• 제목/요약/키워드: Patient caring

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중심성의 이동: 치매 환자 가족의 돌봄 경험에 대한 질적 합성 접근 (Shifting of Centricity: Qualitative Meta Synthetic Approach on Caring Experience of Family Members of Patients with Dementia)

  • 유영미;유미;오세은;이해영;김해진
    • 대한간호학회지
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    • 제48권5호
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    • pp.601-621
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    • 2018
  • Purpose: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. Methods: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). Results: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. Conclusion: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.

만성질환자를 돌보는 중년기 주 돌봄 제공자의 회복탄력성, 사회적지지와 돌봄 부담감과의 관계 (The Relationship between Resilience, Social support and Caring burden of Middle-aged Caregivers caring for Chronic disease)

  • 김남희;박선영
    • 한국산학기술학회논문지
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    • 제20권2호
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    • pp.300-310
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    • 2019
  • 본 연구의 목적은 만성질환자를 돌보는 중년기 주 돌봄 제공자의 회복탄력성, 사회적지지와 돌봄 부담감과의 관계를 파악하기 위한 서술적 상관관계 연구이다. 자료수집은 B시에 소재한 일개 재활전문병원 주 돌봄 제공자 175명을 대상으로 2018년 7월2일부터 7월31일까지 자가보고 설문지를 통하여 자료를 수집하였고, SPSS Win 21.0 프로그램을 이용하여 분석하였다. 일반적 특성 중 돌봄 부담감과 유의한 차이는 돌봄시간(F=6.67, p<.001), 일상생활 수행능력(F=4.70, p<.001), 환자의 질환(F=4.61, p<.001), 환자와의 관계(F=3.68, p<.013), 건강상태(F=3.08, p=.018), 결혼유무(t=-2.12, p<.036), 진단시기(F=2.92, p=.036) 순으로 나타났다. 돌봄 부담감은 회복탄력성, 사회적지지와 유의한 관계가 없었고, 회복탄력성과 사회적지지는 (r=.487, p<.001)으로 통계적으로 유의한 상관관계가 있는 것으로 나타났다. 따라서 이러한 결과를 바탕으로 만성질환을 돌보는 중년기 주 돌봄 제공자의 돌봄 부담감을 감소시키기 위해 돌봄 부담감에 영향을 준 제 특성요인들을 고려하여 돌봄 부담감 중재프로그램을 개발할 필요가 있을 것이다.

만성질환자 배우자의 돌봄 경험에 대한 이론 구축 (A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness)

  • 최경숙;은영
    • 대한간호학회지
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    • 제30권1호
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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비정신과 간호사가 경험한 정신질환자 간호의 어려움 (Difficulties in Caring for Psychiatric Patient as Experienced by Non-Psychiatric Nurses)

  • 정재원;장미영;심지현;고윤희;신성희
    • 대한간호학회지
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    • 제47권1호
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    • pp.49-59
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    • 2017
  • Purpose: The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness. Methods: Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. Results: General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were 'nurse' related factors, 'patient' related factors, 'resource' related factors. The nine categories were 'unpreparedness', 'nursing barriers due to stigma', 'undervaluing and avoidance of psychiatric nursing', 'eroding into the trap of a vicious cycle', 'facing unapproachable patients', 'dealing with unhelpful family members', 'burdening already overburdened staff', 'obstructive environment', and 'isolation of staff with heavy responsibilities'. Conclusion: The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.

21세기 신생아 전문 간호사의 역할과 전망 (The role of the Neonatal Nurse Specialist in 21st Century)

  • 이자형
    • 부모자녀건강학회지
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    • 제3권2호
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    • pp.81-93
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    • 2000
  • The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.

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말기 암환자 가족의 돌봄 경험 (Experiences of Family Caregivers of Patients with Terminal Cancer)

  • 최은숙;김금순
    • 대한간호학회지
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    • 제42권2호
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    • pp.280-290
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    • 2012
  • Purpose: This study done to identify the experiences of families caring for patients with terminal cancer. The question was, "What is the caregiving experience of a family who has a member with terminal cancer?" Methods: Grounded Theory was applied and in-depth interviews were done with 11 family members. Interviews were recorded with the interviewees' consent and were transcribed and analyzed. Participants' relationships to patients were 6 spouses, 4 daughters, and 1 mother. The ages of the participants were between 32 and 62, with an average of 47.5. Results: The study showed "enduring with bonds" as the main category and the main factor affecting this category was the "patients' diagnosis of terminal cancer." The caregiving experience was divided into four stages: shock, confusion, struggle, and acceptance. Mediating factors were relationship with the patient, intimacy with the patient, social support, communication, and trust. Conclusively, participants underwent internal maturity, and changes occurred in family and social and personal life. Conclusion: The families took care of the patients with responsibility and love. The study results should help with the understanding of a family with a member with terminal cancer and should be used to develop nursing, mediating, and consulting programs for these caregivers.

