• 대한간호학회지
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• 제6권1호
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• pp.80-90
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• 1976

정신과 영역의 환자를 위해 간호원의 역활을 필요로 한 이래 여러 가지 간호의 개념으로 간호원의 역할이 변화되어오고 있다. 정신과 환자의 안전만이 가장 큰 치료의 중심일 때는 병동열쇠의 위엄에 곁따라 보호관리에만 치중해 왔으며 정신의학에서 약물요법, 전기요법의 치료과정이 생기면서 간호원의 역할 변화 및 지식의 요구를 필요로 하게 되었으며, 환경과 개인의 밀접한 관계를 중시해오면서 치료적 환경속으로 환자의 인간적 치료가 강조되었을 때 의사소통과 대인관계의 인적 환경으로써 또한 간호원의 역활이 중요시 되어왔다. 이런 관점에서 치료적 환경에 대한 정확한 이해는 간호행위과정의 불완전을 제거하며 보다 활발한 정신과 환자간호에 기여하는 일 일 것이다. DR. Bartom은 병실 환경이 비생산적이고 비 치료적일때 성격의 변화는 물론 행동적 특성의 변화까지 가져올 수 있다고 말했다. 즉 무감동적이고, 무조건적 순종이 있으며 솔선하여 행하는 행위가 줄고 장래 계획에 대한 자극이 줄어들고 될대로 되어 가는 상태 그 자체에 머물러 있어 인간의 특징적 의미와 가치를 상실하게 된다는 것이다. 정신과 병실은 잠정적 체류지로 보아야 하겠고 이 체류지에서의 영향이 환자에게 보다 유익하게 끼칠려면 간호원이 지속적으로 치료적 분위기를 유지해야 할 것이다. 치료적 입장으로서의 간호의 활동 초점은 대인관계에서 환자의 의식수준과 자아관련 수준에서의 취급이 무의식 수준에서의 탐구조사보다 바람직하다. 치료적 가치로써 치료적 환경의 이론적 근거를 DR. Sullivan 은 인간의 상호관련 문제에 두고 있다. 즉 상호작용이 존재하는 환경은 어떠한 곳이든 성격에 영향이 있고 이 성격은 대인관계의 복잡성으로부터 결코 떨어질 수 없다는 얘기다. 자아구성 또한 환경의 영향을 받는데 Cumming은 병동환경과 자아구성 재동기간에 밀접성을 시사한바 있다. Visher와 O'sullivan은 정신과적 치료중에서 일상생활에서 경험되어지는 의사소통과 대인관계속에서 학습되어지는 여러 가지가 있기 때문에 매일의 활동획이 치료적 방향으로 계획되어 져야 한다고 말했다. Maxwell Jones 또한 치료적 환경의 유용한 가동은 전 직원의 기여에 있으며 이는 정신건강을 최적으로 올려 줄 것이다. 라고 말했다. 이러한 상황에서 간호원은 의미 없이 환자의 감정 욕구를 깨닫지 못하고 감정지지를 주지 못하며 정서적 긴장을 예방하지 못한 체 환자와의 관계를 유지한다면 현대간호의 개념에서 이탈되어지고 발달되어지지 못한 미숙아 현상이 유지 될 것이다. 보다 바람직한 치료적 환경 유지는 간호로써 환자에게 기여해 주는 일이다. 간호의 역활과 더불어 전문적 태도는 따뜻하고 포용성 있게 그리고 융통성 있게 대함은 물론 간호인 자신의 "자기이용"을 깊이 그리고 치료적으로 이용할 것을 깨달아야 할 것이다. 즉 정신과 병실에서의 간호원 존재 자제가 환자에게 미치는 영향도 고려해야 한다는 것이다. 덧붙여 환자를 위한 일주일 병동 행사표를 Model로 제시하였고 그 안에서의 간호원의 역활을 약술하였다.

