• 임상간호연구
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• 제17권1호
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• pp.113-122
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• 2011

Purpose: This study was conducted to develop and evaluate an oral care protocol for cancer patients receiving chemotherapy. Methods: The participants in this study were cancer patients in Severance hospital in Seoul. A total of 31 patients were assigned to the experimental group, and 29 patients to the control group. Data were collected from August 1 to October 5, 2010. The protocol included definition and symptom of oral mucositis, self-check method of oral status, prophylactic method of oral mucositis (oral care, eating habits, and gargling) and management of oral mucositis. Oral Assessment Guide (OAG) was used as the measurement tool of oral mucositis in this study, Oral Care Performance Scale was used as the measurement tool of oral care performance status. Data were analyzed with a $x^2-test$ and t-test, and repeated measures ANOVA, using SPSS/WIN 18.0 program. Results: Patients in the experimental group receiving the oral care protocol had a significant difference (t=-2.938, p=.005) in the oral care performance compared to the control group. However, there was no significant difference (F=1.255, p=.274) in the oral mucositis status between two groups. Conclusion: This study showed that the oral care protocol could improve oral care performance status for the patients under chemotherapy.

• 산업융합연구
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• 제18권6호
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• pp.75-83
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• 2020

본 연구는 혈액원 노동자들의 건강한 근무환경 개선을 위한 토대를 제공하고자 작성된 서술적 조사연구이다. 설문지는 2020년 9월 8일부터 10월 31일까지 215부가 수집되었다. SPSS 19.0 통계 프로그램으로 카이제곱검정 및 피셔정확검정(Chi-squared test or Fisher's extract test), 독립표본 t-test, 다중로지스틱회귀분석(Mutiple Logistic Regression)을 하였다. 관련 요인 보정 후 긍정심리자본 및 직무스트레스와 주관적 건강 상태와의 관련성을 평가하기 위해 다중로지스틱회귀분석을 시행한 결과, 일반적 특성 및 업무특성과 주관적 건강 상태와는 관련성이 없었으며, 불건강군과 건강군의 긍정심리자본과 직무스트레스는 유의미한 평균 차이를 각각 보였다(p<.001, p<.001). 긍정심리자본이 한 단위 증가할수록 주관적 건강 상태의 양호한 건강군의 오즈비는 1.1배[95% confidence interval (CI): 1.0-1.1] 유의하게 증가 하였고, 직무스트레스가 한 단위 증가할수록 주관적 건강 상태의 양호한 건강군의 오즈비는 0.9배로[95% confidence interval (CI): 0.8-0.9] 유의하게 감소하는 결과를 보였다.

• 보건행정학회지
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• 제30권4호
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• pp.479-492
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• 2020

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

• 대한임상검사과학회지
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• 제54권4호
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• pp.293-297
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• 2022

2022년 국내 체외순환사(관류사)는 224명으로 간호사나 임상병리사를 모집해 병원 자체교육이나 위탁교육을 실시하고 있다. 일본의 체외순환사는 2021년에 2,100명이며, 주로 임상공학 기사들이 지원한다. 미국의 체외순환사는 2021년 4,212명으로 석사과정, 학사후 자격증 프로그램, 학사과정 등에서 교육을 받았으며 대부분 보건의료과학 또는 생명과학 전공 졸업생이다. 체외순환사는 인공심폐장치를 운용시키는 기술뿐만 아니라 심장해부학, 생리학, 약리학, 혈류역학, 검사분석, 정도보증 등에 대한 지식이 있어야 하기에 임상병리사와 한 직군이다. 메르 스와 코비드-19라는 두 가지 영향력 있는 위기를 통해 체외순환사의 중요성이 더욱 부각되고 있었다. 현재 심장수술의 체외순환은 물론 최근 급격히 확대되고 있는 체외막산소화장치 영역에서 체외순환사가 큰 역할을 하고 있다. 본 연구를 통해 심장수술 및 감염병 치료를 하는 병원은 자격을 갖춘 체외순환사를 일정한 수 만큼 확보하도록 제도화하고, 대한임상생리검사학회 산하에 체외순환기술회(관류기술회)를 설립하여 학술교류가 실시되기를 기대해 본다.

