 추출하여 pH, 이온강도, 이온농도, 화합물형태 변화를 분석했다. 토양이 Cu와 Cd에 의해 오염될수록 토양용액의 이온강도는 증가했다. 이런 변화는 Cd보다 Cu에 의해 더 컸다. 토양용액 중의 Cu와 Cd의 농도는 가한 양(量)에 비해 소량으로 존재했으나 처리량에 비례하여 금속의 농도는 증가했다. 토양용액 중의 Cd의 농도는 Cu보다 훨씬 높았다. 토양용액 중의 Ca, Mg, K의 농도는 중금속에 의해 증가되었으나 주로 free ion상태로 존재했으며 화합물형태는 Cu나 Cd의 처리에 의해 변화되지 않았다. 토양용액 중 중금속이온의 화합물의 변화 경향은 Cu와 Cd이 달랐다. Cu의 경우 토성과 pH에 의해 영향을 받았는데 pH가 낮은 SiCL 및 SL 토양에서는 free $Cu^{2+}$가 95 molar % 이상으로 주된 화합물형태이었고 pH가 높은 LS토양의 경우 free $Cu^{2+}$과 Cu-hydroxide이 주된 화합물형태로 Cu처리량에 따라 이들 화학종의 molar %는 변화되었다. Cd의 경우 free $Cd^{2+}$과 Cd-chloride 화합물이 주된 화합물형태이었고 Cd처리량이 증가함에 따라 $Cd^{2+}$는 감소한 반면 Cd-chloride 화합물 형성은 증가했다. 중금속에 의한 토양용액의 pH감소, 중금속의 흡착에 따른 양이온의 일시적인 증가, 중금속의 화합물 변화들은 식물영양적 측면에서 볼 때 식물에 불리한 변화로 간주되며, 중금속의 생물유효성과 독성을 평가하는 자료로 활용될 수 있을 것이다.

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노인의 근력강화운동이 일상생활기능 및 삶의 질에 미치는 효과 (An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly)

  • 김희자;홍여신
    • 지역사회간호학회지
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    • 제6권1호
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    • pp.55-73
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    • 1995
  • An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly Recent statistics shows that the aged are the fastest growing segment of our population by increasing life span. The age group of over 60 shows multiple health problems and the most serious handicapping problem of these. are related to the changes in muscular skeletal system. With aging, people lose. their muscle mass and muscle strength resulting from biological changes and physical inactivity. Studies documented a 30-50% loss of muscle mass in an advanced age and thus, ordinary life activities can be seriously affected due to weakened muscle strength. Preservation of muscle strength of lower limb is especially important in the aged. Since it is readily affected from reduced physical activity in old age, sometimes to the detriment of moving or walking. So muscle strength exercise program designed for the elderly to improve leg muscle strength and leg muscle endurance. The research design used was nonequivalent control group pretest - protest design. The purposes of this study were to test the effect of muscle strength exercise program utilizing Leg Press on muscle strength, muscle endurance, instrumental activities of daily living(IADL), cognitive perceptual variables and quality of life. Forty nine subjects participating in this study consisted of twenty four male and twenty five female. Twenty four experimental group subjects were selected from C-institution in Chung Buk province, and twenty five control group subjects were selected from O-institution in Chung Nam province. The mean age of subjects was 72.8 years. Muscle strength training program utilizing Leg Press for the experimental group was carried out three times a week for 9 weeks. The data was collected from August, 1993 to October, 1993. Data were analyzed with $X^2-test$, t-test, ANCOVA test, Kruskal Wallis 1-Way ANOVA test using SPSS PC program. Results were obtained as follows : 1) The experimental group showed significantly higher scores on muscle strength (leg lift strength, back lift strength and grip strength) and muscle endurance than control group after the experiment $\ulcorner$F=52.35(p=.001), F=54.07(p=.001), F=6.97(p=.011), F=18.17(p=.001)$\lrcorner$ 2) Experimental group were significantly higher scores on IADL than control group(F=7.51, p=.009). 3) Experimental group showed significantly higher scores on economical state and self esteem aspects of the quality of life scale than control group $\ulcorner$F=10.59(p=.002), F=6.97(p=.011)$\lrcorner$. But there were no differences in emotional state, physical and functional state and relationship with reatives in the quality of life between groups. 4) Scores on IADL showed a significant difference with the level of muscle strength and muscle endurance $\ulcornerx^2=7.73(p=.025),\;x^2=8.86\;(p=.011)\lrcorner$ 5) Scores on self esteem and physical and functional state aspects of the quality of life scale showed a significant difference with the level of IADL $\ulcornerx^2=11.39(p=.003),\;x^2=9.02(p=.011)\lrcorner$. 6) Scores of experimental group after the experiment in cognitive perceptual variables (perceived benefit on exercise, perceived health status, self efficacy, emotion on exercise) were significantly higher than those of control group $\ulcorner$F=32.09(p=.001), F=5.07(p=.029), F=20.63 (p=.001), F=30.38(p=.001)$\lrcorner$. As a result of this study, the effect of strength training exercise program with Leg. Press had improved muscle strength, muscle endurance, IADL, and the perception of self esteem, physical and funtional state, and economical state. Thus strength training program could be beneficially applied for the prevention of disablity and promotion of health and wellbeing in the aged easily and safely. The subjects in the experimental group have maintained their exercises till six months after the cessation of the experiment. This seem to illustrate that changes in cognitive perceptual variables and the improvement in health status have reinforced motivation for the continuation of voluntary exercises. A further study is necessary to determine the factors affecting maintainance of muscle strength exercise and to assess the effect of weight training program on bone density.

