• 제목/요약/키워드: Psychosocial aspects

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메니에르병 환자의 질병 체험 연구 (Qualitative Study on the Experience of Patients with Meniere Disease)

  • 정우정
    • 대한간호학회지
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    • 제50권5호
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    • pp.699-713
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    • 2020
  • Purpose: The purpose of this study was to understand and describe the experiences of patients with Meniere disease. Methods: Data were collected from February 19, 2019, to February 5, 2020, through individual in-depth interviews with 13 Meniere patients. Verbatim transcripts were analyzed using Colaizzi's phenomenological analysis. Results: The experiences of patients with Meniere disease were clustered into the following four themes from 22 meaning units: 1) Complex unfamiliar symptoms that shatter both balance of the body and peace of the heart; 2) A disease that medical treatment and health professionals cannot cure; 3) Suffering hardships that cannot be understood by non-Meniere sufferers; and 4) Making daily efforts to become healthier. Symptoms of Meniere disease are life-shattering and depressing because they are neither visible nor easily curable. Over time, as they accepted the reality of living with the disease, the participants would shift their focus from complete symptomatic cure to leading a healthy and more balanced life. Conclusion: This study shows that Meniere disease has a pervasive impact on all aspects of the patients' lives. Patients are prone to experiencing restrictions in their social functioning and activities. They also experience psychosocial problems due to the unseen nature of their symptoms. This study elucidates the experiences of Meniere patients and the need for nursing intervention to help improve their quality of life and ability to self-manage. Lastly, this study shows the need for a coordinated interdisciplinary approach to raising public awareness of the disease.

암성 통증의 평가방법에 대한 고찰 (Investigation on Cancer Pain Assessment)

  • 조정효
    • 동의생리병리학회지
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    • 제21권2호
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    • pp.548-553
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    • 2007
  • In general, cancer pain is neither fully recognized nor adequately treated. The inadequate pain control is due to failure of accurate assessment of cancer pain. This study was aimed to understand various characters of cancer pain and investigate available assessment scales which have been designed for, or frequently used with people with cancer pain. A total of 23 articles were selected from two different databases. The selected articles were analyzed according to three aspects of initial assessment, patient self-report and assessment of the outcomes of pain management. The characters of cancer pain is complex and includes physical, psychosocial, and spiritual dimension. Also, subjective pain can be classified into at least four specific factors, such as pain intensity, pain affect, pain relief, and pain quality. Based on various classification, the pain assessment scales can be divided into unidimensional or multidimensional. Among the more commonly used clinical tools are numeric rating scales, verbal rating scales, visual analog scales, and picture scales. Above all, in order to assess cancer pain objectively, the clinician must select appropriate assessment instruments which reflect pain definition and clinical purpose.

The Effect of Public Health Center-Based Hypertension School on Hypertension-related Knowledge, Self-efficacy, Anthropometric Value and Blood Pressure

  • Chang, Koungoh;Kim, Sohee;Lee, Naeyoung
    • International journal of advanced smart convergence
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    • 제7권3호
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    • pp.44-60
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    • 2018
  • This study is to identify the effects of hypertension management program at a community health center on the disease-related knowledge, self-efficacy, anthropometric measurements and blood pressure of a hypertensive patient in local community. This study is a quasi-experimental study using nonequivalence control group no-synchronized design in order to verify the effects of the hypertension management program at a community health center on the hypertension-related knowledge, self-efficacy, anthropometric measurements and blood pressure of a hypertensive patient in local community. The result indicated a significant difference between the experimental group and control group in the scores of hypertension-related knowledge (t=-4.25, p<.001), self-efficacy (t=-4.20, p<.001), systolic blood pressure (t=7.70, p<.001) and diastolic blood(t=5.91, p<.001), body weight(t=2.32, p=.026) and abdominal circumference(t=2.17, p=.036). The hypertensive patients' knowledge and self-efficacy were improved, and their weight and abdominal circumference as well as systolic blood pressure and diastolic blood pressure were reduced. Therefore, it was confirmed that multilateral approaches in terms of physical and psychosocial aspects only targeting hypertensive patients were required for managing hypertensive patients in local community.