• 한국강구조학회 논문집
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• 제23권3호
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• pp.261-273
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• 2011

최근에는 건축물의 대형화, 고층화라는 시대적인 흐름과 요구로 인해서 철골 구조의 수요가 급증하고 있다. 일반적인 철골 구조의 해석은 접합부를 강접합과 단순접합으로 가정하여 수행되고 있는데, 강접합(Fixed connection)의 경우에는 절점에 연결된 각 부재의 변형 전 상대적인 각도가 변형 후에도 그대로 유지된다고 가정하므로 접합부가 충분한 강성을 발휘하고 안정성을 확보하도록 패널존 부분에 스티프너로 보강을 한다. 하지만 인건비 상승과 함께 강접 접합부의 제작비가 과도해짐으로 경제성 측면에서 스티프너 보강을 생략한 접합부의 필요성이 증가하고 있다. 반면, 단순접합(Pinned connection)의 경우에는 단순보처럼 거동하여 보와 기둥 사이에 휨모멘트가 전달되지 않는다고 가정한다. 이는 공장제작이 간단하고, 시공이 간편한 장점이 있으나 접합부에서 모멘트를 전달할 수 없어서 구조적인 효율이 떨어지는 단점이 있다. 반강접의 도입은 단면치수 결정의 효율성을 증대하고, 현장에서의 부재조립 용이성, 골조 전체의 안전성 확보 등의 이점이 있어서 외국의 경우, 보-기둥 접합부의 실제적인 거동을 파악하기 위해서 계속적인 노력을 해왔고 그 결과를 규준에 적용하고 있다. 본 논문은 미국 AISC의 LRFD 설계규준을 참고하여 국내 강재를 적용한 반강접의 구조해석을 실시해서 각 강재에 대한 자료은행을 만들 것이고 이상화된 접합부의 구조해석 결과와 비교하여 경제성 측면, 단부 고정계수, 회전강성과 함께 반강접을 고려한 구조물의 설계 방안을 제시 하고자 한다.

• 한국병원경영학회지
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• 제6권3호
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• pp.109-129
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• 2001

The purpose of this study was the acquisition of the optimum scale of the apportionment of standard & high-class bed for the maximum profit representative of the desire of customers in a General Hospital with 1,100 beds located in Seoul. This investigation was proceeded by the analysis of the result of the simulation with the survey of both the patients' needs for bed and the degree of the medical service by the grade of the ward. And finally the consequence was obtained as follows: 1. The result of the investigation of the inpatients' preference for the grade of ward classes shows that a private ward reflected 4.3 percent, a semi-private ward 1.7 percent, a three-bed ward 0.1 percent, and a ward with six beds 93.9 percent each other. 2. A questionnaire poll was paralleled of service terms of a medical doctor and a nurse by ward class, the data were used for the standard of the allotment of labor cost by the ward class. The poll shows that the service tenn of a medical doctor and a nurse based on a ward with six beds by ward class showed 1.7 times in internal medicine and 1.9 times in surgery at a private ward; 1.4 times in internal medicine and 1.7 times in surgery at a semi-private room; and 1.2 times both in internal medicine and in surgery at a three-bed ward 3. The resultant findings revealed the most profit per bed and per patient in a private ward. However, an analysis of profit with a standard of unit area by ward class represented a higher profit in both the internal medicine and the surgery semi-private ward than other ward classes. 4. The result of the analysis through simulation based on the data of the prime cost per the ward class proved the optimum scale of the distribution of beds by class as follows: sixteen beds of the internal medicine and twenty three beds of the surgery in the private ward; two hundreds and two of the internal medicine and one hundred and ninety eight of the surgery in the semi-private room; three of both the internal medicine and the surgery each other in the three-bed ward; one hundred and ninety eight of the internal medicine and two hundred and fifty two of the surgery in the ward with six beds. The result of this research exhibits that the income and expenditure of the hospital could be improved by changing parts of wards into private ones(containing the maximum profit per a unit of width) in case the scale of the number of beds is reset with the consideration of the profit per the unit width. In the near future it's strongly expected that the research for the more scientific standard of the allotment of labour cost by ward class and for definition of the optimum scale of the number of beds that actualize the maximum profit with the change of the three elements of the prime cost: cost of materials; labor costs; management expenses.

