• 제목/요약/키워드: pain intervention

검색결과 1,416건 처리시간 0.024초

호스피스 간호 관련 국내 연구 동향 (Trends in Research on Hospice Care in Korea)

  • 이영은;최은정
    • Journal of Hospice and Palliative Care
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    • 제14권3호
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    • pp.152-162
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    • 2011
  • 목적: 본 연구는 우리나라 호스피스 간호 연구 동향을 알아보기 위해 시도되었다. 방법: 본 연구의 대상은 1985년부터 2009년까지 24년 동안 발표된 국내 호스피스 간호 관련 논문 총 183편으로 간호학위논문 62편과 비학위논문으로서 학술지에 게재된 논문 121편이었다. 본 분석대상 논문은 한국교육학술정보원에서 제공하는 학술정보서비스(http://www.riss.kr)를 이용하여 호스피스(완화) 간호, 말기(암)환자의 핵심어를 조합하여 검색하였다. 검색결과 호스피스 관련 국내 학위논문과 대한간호학회지, 아동간호학회지, 정신간호학회지, 성인간호학회지, 병원간호사회지, 행정간호학회지, 종양간호학회지, 한국 호스피스 완화의료학회지, 호스피스 학술지, 호스피스 논집 등에 게재된 논문들을 대상으로 하였고, 학위논문 중 학술지에 게재된 것은 학술지를 분석대상으로 하였다. 단, 종설과 인터넷으로 원문수집이 불가능한 논문은 제외하였다. 결과: 호스피스 간호 관련 논문 수가 급증하였고, 연구설계 유형은 양적연구가 질적연구보다 월등하게 많았다. 분석대상 논문에서 도출된 주요어는 5개 영역에서 총 74개가 도출되었고, 총 225개의 주요어를 사용하였다. 자료수집시 윤리적 고려는 서면동의가 많았고, IRB를 통과한 연구가 극소수이며, 다학제간 연구 지원금은 점차 증가하였다. 결론: 결론적으로 말기암환자의 간호문제나 현상을 연구하기 위해서는 조사연구보다는 질적연구 방법의 접근이 많이 필요하고, 연구개념도 삶의 질과 더불어 죽음의 질에 대한 연구가 필요하며, 중재연구에 있어서는 말기암환자의 가장 큰 문제로 대두되고 있는 통증완화, 기타 주요 신체간호, 그리고 보완대체요법에 관한 간호연구가 더 필요하다고 본다. 또한 간호학 연구를 넘어 다학제적 팀 연구가 더 많이 수행되어야 하며, 마지막으로 아동호스피스에 관한 연구가 매우 미비한데, 이에 관한 연구가 더 시행되어야함을 제안한다.

내적모형과 대응자원을 이용한 만성관절염 환자의 적극적 대응전략모형 (Active Coping Strategy Model for Chronic Arthritis : Appling Internal Model of World and Coping Resource)

  • 문미숙;임난영
    • 근관절건강학회지
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    • 제6권1호
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    • pp.100-135
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    • 1999
  • Typical symptoms of rheumatic disease affect overall daily living and cause severe stress. Individuals afflicted with rheumatic disease have many illness-related stresses. Pain was the predominantly perceived stress followed by limitation in mobility, difficulties in carrying out activities of daily living. helplessness, dependency on others, threat to self-esteem, interference in social activity, interference in family relationships. difficulties performing at work, and discomfort of the treatment. Patients with chronic arthritis are subjected to long periods of continuous stress, which may require the management by the health care provider. In these cases, the purpose of the nursing is helping to promote health through supporting patient's coping. Therefore, for the nursing intervention to be effective, it is critical to build a theoretical framework that describes stress-coping for chronic arthritis. Thus, the purpose of this dissertation is to present a theoretical framework which describes the stress-coping processes and to empirically test pathos of this framework for the people with chronic arthritis. The foundation upon which this framework is built in the Erickson, Tomlin, and Swain(1983) theory of Modeling and role-Modeling. The subjects were 275 patients with rheumatoid arthritis or osteoarthritis who visited the outpatient clinic. A hypothetical model of stress-coping was tested by covariance structure analysis with PC-LISREL 8.12 program. As a result, the overall fit was good(Chi-square=94.49, P=0.00, RMR=0.067, GFI=0.95, AGFI=0.91, NNFI=0.93, NFI=0.91) for the hypothetical model. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on coping resources. However, independent variables(basic need satisfaction, internal health locus of control, illness-related experience, emotional stress and coping resource) did not have significantly influence on coping. And then, the hypothetical model was modified by considering both the theoretical implication and statistical significance of the parameter estimates. The revised model had a better fit to the data(Chi-square=83.11(P=0.00), RMR=0.061, GFI=0.96, AGFI=0.92, NNFI=0.95, NFI=0.92). Hypothesis emerged from the revised model was tested. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on illness-related experience and coping resources. Internal health locus of control, illness-related experience, emotional stress and coping resources had a significantly influence on coping. According to the results of this dissertation, basic need satisfaction and internal health locus of control play a central role in appraisal of illness-related experience and coping resources. And illness related-experience, emotional stress, and coping resources affect on coping activities. In summary, nursing interventions to enhance basic need satisfaction and internal health locus of control will decrease illness related experience and emotional stress and increase coping resources. Increased coping resources will prompt coping activities.