• 임상간호연구
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• 제29권1호
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• pp.24-41
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• 2023

Purpose: This study aimed to update the previously published nursing practice guideline for prevention of venous thromboembolism (VTE). Methods: The guideline was updated according to the manuals developed by National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN), and a Handbook for Clinical Practice Guideline Developer Version 10. Results: The updated nursing practice guideline for prevention of VTE was consisted of 16 domains, 46 subdomains, and 216 recommendations. The recommendations in each domain were: 4 general issues, 8 assessment of risk and bleeding factors, 5 interventions for prevention of VTE, 18 mechanical interventions, 36 pharmacological interventions, 36 VTE prevention starategies for medical patients, 25 for cancer patients, 13 for pregnancy, 8 for surgical patients, 7 for thoractic and cardiac surgery, 16 for orthopedic surgery, 10 for cranial and spinal surgery, 5 for vascular surgery, 13 for other surgery, 3 educations and information, and 2 documentation and report. For these recommendations, the level of evidence was 32.1% for level I, 51.8% for level II, and 16.1% for level III according to the infectious diseases society of America (IDSA) rating system. A total of 112 new recommendations were developed and 49 previous recommendations were deleted. Conclusion: The updated nursing practice guideline for prevention of VTE is expected to serve as an evidence-based practice guideline for prevention of VTE in South Korea. It is recommended that this guideline will disseminate to clinical nursing settings nationwide to improve the effectiveness of prevention of VTE practice.

• 임상간호연구
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• 제15권1호
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• pp.19-28
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• 2009

Purpose: The purpose of this study was to examine the effect of position change on discomfort and bleeding in patients undergone coronary angiography with a vascular device and required bed-rest. Method: This study utilized nonequivalent control group non-synchronized design. Data were collected from 118 inpatients after coronary angiography and stayed in general ward at Y hospital in Seoul, from June 5 to August 12, 2008. After coronary angiography, position change was performed to the experimental group who consisted of 59 patients. They stayed in supine position just after angiography and then head-up position with 15 degrees was applied 1 hour later. After that, they could change the position alternatively into lateral position with leg down and supine position. The control group was positioned keeping the affected leg immobile with supine position for 4 hours. Results: The experimental group reported significantly more comfortable than control group after position change. There were no significant differences in the grades of bleeding or hematoma at puncture site between the two groups. Conclusion: The position change in patients undergone angiography could be applied without any harm such as bleeding or hematoma, but effective in reducing back pain and subjective patients' discomforts.

• 대한기관윤리심의기구협의회지
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• 제5권2호
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• pp.51-58
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• 2023

Purpose: To validate the effectiveness of obtaining consent education on errors in the consent process and to develop the education program for researchers. Methods: From February 2019 to February 2022, a 30-minute, 1:1 face-to-face consent education developed using the ADDIE model was conducted on 78 nurses as principal investigators. An informed consent audit tool, which includes 6 items developed by Asan Medical Center Human Research Protection Center, was used to analyze errors in obtaining informed consent process. Data analysis was performed using the SPSS ver. 25.0, and the Mann-Whitney U-test and χ²-test were utilized to verify the difference in errors between the experimental and control groups. Results: The participants consisted of 42 in the experimental group and 36 in the control group, with no statistically significant difference between the 2 groups. Both 2 groups showed the highest frequency of documentation errors, followed by format errors, errors related to a suitability of investigator, participant, or participant's legally acceptable representative, witness and confidentiality issues. After education, there was a significant decrease in both format errors (p=0.002) and documentation errors (p<0.001) in the experimental group. The proportion of participants without any errors in all items was higher in the experimental group (35.7%) compared to the control group (5.6%), and this difference was statistically significant (p=0.001). Conclusion: The obtaining consent education program was found to be effective in reducing informed consent errors. This study emphasizes the importance of education, suggesting the need for its expansion and accessibility, as well as the necessity for all researchers conducting clinical studies to receive the obtaining consent education.

• 대한간호학회지
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• 제20권3호
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• pp.414-429
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• 1990

