• 한국노년학
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• 제31권1호
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• pp.143-155
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• 2011

본 연구에서는 장애문제와 노인문제를 동시에 경험하는 취약한 집단인 장애노인을 대상으로 9가지 일상생활만족도와 일상생활만족도에 영향을 주는 요인에 성별차이가 있는지 살펴보았다. 이를 분석하기 위하여 '제1차 장애인고용패널조사(2008)' 중 만65세 장애노인 386명을 추출하였다. 연구질문을 확인하기 위한 분석방법은 독립표본티검정, 다중회귀분석방법을 활용하였다. 분석결과, 장애노인의 9가지 일상생활만족도 차원 중 6가지 차원이 성별차이가 있는 것으로 파악되었다. 그리고 장애노인의 일상생활만족도에 영향을 주는 요인을 비교 분석한 결과, 여성 장애노인과 남성장애노인은 일상생활만족도 영향요인의 차이가 있는 것으로 파악되었다. 공통적으로 '사회경제적 지위: 하층', '건강상태: 나쁜 편', '만성질병 있음', '가족과 타인의 도움필요', '장애정도: 중증'이 일상생활만족도에 통계적으로 유의미한 영향을 주는 요인으로 나타났다. 이러한 연구결과로부터 남녀장애노인에 대한 건강지원정책 및 프로그램을 제공, 장애인활동보조서비스 확대, 중증장애노인에 대한 보다 적극적인 정책 및 실천적으로 지원할 수 방안을 제언하였다. 반면에 차별영향 요인은 연령과 교육수준으로 분석되었다. 즉, 여성 장애노인은 연령이 높을수록 일상생활만족도가 낮은 것으로 나타났다. 반면에 남성 장애 노인은 교육수준이 무학일 경우보다 중졸과 고졸이상일수록 생활만족도가 높게 나타났다.

• 한국노년학
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• 제39권1호
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• pp.37-60
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• 2019

이 연구는 한국 노인들의 노화과정을 추적해 노화의 궤적을 도출하고, 그 특성을 파악하고자 시도된 것이다. 특별히 연구는 Rowe와 Kahn이 제시한 성공노화모델을 분석틀로 삼고, 집단중심 다중궤적모형을 활용해 귀납적 방식으로 노화궤적을 도출하였다. 또한 주요 인구사회적 특성들을 기본 예측요인으로 삼아 각 노화궤적의 특성들을 다항로지스틱 분석으로 파악하고자 했다. 분석을 위해 활용된 자료는 고령화연구패널(KLoSA)의 1~6차 조사자료이며, 분석대상은 65세이상 74세이하의 전기노인 2,682명이다. 다중궤적모형에 활용된 분석지표는 만성질환, 신체기능, 인지기능, 우울증상, 그리고 사회참여활동이다. 분석을 통해 도출된 노화궤적은 5개이며, 각각은 5개 지표의 변화양상에 따라 일반노화군(33.9%), 경도인지장애동반군(22.1%), 건강기능저하군(18.2%), 성공노화군(17.8%), 병적노화군(7.9%)로 명명되었다. 한편, 다항로지스틱분석을 실시한 결과 일반적으로 성공 노화는 남성, 저연령, 고학력, 고소득, 유배우자 집단이 경험할 가능성이 컸다. 반면, 저학력, 저소득, 그리고 고연령의 경우 상대적으로 어려운 노화의 과정을 겪을 가능성이 컸다. 특히, 경도인지장애동반노화를 겪을 가능성은 배우자가 없는 저학력, 저소득, 그리고 고연령 여성에게서 크게 나타났다.