• 대한간호학회지
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• 제5권1호
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• pp.93-111
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• 1975

As the hospitalized patients will be facing new stress situation due to change of his environment from home to hospital it will be very important to understand the psychological stress experienced by hospital patients not only for helping patients in the process of recovery from illness but also fulfil1ing the objective of comprehensive nursing care by understanding the needs of the patients. There is no doubt that it would be very helpful for treatment of patients as well as for improvement of nursing care if we know more about psychological needs of patients and give them adequate support to meet these needs. The study to find out the causes and degree of stress events experienced by hospitalized patients, with the objective of instituting improvement of nursing care program based on the needs of patients, was conducted during the month of September 1974 with 60 patients randomly selected from those admitted to medical and surgical wards at Yonsei Medical Center in that period The questionnaire form included 36 questions which are considered to be stress events for hospital patients, and was devide into five areas namely, such events related to 1) disease itself, 2) hospital environment, 3) nursing care and treatment, 4) communication and human relations, and 5) family and economic problems. The results of the study were as follows: 1. It was confirmed that hospitalization considered to be a stress producing factor and most patients perceived the admission to hospital as a stress factor. 2. According to the rating scale, it was found that degree of perceived stress shows a variation according to the source of stress producing event. 3. No significant differences in the mean values were observed statistically with the perceived stress levels according to demographic and other variables of patients related to hospitalization. 4. Among the questions related to disease itself, "Admission for surgery" was perceived most frequently as a stress event (97.14%) by patients. 5. With regard to the questions related to hospital environment, "death of the patient room-mate" was the most serious stress event perceived by patients (90%) and "living with hospital regulations"was considered to be less serious stress event (23.33%). 6. As for the questions related to nursing care and treatment, "limitation of freedom" was perceived as a stress factor most frequently (70.91%) by the patients and "worry for wrong treatment" turned out to be less frequent stress event (50.0%). 7. As for the questions related to communication and human relations, "difficulty to meet doctors when wanted"appeared to be the most frequent stress event by the respondents (75.86%) , followed by "no explanation about treatment or examination"(75.0%) and "no explanation about nursing care procedures"(71.66%). 8. With regard 111 tile questions related to family and economic problems, "inadequate finances for family living due to hospitalization"and "high cost of hospitalization" were the most frequent cause of stress mentioned by the patients. (80.0%). 9. As a result of application of the stepwise regression analysis, it was found that about 89% was explained by those events associated with disease itself, hospital environment and family and economic problems. By adding those events related to "nursing care and treatment" and "communication and human relation", 100% of stress associated with hospitalization was explained.

• 대한간호학회지
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• 제15권3호
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• pp.5-20
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• 1985

The purpose of this study was to assess the value-of post-operative treatment in terms of nursing care in the allevation of pain. More specifically, the effects of supportive touch and patient education were examined. On the date before each patient's operation, the Bevels of anxiety, depression and affiliation were examined. The post-operative treatment was adminis. tered after an initial measurement of the patient's fain, according to the experimental category for the three days following the operation. On the final day, the level of anxiety and depression were again measured. The subjects of this study were 138 patient from the general surgical and gynecological wards in H university Hospital in Seoul. The study was conducted over a three-month period from June 24, 1984 to September 18, 1984. All patients had undergone laparatomies. Various standard instruments were used to measure the pain, anxiety, depression and affiliation levels. for pain, 5 grate Simple Descriptive Scale, and the Mclachlan four-range Observational Pain Scale were employed. For anxiety and depression, respectively the Spielberger State Anxiety Inventory and Beck Depression Inventory (B.D.I.) were used. Lastly, the affiliation was determined by the Mehrabian Affiliation Scale. The outcome of the research was as follows: 1. The first hypothesis concerning the existence of lower pain levels of Experimental Group A and Experimental Group B than the pain levels of Control Croup C was not supported. 2. The second hypothesis concerning the existence if lower anxiety levels of Experimental Group A and Experimental Group B than the anxiety levels of Control Group C was supported at the level of F=3.58 (p=.03). 3. The third hypothesis concerning the existence of lower depression levels of Experimental Group A and Experimental Group B than the depression levels of Control Group C was not supported. 4. The fourth hypothesis concerning the existence of different levels of pain in accordance with the levels of affiliation in Experimental Group A was not supported. 5. A positive correlation did exist between pain and anxiety after surgery (r=.34, p=.0001). Thus, the fifth hypothesis was supported. 6. A positive correlation did exist between pain and depression following surgery(r=.36, p=.0001). Thus, the sixth hypothesis was supported. Based on the above results, it was found that supportive touch and patient education either through human sources or via tape recorder do influence the anxiety of a patient after surgery, that a Positive correlation between pain, anxiety and deparession exist, that affiliation does not alter the influence of supportive touch, and that the graph on which pain levels were depicted indicates the possibility of development even if the effects of supportive touch did not reach a meaningful level. Thus it can be concluded that patient education, regardless of its form, is essential for the patient after surgery and that supportive touch, when reasonably modified and supplemented, can be an effective method of alleviating pain.

