• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2016년도 춘계 종합학술대회 논문집
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• pp.231-232
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• 2016

요양보호사는 치매와 같은 질병을 가진 이용자를 돌보는 과정에서 폭력, 폭언 등에 무방비로 노출되어 있으며, 실제로 장기요양기관의 요양보호사가 언어폭력이나 신체적 폭력을 경험한 것으로 나타났다(머니투데이, 2012. 07. 01, 보건복지자원연구원, 2012). 이에 본 연구는 장기요양서비스의 이용자에 의한 폭력경험이 요양보호사의 이직의도에 미치는 영향을 분석하고자 한다. 본 연구는 290명의 요양보호사를 무작위 추출하여 최종 191부를 분석에 활용하였다. 위계적 회귀분석 실시 결과 이용자로 부터의 폭력경험이 이직의도에 영향을 미치는 것으로 나타났다. 이러한 결과를 통해 요양보호사의 이직의도를 예방하는 함의를 제공하고자 한다.

• Journal of Trauma and Injury
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• 제32권3호
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• pp.150-156
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• 2019

Purpose: To determine whether a peripherally inserted central catheter (PICC) meets the goals of a low infection rate and long-term use in trauma patients. Methods: From January 2016 to June 2018, the medical records of patients who underwent central venous catheterization at a level I trauma center were retrospectively reviewed. Data collected included age, sex, injury severity score, site of catheterization, place of catheterization (intensive care unit [ICU], emergency department, or general ward), type of catheter, length of hospital stay during catheterization, types of cultured bacteria, time to development of central line-associated bloodstream infection (CLABSI), and complications. Results: During the study period, 333 central vein catheters (CVC) were inserted with a total of 2,626 catheter-days and 97 PICCs were placed with a total of 2,227 catheter-days. The CLABSI rate was significantly lower in the PICC group when the analysis was limited to patients for whom the catheter was changed for the first time in the ICU after CVC insertion in the ER with similar indication and catheter insertion times (18.6 vs. 10.3/1,000 catheter-days, respectively, p<0.05). The median duration of catheter use was significantly longer in the PICC group than in the CVC group (16 vs. 6 days, respectively, p<0.05). Conclusions: The study results showed that the duration of catheter use was longer and the infection rate were lower in the PICC group than in the CVC group, suggesting that PICC is a safe and reliable alternative to conventional CVC.

• 한국의료질향상학회지
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• 제9권2호
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• 성인간호학회지
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• 제21권2호
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• pp.187-198
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• 2009

Purpose: This study was to compare and examine the factors influencing burden of primary family caregivers according to the severity of illness of elderly patients admitted in an intensive care unit. Methods: Subjects were the families of elderly patients in intensive care units of K, S and Y hospitals in Seoul. Data were collected from March to October 2007. Subjects were 108 persons over age 65. Data were analyzed by SAS statistics. Results: First, groups 5 and 3 showed higher burden than that of group 4. Second, high correlation was found between stress and burden, stress and anxiety, and burden and anxiety. Third, factors influencing family burden were found to be stress for group 5, stress, anxiety, and monthly income for group 4, and stress and patient age for group 3. Conclusion: Specific nursing interventions to decrease the stress of primary family caregivers of serious ill elderly patients in an intensive care unit are needed. Additionally, more effective and systematic activation of a long-term medical insurance system for seriously ill seniors is considered necessary to mediate the burden of primary family caregivers.

• 한국식생활문화학회지
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• 제34권4호
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• pp.389-400
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• 2019

In this study we compared the cognitive function (Mini-Mental State Examination for Dementia Screening: MMSE-DS) and nutrient intake of elderly women with dementia in a long-term care facility (EW-LCF) and a day-time care facility (EW-DCF). This survey was conducted from July 2015 to May 2017 on 73 elderly women with dementia (47 women in LCF and 26 women in DCF) in the city of Incheon. The data obtained from interviews with the subjects and caregivers were analyzed using the SPSS 20.0. The total score of the MMSE-DS and intakes of most nutrients in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). The nutrient adequacy ratios (NAR) of protein, vitamin A, C, $B_6$, $B_{12}$, thiamin, riboflavin, niacin, folic acid, calcium and phosphorus in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). However, the indexes of nutritional quality (INQ) of vitamin C, $B_6$, thiamine, niacin, calcium, magnesium, and iron in the EW-LCF were significantly higher compared to the EW-DCF (p<0.05). As a result, the subjects showed an unbalanced and insufficient nutrition intake status regardless of the type of care facility. Most nutrient intakes of the EW-LCF with lower cognitive function were very significantly lower compared to the EW-DCF (p<0.001). Therefore, it is necessary to assess the cognitive function and nutritional status regularly at care facilities for the elderly women suffering with dementia and to provide specialized individual nutritional management.