• Child Health Nursing Research
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• 제4권1호
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• pp.60-75
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• 1998

The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

• 농촌의학ㆍ지역보건
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• 제1권1호
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• pp.29-36
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• 1976

Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

• 대한간호
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• 제29권2호
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

• 한국산학기술학회논문지
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• 제19권3호
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• pp.479-488
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• 2018

본 연구는 독거노인의 질병과 건강행태의 파악을 통해 독거노인의 저체중에 영향을 미치는 요인을 규명하기 위한 조사연구이다. 2014년 지역사회건강조사 원시자료를 활용하였으며, 65세 이상 저체중 독거노인 922명의 자료를 최종분석에 사용하였다. 자료의 분석은 SPSS/WIN 22.0 프로그램의 복합표본분석 모듈을 이용하여, 기술통계, Rao Scott $x^2$ test, 로지스틱 회귀분석을 통해 분석하였다. 본 연구의 결과, 독거노인들은 만성질환을 가지고 있는 비율이 높았으며, 흡연, 음주, 운동량 부족, 짜게 먹는 식습관, 틀니사용에 의한 저작 불편, 나쁜 주관적 건강상태와 같은 좋지 않은 건강행태를 가지고 있는 것으로 나타났다. 로지스틱 회귀분석 결과 독거노인의 성별에 따른 저체중 발생 위험확률은 다음과 같다. 흡연으로 인한 저체중 위험도는 여자노인에서 가끔 피우는 경우 3.004배, 걷기량으로 인한 저체중 위험도는 3일미만 걷는 사람이 저체중일 가능성은 1.420배로 유의하게 높았다. 주관적 스트레스를 많이 느끼는 경우 저체중일 가능성은 남자노인에서 2.220배, 여자노인에서 1.282배로 유의하게 높았다. 주관적 건강수준이 나쁜 사람이 저체중일 가능성은 남자노인에서 3.633배, 여자노인에서 1.590배로 유의하게 높았다. 본 연구의 결과를 토대로 저체중 독거노인의 건강행태 개선을 위한 적절한 간호중재의 수립과 관리방안의 마련이 필요하다. 또한, 저체중 독거노인에 대한 신체적, 심리적, 사회적 특성 등의 다양한 변인을 고려한 반복연구가 필요할 것이다.

• 대한화장품학회지
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• 제30권4호
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• pp.533-541
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• 2004

아토피 피부염은 다른 말로 태열이라고도 하며, 유아 시기에서부터 성인까지 광범위한 연령층에 병변의 특징적인 분포 그리고 개인적 혹은 가족적인 병력을 가진 특히 유전적 소인을 보이는 질환으로 심한 가려움증과 건조증 등을 동반하는 일종의 재발성, 만성의 알레르기성 습진을 말한다. 그 유병율은 매우 흔하여 어린이의 약 $9~12\%$ 에서발생한다. 그러나 최근에는 사회 자연환경의 변화와 음식문화의 변화, 삶의 방식의 변화에 의해서 계속 증가하는 추세를 보이고 있다. 인간의 피부는 외부 환경으로부터의 물리적, 화학적 자극에 대한 장벽기능의 역할을 하는데 아토피 피부염 환자의 피부는 각질층에서의 피부 장벽기능 및 수분유지 기능이 감소되어 있고 이러한 기능 장애의 원인으로 최근 연구에 의하면 세라마이드의 감소에 따른 것으로 밝혀지고 있다. 세라마이드는 스핑고신에 지방산이 연결되어 있는 구조를 가지고 있는 스핑고 지질의 일종이다. 세라마이드는 피부 각질층을 구성하는 각질세포간 지질 중 약 $40\%$를 차지하며, 수분 증발을 억제하는 지질 방어벽 역할과 각질층의 정연한 구조를 유지하게 하는 기능을 가지고 있다. 피부 각질층은 각화된 세포가 벽돌모양의 다층 구조로 구성되어 있으며 이러한 각화세포는 세라마이드, 콜레스테롤, 유리 지방산에 의해 견고히 결합되어 있다 따라서 이 세라마이드가 함유된 크림이나 연고를 아토피 피부염 환자에 도포함으로써 환자의 피부 장벽기능의 복구에 도움을 주어 아토피 피부염을 치료할 수 있다는 보고가 있다. 본 연구는 아토피 피부염 전용화장품으로서 아토피 피부에서 피부장벽을 복구하는데 기여한다고 증명된 각질 세포간 지질 성분들(세라마이드, 콜레스테롤, 유리지방산)을 포함하는 유액제품과 피부 면역조절과 항 염증 효과가 있다고 보고된 베타글루칸, 신이화 추출물 감초 추출물 등을 포함하는 세럼형태의 액상제품으로 구성된 두 가지 제품을 아토피 피부염 환자에게 도포하게 하여 그 제품의 안전성과 유효성을 확인하여 보았다. 그리고 그 제품이 새로운 시장인 아토피 피부염 전용 보습화장품으로서의 시장진입 가능성을 확인하여 보았다.