Numerous research reports have substantiated the role of stressful life events in relation to the onset of health changes. The relationship tends to hold across different age groups. Theoretically, adolescence has been considered a developmental crisis period of great stress, impoverished coping skills and high vulnerability to biological, social and psychological demands. The research problem addressed by this study was to examine the relationships between stressful life events and health symptom patterns, and the effect of two variables, coping and social, support, theoretically considered to mediate the relationship between stress and health symptoms in adolescents. The following five hypotheses were tested in this research : 1. Health symptoms are positively related to stressful life events in adolescents, 2. Health symptoms are negatively related to coping in adolescents, 3. Health symptoms are negatively related to social support in adolescents, 4. When coping is controlled, the relationship between health symptoms and stressful life events will decrease, and 5. When social support is controlled, the relationship between health symptoms and stressful life events will increase. The study subjects consisted of 1090 high school students of the metropolitan city of Seoul. The following sampling procedure was used : 1. Of the 169 high schools in nine school administrative districts in the city, a proportional sample of ten schools was selected. 2. One class from each of the freshman and sophomore was randomly selected and all the students who were in the sampled class were used as the study sample. The study was limited to freshman and sophomore adolescents, aged 15 to 18(mean＝16.6). Of the 1090 subjects 688(63%) were boys and 402(37%) were girls. An Adolescent Inventory of Stressful Life Events, a Health Symptom Questionnaire and an Adolescent Coping Inventory were adapted for this study. The Norbeck Social Support questionnaire was utilized to collect the data on perceived social support. Five high school teachers in the areas of school health and counselling reviewed the items of each questionnaire for content validity. A pilot study was undertaken to ascertain reliability. Fifty three high school students responded to the questionnaires and gave their opinions on the items. For stressful life events, health symptoms, coping, and social support, the Cronbach's alpha's on the study were .70, .94, .77, and .76, respectively. Research assistants attended all the sampled classes with the school proctor to explain the purpose and procedures of the study to the students. The questionnaires along with a ballpoint pen were distributed to the students who were asked to complete each item. The research assistants left the ballpoint pen with the students as a gift for their cooperation. An average of 50 minutes was required to complete the questionnaires. Using an SPSS, the first, three hypotheses were tested using Gamma, a measure of association for ordinal variables. Partial gamma was used to test the fourth and fifth hypotheses. Patterns of elaboration described by Babbie were selected to interpret the relationship of the three variable analyses. The significance of gamma was determined by Chisquare at a .05 level of significance. There was a positive relationship between health symptoms and stressful life events(Gamma＝.35, p＝.000). Thus the first hypothesis was supported. Unexpectedly, coping was positively related with health symptoms(Gamma＝.13, p＝.000). That is, the higher the coping levels, the greater number of health problems. The third hypothesis, the higher the level of social support, the fewer the health symptoms, was not accepted in this adolescent study group. When coping was controlled, under the condition of low coping the association between health symptoms and stressful life events increased significantly to a partial gamma of .39, and under the condition of high coping it was .30. According to the elaboration model, when one partial relationship is the same or greater than the original and the other is smaller, the control variable should be considered to be specifying the conditions. When social support was controlled the relationship between stressful life events and health symptoms increased under the condition of low social support, but with high social support, the relationship decreased. Both partial gamma were statistically significant at .05 level(.43 and .26 relatively). It can be interpreted that stressful life events are strongly and positively related to health symptoms under the condition of low social support, however this relationship can not be expected with high social support. Thus, the last two hypotheses were conditionally sustained. In this study, the relationships between stressful life events and health symptoms, and the specified me diating roles of coping and social support were found to have statistical interaction. This finding supports the theoretical position of this study. It suggests that stressful life events would create high susceptability to biological social and psychological health symptoms and coping and social support buffering the relationship between stressful life events and health symptom. The findings of this study have implications for nursing practice. When adolescents are confronted with non-developmental life events that are perceived as stressful, nurses should recognize the evidence of the stress-buffering effect of coping and social support on health symptoms and utilize the diverse sources of social support that are readily available to adolescents.

• 정신신체의학
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• 제16권2호
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• pp.112-119
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• 2008

연구목적 : 월경전기 증후군(Premenstrual Syndrome : PMS)은 가임기 여성의 약 80% 이상에서 발생하는 것으로 알려져 있다. 월경 주기와 일치하는 질환의 특성 상 여성 호르몬의 변화가 질환과 가장 밀접한 연관이 있는 것으로 알려져 있으나 아직까지 특징적인 생물학적 원인에 대한 일관된 보고는 되어 있지 않다. 이에 질환의 심리학적 원인에 대한 여러 가지 가설들도 제시되고 있는데 그 중에서도 심리적 외상 경험과의 연관성에 대한 연구들은 과거의 심리적 외상이 클수록 월경전기 증후군의 증상이 심해진다는 흥미로운 관점을 제시한다. 한편 과거의 심리적 외상은 해리 증상과도 연관이 있는 것으로 알려져 있는데 이러한 사실들로부터 월경전기 증후군과 해리증상의 연관성에 대한 가능성을 유추할 수 있다. 이에 본 연구에서는 월경전기 증후군의 정도와 해리증상 경험의 정도, 과거 학대 경험의 연관성을 알아보고자 하였다. 방법 : 본 연구는 서울 경기 경북에 근무하는 377명의 간호사들 중 설문과 기록을 충실하게 수행한 183명을 대상으로 하였다. 월경전기 증후군의 존재 여부와 증상의 정도는 Daily Record of Severity of Problems(DRSP), Shortened Premenstrual Assessment Form(SPAF)을 이용하여 측정하였다. 해리 증상의 정도는 Dissociation Experience Scale(DES-K)을 사용하였고 과거의 신체/언어적 학대 경험, 성적 학대 경험, 부모의 배우자 학대 경험은 각각 부모의 신체적 언어적 학대 방임 척도, 성적 학대 척도, 배우자 학대 척도를 이용하였다. 결과 : SPAF 점수를 기준으로 대상자들을 월경전기 증후군이 없는 군(No PMS), 경도에서 중등도의 증상을 경험하는 군(mild to moderate PMS), 중증의 증상을 경험하는 군(severe PMS)으로 나누었을 때 신체적 언어적 학대 방임 척도($x^2=14.397$, df=2, p=0.001), 성적 학대 척도($x^2=8.376$, df=2, p=0.015), 부모의 배우자 학대 척도($x^2=9.322$, df=2, p=0.009)에서 각 군 간에 유의한 차이를 보였다. 마찬가지로 DES 점수에서도 각 군 간에 유의한 차이가 있었다($x^2=14.966$, df=2, p=0.001). SPAF를 사용하여 측정한 월경전기 증후군의 증상 정도와 과거의 학대 경험 정도는 양의 상관관계를 보였으며 이는 해리 증상의 경험 정도에서도 마찬가지였다. 결론 : 상기 결과는 월경전기 증후군의 증상과 해리증상, 과거 외상경험이 연관이 있을 수 있음을 시사한다.