• 한국보건간호학회지
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• 제17권2호
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• pp.317-332
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• 2003

This study attempts to investigate the relations between the types of communication, the job satisfaction. and the nursing performance of the staff nurses. The subjects of this study were the 114 nurses working in general wards, intensive care units, and the emergency rooms of the general hospital in Kyongbuk province. They were asked to answer the questionnaires as regards the types of communication and job satisfaction, and their performance of nursing, and these were evaluated by the head nurses, and their direct seniors. The data were collected for 10 days from the September 17 to 26, 2002. According to the purpose of the study, descriptive analysis, ANOVA. Pearson correlation coefficient, and stepwise multiple regression were applied for the data analysis using SPSS 10.0. The results are as follows : 1. The types of communication of staff nurses showed that the upward communication was $3.12\pm0.56$. the downward communication was $3.56\pm0.42$. the horizontal communication was $2.98\pm0.44$. and the informal communication was $2.59\pm0.49$. It showed that the most frequent communication was the downward communication. 2. In terms of the job satisfaction, there was significant difference according to the length of the period working for one ward (F=5.95, p=0.003), 3. The performance of nursing was significantly different according to the age (F=23.52, p=0.000), the working duration as a nurses (F=21.9, p=0.000), the types of nursing unit (F=5.33, p=0.002), and the working duration in present nursing unit (F=15.87, p=0.000). 4. In terms of communication type, the job satisfaction was associated with quality of the upward communication (F=6.23, p=0.003), the downward communication (F=5.78, p=0.004), and the horizontal communication (F=11.73, p=0.000) There were no association between the types of communication and the performance of nursing. 5. There was a positive correlation between the communication and the job satisfaction. And the downward communication (r=0.398) showed the greatest correlation with the job satisfaction. There was no statistically significant correlation between the communication and the performance of nursing. And the upward communication (r=-0.058) showed a negative, though not significant correlation with performance of nursing. 5. There was a positive correlation between the communication and the job satisfaction. And the downward communication (r=0.398) showed the greatest correlation with the job satisfaction. There was no statistically significant correlation between the communication and the performance of nursing. And the upward communication (r=-0.058) showed a negative. though not significant correlation with performance of nursing. 6. The stepwise multiple regression result showed that the downward communication accounts for $15.8\%$ (p=0,000) of the job satisfaction.

• Child Health Nursing Research
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• 제6권2호
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• pp.132-143
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• 2000