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섬유조직염 환자의 질병 특성과 치료행태 (Disease Characteristics and Behavior Pattern of Treatment for Patient with Fibromyalgia)

  • 한상숙;강현숙
    • 근관절건강학회지
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    • 제6권1호
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    • pp.22-36
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    • 1999
  • The purpose of the study was to identify disease characteristics and behavior pattern of treatment for patients with Fibromyalgia. This study was carried out between May to Aug. in 1998 through direct interview in Rheumatism clinic at H. University Hospital and subject in this study were 125 outpatients diagnosed with Fibromyalgia. Collected data were analyzed by descriptive statistics and t-test, ANOVA using SPSS Window program. The results of this study are as follows. 1. General Characteristics : All of the persons with Fibromyalgia were female who were mostly in their forties(37.5%). A third of them(38.4%) were graduated from high school. The greatest part of them(54.4%) were christians but little part of them(16.8%) were employed 2. Disease Characteristics : They have struggled with Fibromyalgia for 10 years on an average. About half of them(56.9%) suffered from Fibromyalgia only but the others had another diseases which were in greatest part occupied by Osteoarthritis. The number of tender point which is a feature of Fibromyalgia differed according to measuring criteria. Yunus criteria. however, was proved to be the most proper measuring criteria than any other method as it showed high correlations between symptoms and physical activities. The most serious symptoms that complained the patients among subjective symptoms are pain, sleep disorder, and fatigue in sequence, and activities most hard to do among physical activities are washing by hand, scrubbing by hand, and shopping in sequence. 3. Behavior Pattern of Treatment : The largest part of them(42.4%) had received medical treatment after they were determined to have the disease and most of them were taking medicine as prescribed by physician(88.8%) or other medicines(16.8%), Of them, two thirds stated that the medicine they took were effective. Around a third of them took exercises mostly composed of swimming. The medical institution they visited in the past were orthopedic surgical department, Oriental hospital, physical therapy department in sequence and, in a slight percent(11.4%), psychiatric department. 4. Relations between Disease Characteristics and Behavior pattern of Treatment : It shows that number of tender point and level of symptom are significantly different according to duration of disease and medical intervention. As a results, it can be suggest that persons with Fibromyalgia need to take exercises and medicine continually regardless of medical treatment as it is a chronic disease whose symptoms are hardly mitigated.

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노인들이 지각하고 있는 건강수준에 관한 연구 (A Study on the Health as Perceived by the Aged)

  • 양경희;장혜숙;김영희
    • 지역사회간호학회지
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    • 제7권2호
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    • pp.229-243
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    • 1996
  • The purpose of this study was to develop a nursing model for the aged. This study was conducted to measure the physical, psychological and mental health status of the aged and to identify relationships between these health levels and various variables. The data were collected from 172 aged(over 60 years old) by interviews. The tools used for this study was a structured questionnaire which was developed and revised by the researchers. The tool consisted of 22 items on physical health assessment, 7 items on psychological health assessment, 9 items on mental health assessment and 10 items on an ADL evaluation. The major results of the study were as follows ; 1. In physical health, the aged complained of visual disturbance(60.5%), incontinence of urine (55.2%), back or muscle pain(73.3%), dizziness(70.3%) and diarrhea or constipation(44.2%). In psychological health, most aged people felt anger when they got some order from an other person(80.2%). Also, they had depression (69.8%) and felt like dying(64.0%). The ADL level was mostly normal for daily life. 2. The aged man was more healthy than the aged woman in physical and mental health especially the 60-64 year old group. The physical, mental health and ADL level had a positive correlation with age(p>.004), but psychological health had a negative correlation with age. 3. The physical, psychological, mental health and ADL level was positively interrelated with each other. 4. The physical, mental health, & ADL level lowered with inceasing age. Physical & psychological health worsened rapidly from 65-69 years, but for 10-15 years, their health level was preserved. Psychological health level was high in 80-84. 5. The physical health was affected by edu cational level, sex and pocket money (R=.4029, 16.24%). The psychological health was affected by the supportive style and pocket money (R=.5128, 26.30%). And the mental health was affected by education level, age, support ive style, sex and job(R=.4377, 19.16%). As seen above, we suggest the intervention of the young for the old to cope with their life and to maintain their healthy late adulthood. Also, if they have received psychological support in the institution, they will maintain healthy life condition. For further studies should be a search for variables that affect aged health, and should contribut to a nursing program better suited for the aged.