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일 지역 중·고등학생의 흡연실태 (A Study on the Actual Conditions of Smoking in Middle and High School Students in One Region)

  • 김현옥
    • 한국학교보건학회지
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    • 제12권1호
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    • pp.149-167
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    • 1999
  • To investigate the actual conditions of smoking in middle and high school students in Chinan County, I used a sturctured questionnaire for 1,579 students attending twelve middle-high schools from December 1, 1998 to December 20, 1998. I collected and data correlated the using an $SPSS-PC^+$ 1. The smoking rate of middle-high schoo1 students in Chinan County was 17.9%, relatively high. This smoking rate was different according to the gender, grade, religion, and economic situation. In mals, high school students, non-religious, students low income family students, the smoking rate was higher. The smoking rate of high school students was almost the same as the smoking rate of adults, generally higher than that of foreign teenagers. Because the smoking rat of studinets in the third grade of middle school and in the first grade of high School was six times higher, increased education should be conducted during this time in an attempt to curb the sudden increase of the smoking rate. The smoking rate of girl students was 5.0%; this has increased mor than three times from ten years ago. Consequently, counter measures should be taken against the smoking of female students as well as juvenile smoking in general. In addition, the smoking rate of middle-high school students showed interesting differences when correnated with enviornmental factors. Students with low grades, who are not satisfied with school life, who don't have both parents, who have uncaring parents who nare too strict or too arbitary, who have smoking parents, or who have experienced smoking commonly smoked. Therefore, to lower the smoking rate we should improve the school environment, improve a student's interest in school life. And parents or siblings should lead by example and quit smoking at home. Schools should educate students more effectively concerning the harmful effects of smoking and create an accurate understanding of its dancers. From the beginning, we should teach students never ever to touch cigaretts. 2. The surve discovered that most students started out of curiosity, or solicitantion from friends or elders at middle school, and had been smoking one to five cigarettes for more than a year. They obtained cigarettes at stores and most of them have friends who smoke. As a result anti-smoking education should be conducted at elementary schools prior to middle school. More than 95% of the teenagers who smoke had friends who smote and smoked out of curiosity or the recommendation of elders. Thus, we must focus on teenagers who smoke in group, rather than individually. Fuyrthermore, the strict application of the regulation of tobacco sales as well as tobacco cooperation from retailers are needed. While students did not show any mood or academic achievement difference after beginning smoking, 58.1% of the students a health situdation that was worse. Juvenile smoking is more harmful to the juvenile than adult smoking is to the adult. This should be focused on in an anti-smoking campaign. 3. Students who smoke hada more positive attitude toward smoking than students who don't smoke. Students who smoke had a tendency to have a nuetral position and are not concerned about smoking compared to non-smoking students. The survey showed that the great number of students had a nuetral position. Because this nuetrality may increase Juvenile smoking, education that provides an exact understanding of smoking should be performed to build the correct attidude toward smoking. 4. Middle school students smoke when angry, gloomy, anxious, a lone and when they have some problems to solve, on when they feel inconveniened in other wores, they smoke to reliver stress. They also smok due to addiction. Because smoking is not a praetical method to relieve stress, a program which helps to acquire positive relief stress should be provided to help reduce smoking. 5. About 65% of students who smoke want to quit smoking because of health problem, 78% of them have tried mor than once to quit but failed due to weak will power and peer pressure from friends who smoke. Juvenile smoking is group, oriented. Thus, the program that advances less smoking will be the one that focuseds on groups. 6. As for advice to students who want to quit smoking, "persuasion" was used most commonly, followed by a "presentation on how to quit smoking". Another method were severe punishment. About 70% of the students wanted the anti-smoking guide at school. 7. Most students (73.5%) had a position that more anti-smoking education at school is needed. Obriously, then, anti-smoking education at middle-high schools should be reinfoced. Although the education which explains the harmful influence of tobacco is known as an efficient way prevent smoking; it does not influence students who already smoke. Therefore, for students who smoke, multi-dimensional approaches must be attempted that include physical training, phychokogical approache, consultation and discussion, medical chek-ups, audio-visual education technigues, and professonal instructors, in addition, because smoking students have more negative on lukewarm attitude to anti-smoking education anti-smoking education should be conducted through a communicative style by dedicated teachers who care about students. In order to increase the effectiveness of this program.