• 농촌의학ㆍ지역보건
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• 제37권3호
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• pp.167-180
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• 2012

본 연구는 대구광역시 심뇌혈관질환 고위험군 등록관리 시범사업단 고혈압 당뇨병 교육정보센터를 방문한 고위험군환자와 교육자의 교육요구도를 반영하여 질환, 영양, 운동 3영역의 기본, 심화, 개별 3단계로 단계별 교육프로그램을 개발하였다. 이 프로그램의 효과평가를 위하여 교육정보센터에 방문한 기본교육군 32명, 단계교육군 37명을 대상으로 교육 전후 임상적 지표, 행동변화단계, 자아효능감을 측정하였고 주요 연구결과는 다음과 같다. 교육요구도조사결과 고위험군과 교육자의 요구도가 높은 소그룹형태, 30분-1시간이내 수업 및 이론 50%와 실습 50%의 구성과 형태로 이루어지며 3개월의 교육과정인 질환, 영양, 운동영역의 단계 교육프로그램을 개발하였다. 교육요구도조사 결과 교육영역별 교육내용은 고위험군과 교육자의 필요도와 지식정도의 통계적으로 유의한 차이에 따라 5가지 범주로 분류하여 프로그램 구성에 적용할 수 있었다. 첫째, 고위험군과 교육자간의 요구도에 유의한 차이가 없는 항목은 기본과정내용으로 반복하게 하였고 둘째, 고위험군의 인지도가 평균점수 이하인 항목은 기본교육과정내용을 조정하여 효과적인 실습방법으로 모든 단계에서 반복할 수 있도록 하였다. 셋째, 고위험군의 지식정도 평균 편차가 큰 항목은 개별교육과정에 포함시켜 문제를 해결할 수 있는 기술습득을 목표로 이루어지도록 하였다. 넷째, 고위험군과 교육자간 지식정도의 유의한 차이가 있는 항목과 다섯째, 고위험군과 교육자간 요구도에서 유의한 차이가 있는 항목은 고위험군의 참여도가 높은 실습 중심의 심화교육으로 구성하며 교육자도 표준 매뉴얼에 따라 교육방법, 교육환경을 일관성 있게 유지하도록 교육훈련을 강화하여 교육자 간 격차를 줄이도록 하였다. 교육자와 고위험군과의 격차를 줄이기 위하여 자가관리 목표, 단기 계획 설정을 고위험군과 교육자 상호약속에 의해서 계획하여 실천동기와 문제해결능력을 향상시키도록 하는 과정을 단계마다 필수적으로 포함시켰다. 교육프로그램의 평가는 기본교육군, 단계교육군을 대상으로 임상적 지표, 행동변화단계 자기 효능감을 측정하여 비교하였다. 임상지표 중 허리둘레, 수축기혈압, 이완기혈압(p<0.05), 자기효능감 중 혈압/혈당조절 불량시 병원방문, 의사의 지시에 따라 약 복용, 식사량 일정유지(p<0.05), 정기적으로 합병증 검사, 정상적인 혈압/혈당을 유지, 허리둘레 유지, 체중 유지(p<0.01), 행동변화단계에서는 싱겁게 먹기(p<0.05)에서 유의적인 차이가 있었다. 환자와 교육자의 교육요구도를 반영하여 개발된 실습 중심의 단계별 교육프로그램은 이론중심의 기본교육프로그램과 비교한 결과 임상지표, 자기효능감, 행동변화단계에서 유의한 차이가 있었다. 대상자 수가 적고 추구관리기간이 짧았으며 임상지표측정이 부족했던 한계점은 있으나 환자가 노인이며 만성질환환자로서 유병기간이 긴 점을 감안하면 이 프로그램을 지속적으로 시행한다면 환자의 심뇌혈관질환 예방에 기여할 수 있을 것이다.