알코올 중독자 자녀에 대한 개입 방안 고찰: 심리적 문제를 중심으로 (Exploring Interventions and Treatments for the Children of Alcoholics: Focusing on Psychological Aspects)

  • 박미숙
    • 감성과학
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    • 제25권2호
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    • pp.101-110
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    • 2022
  • 알코올 중독은 알코올을 사용하는 개인뿐만 아니라 가족 시스템에도 부정적인 영향을 미친다. 가족은 아동의 사회화 과정에서 가장 중요한 요소이다. 이러한 관점에서, 알코올 중독은 자녀에게 심리사회적 및 정신병리적으로 영향을 미친다. 그러나, 현재까지 알코올 중독 분야에서 자녀들은 연구 대상에서 제외되어왔다. 본 연구는 알코올 중독자 자녀들의 심리적 문제에 대해 개입하고 그 효과성을 확인한 문헌들을 개관하고자 하였다. 국내외 연구를 조사하기 위하여 관련 데이터 베이스 및 개관 논문을 활용하였으며, 연구 대상은 알코올 중독자 자녀 또는 자녀와 부모를 대상으로 개입한 연구로 하였다. 연구 결과, 개인 및 가족을 대상으로 한 개입이 자녀의 심리사회적 또는 정신병리적 문제의 감소에 효과가 있었다. 결과를 종합적으로 정리하고, 추가 논의를 통해 추후 효과적인 개입 방안에 대해 논의하였다.

장루 보유자 교육용 자료에 대한 조사 연구 (A Survey on the Ostomate Education Materials)

  • 박경숙;김명숙;최경숙
    • 대한간호학회지
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    • 제28권3호
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    • pp.705-717
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    • 1998
  • Ostomates have suffered from many difficulties due to their physical, psychosocial handicaps and changes of life style to include ostoma management that influences their daily and quality of life. An appropriate nursing education for ostoma management is very important. Practical educational materials needs revision because those were developed by pharmaceutical companies and hospital institutions. The purpose of this study is to provide more practical and reasonable education materials for ostomates by doing analysis and survey of educational materials now being used. We surveyed 8 types of educational materials used in 23 university hospitals and medical centers in Seoul ; four of them were developed by department of nursing and the remainder by an Ostomy Company Data, collected from July 14, 1997 through July 31, 1997 were analyzed. The results are as follows ; 1. The analysis of education guide, on ostomate included 14 subcategories : introduction, structure and function of gastrointestinal tracts, definition of stoma, types of ostomy, definition of peristalsis, methods of defecation management, selection of instrument, resolution of problems and general situations following surgery, daily life, where to ask for help, explanations for terms, information about where to buy instrument, explanations for enterostomal therapist, a matter of consultation with doctor, etc. 2. Introduction contained specific contents on practical ostomate management that ostomates would experience through their lives. Ostomate education guides were developed 3 hospitals except one which missed this point. 3. Most ostomate education guides, except one hospital, helped ostomates to understand their physical structure changes with specific explanations on gastrointestinal tracts with figures. 4. Six institutions did not talk about the definition of peristalsis. 5. All institutions, except two, helped ostomates to understand types of ostomy with figures. 6. More detailed explanations on natural defecation are needed. The benefits and pitfalls of natural defecation should be more specified. 7 No psychosocial difficulties of ostomy management were addressed. 8. The efficiency of enema can be better understood through all explanations with figures. Some institutions did not mention items about definition, benefits, pitfalls of enema, sequency of enema, how to wash, cautions performing and enema, skin management, cleaning instrument after enema proper time to spend. 9. There were no detailed contents and what to do in case of not being able to do enema. 10. Only one educational material mentioned emotional aspects after the surgrey. 11. Most institutions explained subcategory of daily life but did not provide specific contents on the difficulties of physical, psychological, and sociocultural controls. 12. The subcategory of ureterostomy education guides included explanations on normal structure and function of urinary tracts, types of ureterostomy, how to manage skin, usage and types of instrument, commercial urostomy, how to manage instrument, daily life, introduced the general contents. However, more specific explanations were needed.

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제왕절개분만 산욕부와 신생아의 가정간호 사례분석 (A Case Analysis of Home Health Care for Cesarean Postpartum Women and Their Newborns)