• 한국산학기술학회논문지
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• 제20권12호
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• pp.747-757
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• 2019

본 연구는 노인환자가 인식하는 간호사와의 상호작용을 측정하기 위해 개발된 the Korean version of Nurse-Patient Interaction Scale (K-NPIS)을 한국 요양병원에 입원한 노인환자를 대상으로 간호사와의 상호작용을 측정의 신뢰도와 타당도를 검증하려는 목적으로 시행되었다. 진주시, 순천시, 남원시에 소재하는 4개의 요양병원에 입원한 노인환자 202명을 대상으로 신뢰도와 타당도 검증을 실시하였다. 문항분석과 내적일관성 검증을 통해 K-NPIS의 Cronbach α 값은 .96이었다. 전문가들을 통한 내용타당도 검증에서 내용타당도 지수가 0.8 이상으로 확인되었으며, 확인적 요인분석을 거쳐 최종 단일속성으로 구성된 12개 문항 각 10점 척도의 최종 도구가 도출되었으며, 재원기간에 따라 K-NPIS의 점수가 유의하게 차이가 나(p=.042) 판별타당도도 검증되었고, 천장효과나 바닥효과는 나타나지 않았다. 이와 같이 K-NPIS는 신뢰도와 타당도가 높은 도구임이 검증되어 요양병원에서 노인환자를 대상으로 간호사-환자의 상호작용을 측정하는 도구로 사용되는데 적절한 것으로 보이나 장차 준거타당도를 검증할 필요가 있다. K-NPIS는 노인환자가 인식하고 있는 간호사와의 상호작용을 자가보고 형식으로 측정하는 것이므로, 노인환자와의 상호작용을 기반으로 한 돌봄 중재의 성과를 평가하여 간호서비스 질 향상에 기여할 수 있을 것으로 기대된다.

• 한국산학기술학회논문지
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• 제20권12호
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• pp.322-332
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• 2019

본 연구의 목적은 노인장기요양보험 방문간호사의 전문직업성, 직무만족도와 회복탄력성이 재직의도에 미치는 영향을 파악하기 위한 서술적 조사연구이다. 본 연구는 노인장기요양보험 데이터베이스에 등록된 방문간호기관에서 근무하는 방문간호사 141명을 대상으로 2019년 4월 1일 부터 2019년 5월 31까지 자가 보고형 설문지를 배부하여 자료를 수집하였다. 수집된 자료는 SPSS/WIN 22.0 프로그램을 이용하여 independent t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient, 위계적 다중회귀분석을 이용하여 자료를 분석하였다. 연구결과, 대상자의 전문직업성 수준은 5점 만점에 평균 3.51점, 직무만족도는 5점 만점에 평균 3.27점, 회복탄력성은 5점 만점에 평균 3.79점, 재직의도는 5점 만점에 4.04점으로 나타났다. 재직의도와 전문직업성(r=.272), 직무만족도(r=.201) 회복탄력성(r=.530)은 양의 상관관계가 있었다. 최종 회귀모형에서 회복탄력성(β=.455, p<.001), 직무만족도(β=.175, p=.016) 순으로 재직의도에 유의한 영향을 미치는 것으로 나타났다. 이들 변수들의 모형 설명력은 32.0%로 나타났다(F=11.968, p<.001). 본 연구 결과를 토대로, 노인장기요양보험 방문간호사의 재직의도 향상을 위해 회복탄력성 증진 전략에 가장 관심을 기울여야 하고 다음으로 직무만족도 증진 방안 수립이 필요하다.

• 한국응용과학기술학회지
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• 제37권4호
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• pp.659-673
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• 2020

본 연구는 장애인 복지관을 이용하는 지체장애인 및 뇌병변장애인 중 고혈압 환자를 대상으로 복지관 간호사와 간호학생 자원봉사자를 통해 제공된 8주 전화상담 고혈압 자가관리 프로그램의 효과를 파악하는데 목적이 있다. 비동등성 대조군 전후 유사실험설계 연구로, 2019년 12월부터 2020년 5월까지 사전, 사후 조사를 완료한 대조군 28명, 실험군 29명의 자료를 SPSS 프로그램을 이용하여 분석하였다. 주요 연구결과로, 프로그램 적용 후 실험군이 대조군에 비해 고혈압 관련 지식, 건강신념 중 심각성과 민감성, 삶의 질 EQ-VAS에서 통계적으로 유의한 차이를 나타나며 높아진 것으로 나타났다. 따라서 장기적인 건강관리가 필수적인 장애인 고혈압 환자를 대상으로 다양한 자가관리 프로그램을 적용하여 관련 지식, 건강신념 및 삶의 질 등을 높이는 노력이 계속적으로 필요할 것이다.