• 대한간호학회지
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• 제28권4호
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• pp.1047-1059
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• 1998

Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

• 한국노년학
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• 제29권4호
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• pp.1247-1259
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• 2009

노화가 진행됨에 따라 근육은 감소 현상(sarcopenia)을 나타낸다. 근육의 감소는 노인의 의료비 증가와 직접적인 관련성은 없어 보이지만, 근육의 감소가 근력의 감소로 연결되어 체력의 약화, 활동성의 감소, 낙상의 증가 등과 같은 독립적인 생활을 감소시킨다. 이는 신체장애로 연결되며, 또다시 당뇨, 비만, 고지혈증, 고혈압 등과 같은 만성퇴행성 질환으로 연결된다. 결국, 근감소증은 사망률을 상승시키는 잠재 위험요인이 된다. 본 연구는 탄력밴드 운동을 통한 근감소증 예방과 관련된 변인인 신체조성 및 체력의 향상된 변화와 더불어 운동 중단에 따른 운동효과의 상쇄(相殺) 정도를 살펴보는데 있다. 본 연구의 피검자는 S시 J구 J노인복지관 운동프로그램에 참가하는 60-70대의 노인 14명으로 선정하였다. 12주 동안의 탄력밴드 운동은 주2회의 빈도로 실시하였다. 측정시기는 12주간의 통제전, 통제후(운동전), 12주간의 운동 후(운동중단 전), 12주간의 운동중단 후로 신체조성 과 체력 변인을 측정하였다. 12주간의 통제전·후 신체조성과 체력 변인에는 통계적인 유의차가 나타나지 않았으나, 12주간의 운동전·후 신체조성의 체중(t=2.978, p=0.001), 체질량지수(t=3.502, p=0.004), 체지방율(t=2.216, p=0.045), 근육량(t=-3.837, p=0.002), 내장지방면적(t=5.186, p<0.001), 허리-엉덩이 둘레비(t=3.045, p=0.009) 모든 변인에서, 체력의 2분 제자리 걷기(t=-6.891 p<0.001), 덤벨들기(t=-4.702, p<0.001), 의자에서 일어섰다 앉기(t=-4.860, p<0.001), 의자앉아 앞으로 굽히기(t=-5.910, p<0.001), 등 뒤에서 손잡기(t=-3.835, p=0.002), 244cm 왕복 걷기(t=7.560, p<0.001)의 모든 변인에서 운동의 효과를 나타내었고, 그 효과가 12주간의 운동중단 후에도 신체조성의 체중(t=2.323, p=0.037), 체질량지수(t=2.503, p=0.026), 근육량(t=-3.137, p=0.008) 변인에서, 체력의 2분 제자리 걷기(t=-6.489 p<0.001), 의자에서 일어섰다 앉기(t=-4.694, p<0.001), 의자앉아 앞으로 굽히기(t=-3.690, p=0.003), 244cm 왕복 걷기(t=7.539, p<0.001)의 변인에서 그 유지가 지속되었다. 노인에게 있어서 탄력밴드 운동은 신체조성 및 체력에 긍정적인 영향을 나타내며, 그 운동의 효과가 12주가 경과되어도 유지되고 있음을 확인할 수 있었다.