  • 김혜숙;최연순;전은미
    • 대한간호학회지
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    • 제24권4호
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    • pp.696-705
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    • 1994
  • This study was done to provide a basis for home health care management for women following Cesarean delivery. Furthermore it was initiated as an possible application of home health care in the future. In this study, client selection criteria was developed by the researcher and assessment tools for home health care, recording system and problem oriented recording system were revised from Jun's(1993) methods. The selection criteria tool for home health care for women who had a Cesarean delivery was structured and consisted of five areas : physical status, functional status, psychological-emetional status, educational needs status and environmental status. The structured assessment tool consisted of general items, obstetric history, past medical history, methods of feeding, medications taken before ad-mission, laboratory results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of women and their newborns. The visit note consisted of the date : nursing problems : nursing process including initial assessment : nursing goals : visit plan : health status of the postpartum women and their newborn : nursing diagnoses : nursing implementation evaluation : summary : next visit plan and revision. The problem oriented recording system consisted of the date, problem numbers, nursing diagnoses, problem appearance date, problem resolution date. The results of the research are as follows : The seven cases having had a Cesarean delivery were discharged on an average on the 5th day after the Cesarean birth. The total number of home visits was 13. According to Cordon's functional health patterns the total possible nursing diagnoses was 34 diagnoses for the methers and their newborns. Among the 34 diagnoses, there were 13 diagnoses in the health perception /management pattern, 7 in the psychosocial health perception / management pattern, 8 in the psychosocial self-perception, 2 in the nutrition / metabolism pattern of physical function, 2 in the knowledge deficit of newborn management, anxiety related to newborn management, knowledge deficit related to disease process of new-born, anxiety related to disease process of newborn anxiety related to prognosis of baby's condition, knowledge deficit related to newborn jaundice each appeared once. The changes in the number of nursing diagnoses was related to not the number of visits but to the number of nursing diagnoses decreasing. The con-tent of the home health care was categorized ac-cording to assessment, direct care, counseling, education, family care. The recommendation based on the results of this research are Home health care nurses for Cesarean postpartum women and their neonates requires comprehensive knowledge of pregnancy, delivery, and the postpartum period and of the neonate so that they can provide appropriate care and holistic views. Most of cases terminated after the second visit, this outcome may be related to the subjects being discharged on the 5th day after delivery. Therefore, study done with earlier discharge after delivery may have different outcome. It is very hard to assess psychological aspects that need follow-up and to develop communication channels.

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시설 호스피스에 있어서 가족지지가 말기 암 환자의 삶의 질에 미치는 영향

  • 강승계;김수호;김신수;박희명;송근옥;원주희;이명숙;이성옥;이은의;이채영;이현미
    • 호스피스학술지
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    • 제3권1호
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    • pp.31-41
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    • 2003
  • Background: The purpose of this study is to assess the effectiveness of family support on the quality of life in patients admitted to the hospice facility at Saemmul Hospice. Method: The subjects of this study were 152 terminal cancer patients that were admitted to the hospice facility at Saemmul hospice between January 2002 and February 2003. Their each quality of life were assessed at admission, one, three, five and seven weeks at Saemmul Hospice using a questionnaire prepared by the Saemmul hospice and were anlalyzed by means of T-test. Result: There was no difference in the quality of life score between patients with family support and patients without family support in terms of physical, psychosocial, and spiritual aspects in the admission. There was no difference in the quality of life score between the patients with frequent family member's visit(>=8) and less frequent family visit(<=7), and between the patients whose family members stayed at the facility for 24hrs and the patients without staying family members. There was no difference in the quality of life score between the patients in low-middle and low-high class among 9 classes of familial economic status(high-high, high-middle, high-low, middle-high, middle-middle, middle-low, low-high, low-middle, low-low). There was no difference in the quality of life score between the patients whose familial religion were Christianity and the patients with other religions. After 1, 3, 5, 7 weeks assessment, the scores in the physical, psychosocial, spiritual aspect of quality of life were increased. Conclusion: The results suggest that family support is important to improve the quality of life in hospice patients and hospice care team is needed to replace 24 hours of family care. There is a urgent need of trained hospice care teams, so training programs for physicians, nurses, clergies, social workers, and volunteers are necessary.

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임신 및 산후 우울증 (Depression during Pregnancy and the Postpartum)

  • 김율리
    • 정신신체의학
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    • 제15권1호
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    • pp.22-28
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    • 2007
  • 임신과 출산은 일부 여성들을 주요우울증 발병에 취약하게 한다. 산모의 10%에서 출산 후 수주 이내에 산후 우울증이 발병하며 이는 장차 아동의 인지적, 정서적 발달에 부정적 영향을 줄 수 있다고 알려졌다. 임신 중 우울증은 상대적으로 간과되어 왔지만 산후 우울증과 마찬가지로 흔하며 임산부의 정신병리가 태아의 생리 발달에 영향을 미친다는 증거가 축적되고 있어 주목을 받고 있다. 임신 및 출산과 관련된 우울증의 원인을 이해하기 위해서는 다양한 정신사회학적, 생물학적 위험 요인을 포괄적으로 고려할 필요가 있다. 임신과 관련된 우울증을 치료하기 위해 정신과 의사는 임신 및 치료 방법과 관련된 여러 가지 상황의 위험 혹은 이득을 포괄적으로 분석해야 하며 치료 방법을 능숙하게 결정할 수 있어야 한다. 임신 중 우울증에는 심리치료, 약물치료, 전기 충격 요법 등이 효과적이라고 알려져 있다. 산후 우울증을 치료하는 데에는 생물학적, 심리학적, 환경적 개입 등의 방법이 있으며, 구체적으로는 세로토닌 재흡수 억제제 등의 항우울제, 지지적 상담 등의 효과가 증명되었고, 증상이 심할 경우에는 Estrogen이 효과적이라고 알려져 있다. 한편, 임신 및 출산과 관련된 우울증의 신경내분비학적, 심리사회학적 병인을 규명하기 위한 연구들이 진행되고 있다. 향후 임산부의 산전 및 산후 관리에 있어서 임상각과 간의 통합적인 접근에 의한 우울증의 조기 진단 및 치료가 필요할 것으로 보인다.