• The Korean Journal of Physiology and Pharmacology
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• 제19권6호
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• pp.491-497
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• 2015

Traumatic brain injury (TBI) is a major cause of mortality and long-term disability, which can decrease quality of life. In spite of numerous studies suggesting that Epigallocatechin-3- gallate (EGCG) has been used as a therapeutic agent for a broad range of disorders, the effect of EGCG on TBI remains unknown. In this study, a weight drop model was established to evaluate the therapeutic potential of EGCG on TBI. Rats were administered with 100 mg/kg EGCG or PBS intraperitoneally. At different times following trauma, rats were sacrificed for analysis. It was found that EGCG (100 mg/kg, i.p.) treatment significantly reduced brain water content and vascular permeability at 12, 24, 48, 72 hour after TBI. Real-time PCR results revealed that EGCG inhibited TBI-induced IL-$1{\beta}$ and TNF-${\alpha}$ mRNA expression. Importantly, CD68 mRNA expression decreasing in the brain suggested that EGCG inhibited microglia activation. Western blotting and immunohistochemistry results showed that administering of EGCG significantly inhibited the levels of aquaporin-4 (AQP4) and glial fibrillary acidic protein (GFAP) expression. TBI-induced oxidative stress was remarkably impaired by EGCG treatment, which elevated the activities of SOD and GSH-PX. Conversely, EGCG significantly reduced the contents of MDA after TBI. In addition, EGCG decreased TBI-induced NADPH oxidase activation through inhibition of $p47^{phox}$ translocation from cytoplasm to plasma membrane. These data demonstrate that EGCG treatment may be an effective therapeutic strategy for TBI and the underlying mechanism involves inhibition of oxidative stress.

• 대한간호
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• 제33권3호
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• pp.79-91
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• 1994

The purpose of this study was to identify the meaningful nursing diagnosis in maternity unit and to suggest formally the basal data to the nursing service with scientific approach. The subject for this paper were 64 patients who admitted to Chung Ang University Hospital, Located in Seoul, from Mar. 10, to July 21, 1993. The results were as follows: 1. The number of nursing diagnosis from 64 patients were 892 and average number of nursing diagnosis per patient was 13.9. 2. Applying the division of nursing diagnosis to Roy's Adaptation Model, determined nursing diagnosis from the 64 patients were 621 (69.6%) in physiological adaptation mode and (Comfort, altered r/t), (Injury, potential for r/t), (Infection, potential for r/t), (Bowel elimination, altered patterns r/t), (Breathing pattern, ineffective r/t), (Nutrition, altered r/t less than body requirement) in order, and 139 (15.6%) in role function mode, (Self care deficit r/t), (Knowledge deficit r/t), (Mobility, impaired physical r/t) in order, 122 (13.7%) in interdependence adaptation mode, (Anxiety r/t), (Family Process, altered r/t) in order, 10(1.1%) in self concept adaptation mode, (Powerlessness r/t), (Grieving, dysfunctional r/t) in order. 3. Nursing diagnosis in maternity unit by the medical diagnosis, the average hospital dates were 3.8 days in normal delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 64.6%, (Self care deficit r/t) 13.6% in order, and the average hospital dates were 9.6 days in cesarean section delivery and majority of used nursing diagnosis, (Comfort, altered r/t) 51.6%, (Self care deficit r/t) 15.2%, (Infection, potential for r/t) 9.9%, (Injury, potential "for r/t) 8.1%, (Anxiety r/t) 5.0%, (Mobility, impaired physical r/t) 3.3% in order, and the average hospital dates were 15.8days in preterm labor and majority of used nursing diagnosis, (Comfort, altered r/ t), (Anxiety r/t), (Injury, potential for r/t) in order, and the average short-term hospital dates were 2.5days, long-term hospital dates were 11.5days in gynecologic diseases and majority of used nursing diagnosis, (Comfort, altered r/t). (Self care deficit r/t), (Injury, potential for r/t), (Infection, potential for r/t) in order.