The purpose of this correlational study was to find the correlation between the infant temperament, mother-infant interaction, and child-rearing environment. The subjects of this study were 37 dyads of healthy mothers and healthy infants. Data were collected from 15th of March to 3rd of September, 1999. Convenient sampling was done at Obstetric wards of one University hospital, and demographic data were collected before discharge. At one month and three month postpartum, we visited subject's home, and collected the data on the infant temperament, and also video taped the mother-infant interaction during feeding. In addition, child-rearing environment was checked by researcher according to HOME(Home Observation for Measurement of the Environment) at three months postpartum. Mother-infant interactions were rated according to the NCAST Feeding Scale later. Data were analyzed by window SPSS program, and correlations between the infant temperament, mother-infant interaction, and child-rearing environment were analyzed by Pearson's correlational coefficient. The results were as follows: 1. Infant temperament. 1) Among the subscales of infant temperament, mothers perceived cuddliness and amenability most positively at one month, and responsivity and amenability most positively at three months. 2) In subscale analysis of stability, amenability, responsivity, and persistence were stable with the time. 3) Significant relationships were found between the malleability and amenability, between the malleability and responsivity at one month, and also between the malleability and amenability, and between the malleability and cuddliness at three months. 2. Correlations of infant temperament and mother-infant interaction. 1) There was no significant relationship between the infant temperament and mother-infant interaction at one month. 2) There was a significant relationship between the infant temperament and mother-infant interaction at three months(r=.335, p<.05). In subscale analysis, there were significnt relationships between the total score of infant temperament and maternal sensitivity to infant's cues(r=.372, p<.05), and between the total score of infant temperament and maternal response to infant's distress (r=.331, p<.05). 3. Correlations of infant temperament and child-rearing environment. 1) There was no significant relationship between the total score of infant temperament at one month and total score of HOME at three months. In subscal analysis, the total score of infant temperament at one showed significant relationships with the organization of environment(r=.413, p<.05), and the emotional, verbal response at three months(r=.337, p<.05). 2) There was a significant relationship between the total score of infant temperament at three months and the total score of HOME at three months (r=.599, p<.01). In subscal analysis, the total score of infant temperament at three months showed significant relationships with the organization of environment(r=.410, p<.05), maternal involvement(r=.482, p,.01), and the emotional, verbal response(r=.695, p<.01) at three months. 4. Correlations of mother-infant interaction and child-rearing environment. There was a significant relationship between the maternal score of mother-infant interaction at one month and three months and the total score of HOME at three months (r=.474, p<.01; r=.452, p<.01). In conclusion, it was proved that infant temperament had significant relationships with mother-infant interaction and child-rearing environment, especially when the infants were getting older. This showed the possibility for changeability of infant teperament by the maternal factors.

• 의료법학
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• 제10권2호
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• pp.203-249
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• 2009

It is the so-called Shinchon Severance Hospital Case brought to an end by the decision of the Supreme Court that opened the real discourse of withholding or withdrawing of LST (Life-Sustaining Treatment) in the legal profession as well as medical profession in Korea. Everyone has sympathy with the validity and necessity of legal regulation on withdrawing-including withholding-of LST save the requirements & procedure of withdrawing of LST. In this situation, the legislative bill of amendment to the Korean Civil Law introducing of adult guardianship was pre-announced by the Ministry of Justice on September 18th 2009. The adult guardianship is a guardianship system that supports an mentally handicapped adult to deal with his affairs by support of a guardian. The object of adult guardianship includes affairs of body or well-being as well as property of adult wards. In particular, affairs of medical matters are of importance in the duty and authority of adult guardians. So, the introduction of adult guardianship is of much importance de lege lata as well as de lege ferena in the discussion of withdrawing of LST as a medical treatment. Since the legislation on withdrawing of LST intents to protect the right of death with dignity on the basis of patients' autonomy, the ratio legis of withdrawing of LST is variant from that of adult guardianship. In this context, it seems reasonable to legislate the withdrawing of LST separately from the adultguardianship. In the meantime, the adult guardianship of the legislative bill of amendment to the Korean Civil Law is related to the withdrawing of LST, since the main purpose of adult guardianship is to protect patients' quality of lives and to regulate guardianship contracts based on patients' autonomy. In that context, it seems reasonable to incorporate the legislation of withdrawing of LST into the adult guardianship system. In the latter case, it is not easy to adopt the withdrawing of LST into the legislative bill of the Korean Civil Law for the bill is pre-announced already as previously stated. However, the legislation of withdrawing of LST is not inferior to the legislation of adult guardianship as a matter of urgency. Moreover, it is likely that the legislative bill of Amendment to the Korean Civil Law generates discrepancies in interpretation of the requirements & procedure of withdrawing of LST as the amended German Civil Law did. In short, it is desirable for the legislator to revise the legislative bill despite delay.