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한국형 자가평가 불안척도의 개발 (Development of the Korean Form of Zung's Self-Rating Anxiety Scale)

  • 이중훈
    • Journal of Yeungnam Medical Science
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    • 제13권2호
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    • pp.279-294
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    • 1996
  • 불안의 존재나 정도를 양적으로 측정하고 평가하기 위해서 한국형 자가평가 불안척도를 연구 개발하기 위하여 1994년 8월 부터 1996년 9월까지 영남대학교 의과대학 부속병원 정신과 및 국립 부곡 정신병원 정신과에 외래 및 입원한 불안장애 환자를 대상으로 하여 본 연구를 시행하였다. 불안장애 환자 집단은 남자 52명(53.6%), 여자 45명(46.4%)으로 총 97명(32.1%)이며, 이들 진단의 정확도를 위하여 환자의 선정 기준은 DSM-IV에 의해 불안장애 환자로 진단한 사람들을 대상으로 하였다. 비교 집단은 검사 당시 정상적인 사회 활동에 참여하고 있는 피험자로 주로 고등학교 학생과 일반 대학생 그리고 지역 사회 일반 성인 및 그 가족을 중심으로 하여 남자 104명(50.7%), 여자 101명(49.3%)인 총 205명(67.9%)이였다. 이들에게 Zung의 자가평가 불안척도를 한국형으로 번안하여 조사 방법으로 시행하였다. 본 조사에서 수집된 자료는 종합 검토하여 불충분한 자료를 제거하고 SPSS의 프로그램을 통해서 분석하였다. SAS의 문항 분석을 시행하여 각 문항간의 상관관계, 문항 내적 상관도, 검사의 신뢰도 검증 및 요인분석 그리고 불안척도를 사용하여 정상과 이상 집단을 판별 할 수 있는 판별력을 알아 보기위하여 판별분석 등을 시행하였다. 불안척도로 평가된 비교 집단의 평균 총점은 $32.36{\pm}6.35$이였다. 불안척도로 평가된 불안장애 환자 집단의 평균 총점은 $50.53{\pm}7.67$이였다. 비교 집단인 정상 집단은 전체 불안 점수의 분포는 50점 이상인 경우가 1.0%(2명)이었고, 불안장애 집단의 전체 불안 점수의 분포는 50점 이상인 경우가 25.9%(56명)이었다. 본 척도에 대한 검사-재검사의 신뢰도 검증에서 신뢰도 계수는 0.98(p < 0.001), 항목-전체간의 상관계수의 평균치는 0.60(0.16-0.76), 내적 일관성은 0.96(p < 0.001)이며, 모두 통계적으로 의미있는 신뢰도를 보여주었다. 요인분석에서 4개의 요인이 추출되었는데, 이러한 점은 불안이 여러 가지 요소로 구성되어 있을 가능성도 시사한다. 불안척도에서 비교 집단인 정상인 집단에서 항목별로 높게 평가된 상위 문항들은 발한, 초조, 우려, 불면 및 호흡곤란 등이었고, 하위 항목은 졸도감, 혼돈, 이상감각, 현기증 및 진전 등의 항목이였다. 불안장애 집단이 SAS에서 항목별로 높게 평가된 상위 문항들은 우려, 초조, 발한, 호흡곤란 및 불면 등이며, 하위 항목은 졸도감, 이상감각, 악몽, 현기증 및 진전 등으로 본 연구에서 분석한 결과에서 서로 항목별 내용이 비슷한 결과를 보였다. 본 연구에서 한국형 자가평가 불안척도를 사용하여 판별분석을 한 결과 두 집단을 정상인 집단과 불안장애 환자 집단으로 판별하는 전체 정확 판별율(93.7%)이 비교적 양호한 결과를 보였다. 앞으로 한국형 자가평가 불안척도를 사용하여 불안장애가 있는 피험자를 객관적인 자료에 의해 선발 할 수 있는 도구가 될 것이라고 사려된다.

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