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인터넷중독 위험 청소년에 대한 단기 산림치유 효과: 생물학적, 신경인지적 및 심리-사회적 측면을 중심으로 (The Effect of Short-term Forest Therapy Camp on Youths with Internet Addiction Risk Group: Focused on the Biological, Neurocognitive and Psychosocial Aspects)

  • 정안수;최삼욱;우종민;목정연;김기원;박범진
    • 한국산림과학회지
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    • 제104권4호
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    • pp.657-667
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    • 2015
  • 본 연구에서는 인터넷중독 위험 청소년들에 대한 '산림치유(Forest Therapy)'의 생물학적, 신경인지적 및 심리사회적 영역에서의 효과를 살펴보았다. 청소년 인터넷중독 위험군을 대상으로 2박 3일 혹은 3박 4일 형태의 산림치유 캠프를 진행했고, 캠프 전-후로 참가자들의 혈청 뇌유래신경영양인자(BDNF), 종합주의력 검사(CAT) 그리고 우울(CDI) 및 상태 불안(STAI)을 포함한 다양한 심리사회적 변인들을 측정했다. 그 결과, 산림치유 캠프에 참가한 이후에 참가자들의 혈청 BDNF 수치 및 CAT의 수행점수가 증가했고, 인터넷/게임 욕구가 감소했으며, 회복탄력성 및 대인관계가 긍정적인 방향으로 변화하였다. 또한, 산림치유 캠프 노출량에 따라 집단을 구분하여 분석한 결과, 집단내에서 일부 불안 완화를 보고하기도 하였다. 전반적으로 인터넷중독 위험 청소년의 증상 개선 및 적응력 증가를 위한 산림치유의 적용가능성을 확인하였다.

Determinants for further wishes for cosmetic and reconstructive interventions in 1652 patients with surgical treated carcinomas of the oral cavity

  • Holtmann, Henrik;Spalthoff, Simon;Gellrich, Nils-Claudius;Handschel, Jorg;Lommen, Julian;Kubler, Norbert R.;Kruskemper, Gertrud;Rana, Majeed;Sander, Karoline
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제39권
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    • pp.26.1-26.10
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    • 2017
  • Background: The impairment of the appearance is a major problem for patients with carcinomas of the oral cavity. These patients want to recover their preoperative facial appearance. Some do not realize that this is not always possible and hence develop a desire for further cosmetic and reconstructive surgery (CRS) which often causes psychological problems. Method: The desire of patients for CRS (N = 410; 26%) has been acquired in this $D{\ddot{O}}SAK$ rehab study including multiple reasons such as medical, functional, aesthetic and psychosocial aspects. They relate to the parameters of diagnosis, treatment and postoperative rehabilitation. Patients without the wish for CRS (N = 1155; 74%) served as control group. For the surgeons, knowledge of the patient's views is relevant in the wish for CRS. Nevertheless, it has hardly been investigated for patients postoperatively to complete resection of oral cancer. In this retrospective cross-sectional study, questionnaires with 147 variables were completed during control appointments. Thirty-eight departments of Oral and Maxillofacial Surgery took part, and 1652 German patients at least 6 months after complete cancer resection answered the questions. Additionally, a physician's questionnaire (N = 1489) was available. Statistical analysis was performed with SPSS vers. 22. Results: The patient's assessment of their appearance and scarring are the most important criteria resulting in wishes for CRS. Furthermore, functional limitations such as eating/swallowing, pain of the facial muscles, numb regions in the operating field, dealing with the social environment, return to work, tumour size and location, removal and reconstruction are closely related. Conclusion: The wish for CRS depends on diverse functional psychosocial and psychological parameters. Hence, it has to be issued during conversation to improve rehabilitation. A decision on the medical treatment can be of greater satisfaction if the surgeon knows the patients' needs and is able to compare them with the medical capabilities. The informed consent between doctor and patient in regard to these findings is necessary.