• 핵의학기술
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• 제17권1호
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• pp.3-6
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• 2013

Purpose: The treatment of thyroid cancer patients was continuously increased. According to the increment of thyroid cancer patients, the establishment of iodine therapy site was also increased in each hospital. This treatment involves the administration of radioactive iodine, which will be given in the form of a capsule. Therefore, protections and managements for radioactive source pollution and radiation exposure should be necessary for radiation safety. Among the many problems, the problem of disposing the radioactive wastes was occurred. In this study, The date for self-disposal for radioactive wastes, which were contaminated in clothes, bedclothes and trash, were calculated. Materials and Methods: The number of iodine therapy ward was 15 in Korea Institute of Radiological Medical and Sciences. Recently, 8 therapy wards were operated for iodine therapy patients and others were on standby for emergency treatment ward of any radiation accidents. Radioactive wastes, which were occurred in therapy ward, were clothes, bedclothes, bath cover for patients washing water and food and drink which was leftover by patients. Each sample was hold into the marinelli beaker (clothes, bedclothes, bath covers) and 90 ml beaker (food, drink, and washing water). The activities of collected samples were measured by HpGe MCA device (Multi Channel Analysis, CANBERRA, USA) Results: The storage period for the each kind of radioactive wastes was calculated by equation of storage periods based on the measurement outcomes. The average storage period was 60 days for the case of clothes, and the maximum storage period was 93 days for patient bottoms. The average storage period and the maximum storage period for the trash were 69 days and 97 days, respectively. The leftover foods and drinks had short storage period (the average storage period was 25 days and maximum storage period was 39 days), compared with other wastes. Conclusion: The proper storage period for disposing the radioactive waste (clothes, bedclothes and bath cover) was 100 days by the regulation on self-disposal of radioactive waste. In addition, the storage period for disposing the liquid radioactive waste was 120 days. The current regulation for radioactive waste self-disposing was not suitable for the circumstances of each radioactive therapy facility. Therefore, it was necessary to reduce the leftover food and drinks by adequate table setting for patients, and improve the process and regulation for disposing the short-half life radioactive wastes.

• 한국보건간호학회지
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• 제7권2호
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• pp.39-52
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• 1993

The primary purpose of this study is to promote and establish the development of home health care in Korea. It focuses on identifying and classifying the nursing activities that were provided by health professionals for patients who were admitted to two hospitals with cerebral vascular disease. And also. the study was conducted for comparison of client selection criteria between health professionals, and identifying patients who needed home health care The subjects of this study were 38 patients with cerebral vascular disease who were admitted to neuro-surgery wards at 2 hospitals with more than 500 beds in Daegu from November 1. through 30. 1991. Survey instruments were questionnaires to identify nursing activities and classify patients who needed home health care. Data was collelected by 1 doctor and 2 nurses per patient independently. They checked the same patient with the questionnaire on the same day and never communicated their information about patients with each other. All the questionnaires checked by doctor and nurses completely were 90. Statistical methods for analyzing data were non-parametric tests (Kruskal Wallice test and sign test). Correlation and percentages were used for further analysis. From this study. the following summarized conclusions have been drawn. 1. 10. 2 kinds of treatment and nursing activities were provided by health professionals for patients with cerebral vascular disease in hospital. 2. The points of nursing needs were between 32-37 out of a total of 500 as a result of the assessment about the health status of patients who were admitted to neuro-surgery ward with cerebral vascular disease. The points of Barthel Index of Functional Status Assessing Devices were between 24-34. Client Selection Criteria for Home Health Care was congruent between the Health professionals because the difference were not found to be statistically significant. 3. Patients classfied as home health care clients were $70-80\%$ of all patients who were admitted in hospital. There was not significant difference in patient selection criteria for home health care between health professionals statistically. As a result. the validity of different tools used in classifying home health care client were found to be congruent. 4. $80-85\%$ patients who could be discharged and sent to their homes early were identified as home health care clients. This study using client selection criteria. for home health care contributed to tool development because the validity of tools was verified. And also, this research represented that there was congruency in patient selection criteria for home health care between different health professionals. As a result, this study represented that many patients who were admitted to hospitals could be classified as a home health care clients. On the basis of the findings. further studies are required to develop client selection criteria using universal tools for classifying home health care clients in other chronic diseases. It is also recommended that comparative studies for client selection criteria between health professionals treating in other chronic diseases are necessary.