• 호스피스학술지
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• 제8권1호
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• pp.1-12
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• 2008

목적: 한국과 중국 간호대학생의 죽음의식을 조사하여 죽음교육과정설계에 간호대학생의 특성을 고려한 내용이 반영되도록 기여하고 간호교육 및 임상간호의 질적 향상에 도움이 되는 자료를 제공하고자 하였다. 방법: 본 연구는 2007년 3월19일부터 3월23일 사이에 한국 E대학교 간호대학생 248명과 중국 Y대학교 간호대학생 244명 총 492명을 대상으로 하였으며 측정도구는 Thorson과 Powell(1988)의 죽음의식도구를 박석춘(1992)이 번안하여 사용했던 도구를 이용하였다. 수집된 자료는 SPSS(12.0)통계 프로그램을 이용하여 전산처리 하였으며, 실수, 백분율, 평균, 표준편차는 기술통계 방법을 사용하고, Cronbach Alpha Coefficient, 요인분석, t-test, ANOVA 및 회귀분석 등을 통하여 분석하였다. 결과: 1. 한국 간호대학생은 반수이상(58.5%)이 종교가 있는데 비해 중국 간호대학생은 거의 종교를 가지고 있지 않았다(93.9%). 죽음경험이 한국 간호대학생(66.9%)보다는 중국 간호대학생이 많았다(76.6%). 사후세계유형에서 한국 간호대학생은 '사람이 죽으면 천국이나 지옥중의 한곳으로 간다'고 생각하는 경우가 제일 많았고(27.3%), '사람이 죽으면 어떻게 될 것인지 통 모르겠다'가 2위로 나타났다(22.9%). 중국 간호대학생은 '사람이 죽으면 어떻게 될 것인지 통 모르겠다'가 제일 많고(30.3%), '사람이 죽으면 그것으로 끝이고 사후세계는 존재하지 않는다'가 그 다음으로 많았다(29.5%). 2. 죽음의식은 한국 간호대학생이 평균 2.36점, 중국 간호대학생이 평균 2.50점으로 죽음에 대한 염려, 불안, 두려움이 중간수준이었으며 중국 간호대학생이 한국 간호대학생보다 높았다(t=3.51,p=.000). 3. 한국 간호대학생의 죽음의식은 연령(t=3.20, p=.002), 종교(t=2.56, p=.011), 사후세계(F=4.64, p=.000)에 대한 태도에 따라 유의한 차이가 나타났으며, 죽음의식에 대한 기여도는 사후세계변수가 수량화범위 0.735(p=.000)로 나타났다. 중국 간호대학생의 죽음의식은 모든 변수에서 유의한 차이가 없는 것으로 나타났다. 결론: 본 연구의 결과, 내세에 대한 믿음을 가지고 있는 대상자의 죽음의식이 제일 긍정적이므로 영적간호의 필요성이 강조된다. 한편 중국 간호대학생은 한국 간호대학생보다 죽음을 더 의식하고 죽음에 대한 염려, 불안, 두려움이 더 높게 나타났으므로 간호교육과정의 비교검토를 통해 한국의 죽음교육내용을 참고하고 중국의 정치, 문화와 사회제도에 알맞은 죽음교육을 해야 된다고 하겠다. 죽음의식은 사후세계에 대한 태도가 가장 크게 영향을 미치고 있으므로 이에 대한 지속적인 연구와 교육 및 실무에 적용을 제언한다.