영화 '마빈스룸' 가족간호중재 -시나리오 접근법- (The Scenario Approach Method for Family Nursing Intervention Based on the Movie 'Mabin's Room')

  • 박경민;김정남
    • 지역사회간호학회지
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    • 제12권3호
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    • pp.627-638
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    • 2001
  • Caring is an essential element of nursing. In a family with a patient. a critical situation may happen not only for the patient but also for the members of the family. Therefore, a caring service from the healthcare providers can also be requested for the family members. The movie 'Mabin's Room' deals with family problems. In this study, the assessment, problem, diagnosis and planning for the family nursing situation for family problems were made focusing on the role of characters in the movie 'Mabin's Room'. Regarding family nursing intervention, the framework of the story 'Mabin's Room' was reorganized to solve the problems based on the role of community health nurse. In this scenario approach method, the situation in the movie is used without change but the scenario related to the roles (or communication) of community health nurse for solving the family problems is added. It is a problem solving oriented method by reorganizing the scenario in a movie story situation. The reorganized scenario in this study is just an example of scenario approach method. Community Health Nurses can cultivate their creativity by solving various problems in the community by adopting or modifying this simple scenario in practice.

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환자 돌봄 의사소통 측정 도구 개발 (Development of the Patient Caring Communication Scale)

  • 허명륜;임숙빈
    • 대한간호학회지
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    • 제49권1호
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    • pp.80-91
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    • 2019
  • Purpose: This study attempted to develop a scale that measures the level of patients' recognition of the nurses' care, based on Watson's caring theory, and confirmed its reliability and validity. Methods: The items were developed through a literature review and an expert content validity test. The questionnaires were administered to 285 inpatients of internal medicine and surgical units at two general hospitals. Construct validity was tested using exploratory and confirmatory factor analysis, and reliability was tested using Cronbach's alpha. Results: This process resulted in a preliminary scale composed of 34 items; We used item analysis and five exploratory factor analyses, and consequently selected 14 items composed of three factors (respect, genuineness, and relationality). The confirmatory factor analysis verified the model fit and convergent and discriminant validity of the final items; criterion validity was confirmed with the positive correlation with the measurement scale of the patient-perceived quality of nursing. The overall scale reliability had a Cronbach's alpha of .92, which indicated internal consistency and reliability. Conclusion: The developed scale showed content, construct, and criterion validity, and reliability, as well as convergent validity for each item and discriminant validity between the factors. This makes it suitable for use in a diverse range of future studies on nurse communication using structural equation models.

암환자의 심리사회영적 간호

  • 최화숙;김수지
    • 호스피스학술지
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    • 제6권1호
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    • pp.24-31
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    • 2006
  • Psycho-social-spiritual care should be included with comprehensive nursing care of cancer patient. Because of human being have four dimensions as physical, psychological, social and spiritual dimension and they do interactional relationship with themselves, others and God. So caregivers of cancer patient have to recognize what they have psycho-social-spiritual needs and have to consider how caregivers can combine these in comprehensive nursing care. Cancer patient will be experienced shock, feeling of crisis and fear of death and will be showed denial, anger, bargaining, depression, accept or give-up, hope, spiritual distress and spiritual needs to which help them to do some rituals or interactions according their religion. Loving attitude is essential of cancer patient care especially of psycho-social-spiritual care. Dr. Kim and her some colleques investigated about this and find out 10 concepts(Caring Behaviors) by Graunded Theory Methodology. They are Noticing, Participating, Sharing, Active Listening, Complimenting, Companioning, Comforting, Hoping, Forgiving, Accepting.

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간호학 문제중심학습에 기초한 창의성통합교육모형(C-PBL) 개발 및 효과 (Development of Creativity Integrated Problem-Based Learning Model for Nursing Education)

  • 강소영
    • 한국간호교육학회지
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    • 제17권3호
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    • pp.433-443
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    • 2011
  • Purpose: This study aimed at (a) developing an instructional model of creative thinking education on the problem-based learning method (C-PBL) in undergraduate nursing curriculum at one University, and (b) examining its effect on nursing students' level of creativity and outcomes from problem-based learning. Methods: The C-PBL model was implemented on 43 juniors of the experimental group with a 30 hour-nursing class during one semester. The control group, with 54 seniors, received 4 hours of problem based learning training in an adult nursing class. Pre-and post-tests were done with the Torrance Tests of Creative Thinking for creative thinking ability, the Integrated Creativity Instrument for creative motivation and attitudes, the Problem Solving Competency questionnaire, and the Self-Directed Learning Instrument. Results: The C-PBL model was developed using a caring situation scenario to solve nursing problems with 3 training steps of 'encountering a patient in a caring situation', 'exploring nursing knowledge', and 'designing creative caring beyond given knowledge'. Between the experimental group and the control group, there were significant differences in creativity (p<.010), problem-solving ability (p<.010), and self-directed ability (p<.010). Conclusion: This C-PBL method could contribute in increasing creative competency as well as problem-solving ability for nursing students.