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춤 치유가 외상 후 성장에 미치는 효과 -쉼터거주 가정폭력 피해여성을 중심으로- (Effects of Dancing Healing on Post-traumatic Growth -Focused on Female Victims of Domestic Violence in Shelter-)

  • 신우정;임동호
    • 한국콘텐츠학회논문지
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    • 제18권2호
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    • pp.158-168
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    • 2018
  • 본 연구는 가정폭력 피해여성을 대상으로, 춤을 통한 치유적 신체표현 프로그램을 적용하여, 이들의 외상후 성장에 미치는 효과를 검증하였다. 본 연구의 대상은 서울지역의 가정폭력 피해여성을 위한 쉼터(7개 시설)에 거주하는 가정폭력 피해여성으로서, 실험집단 23명, 통제집단 23명으로 구성하였다. 실험집단에게 적용한 춤 치유 신체표현 프로그램은 총 18회기로 구성하였고, 주 3회, 6주에 걸쳐 진행되며, 각 회기는 90분 동안 실시하도록 하였다. 본 연구의 춤 치유 신체표현 프로그램은 신체표현과 동작 경험을 중심으로 한 춤을 기반으로 삼되, 내면의 표출을 위한 즉흥적 비형식적이고 창조적인 표현에 초점을 두고 있다. 이에 다수의 춤 치유 및 무용치료 선행연구들의 활동과 원리를 참조하고, 가정폭력과 외상 관련 심리 상담 선행연구에서의 상담기법 및 상호작용, 치유적 원리의 특성을 회기 구조 단계마다 적용하였다. 연구 결과, 춤 치유 신체표현 프로그램은 실험집단의 외상 후 성장 전체 및 하위차원인 대인관계깊이, 자기지각, 가능성발견, 영적관심 차원에 향상 효과가 있는 것으로 나타났으며, 실험집단과 통제집단의 사후점수 및 향상정도에서 유의한 차이가 나타났다. 결국 본 연구는 춤의 근원적이고 치유적인 속성을 이해하고, 사회적 차원에서 가정폭력 피해여성과 같이 심리적 고통을 경험하는 대상들에게 스스로 회복할 수 있는 기회를 제공하는 선순환적 치유방식 및 춤의 활용성에 관한 기초자료를 제공하였다는데 의의가 있다.

Healing Beats 프로그램이 경막외강차단 시술 후 환자의 불안, 스트레스, 수축기 혈압, 심박동수 및 Bis Index에 미치는 효과 : 무작위대조군 (Effects of Healing Beats program on patients' anxiety, stress, systolic blood pressure, heart rate and Bis Index after epidural blocking : A randomized controlled trial)

  • 배익렬;송지아
    • 한국산학기술학회논문지
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    • 제21권7호
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    • pp.54-65
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    • 2020
  • 본 연구는 경막외강차단 시술 후 Healing Beats 프로그램 적용하였을 때 환자의 불안, 스트레스, 수축기 혈압, 심박동수 및 Bis index에 미치는 효과를 확인하기 위한 무작위 대조군 전후 실험연구이다. 대상자 선정은 경막외강차단 시술을 위해 2018년 12월부터 2019년 5월까지 마취통증의학과를 방문하여 모집공고를 통해 자원한 환자를 대상으로 하였으며, 실험군 25명, 위약군 24명, 대조군 25명으로 총 74명의 자료를 수집하여 분석하였다. 수집된 자료는 x2-test, F-test와 시간에 따른 효과를 검증하기 위하여 repeated measures of ANOVA로 반복측정 분산분석하였다. 연구결과 실험군, 위약군 및 대조군의 일반적 특성 및 변수는 모두 동질하였으며, 불안은 사전 사후 2회 측정한 결과 집단간 유의한 차이가 있었고(F=27.175, p<.001), 스트레스(F=4.78, p<.001), 심박동수(F=4.22, p<.001) 및 Bis index(F=7.96, p<.001)는 반복측정 분산분석한 결과 집단과 시간에 따라 교호작용에서 유의한 차이를 나타냈다. 하지만 수축기 혈압에서는 유의한 차이가 없었다(F=1.23, p=.298). 따라서 Healing Beats는 통증 시술 후 회복실에서 진정을 유도하기 위한 간호 중재로 효과적이며, 시간 흐름에 따른 추적 조사를 통해 중재 시간을 파악할 수 있었다. 결론적으로 Healing Beats 프로그램은 임상현장이나 일상생활의 스트레스 상황에서 진정을 위한 효율적, 효과적인 중재로 사용할 수 있다고 본다.

암생존자의 자가관리 프로그램 개발을 위한 증상관리 및 신체적 활동 관련 가이드라인의 통합적 고찰 (Integrative Review of Guidelines Related Symptom Management and Physical Activity for Developing of Self-Care Management Program for Cancer Survivors)

  • 송지은
    • 한국콘텐츠학회논문지
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    • 제18권4호
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    • pp.586-600
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    • 2018
  • 본 연구는 암 치료를 완료한 암생존자를 위한 통합 자기관리 어플리케이션 개발을 위한 기초자료를 수집하고자 시도되었다. 자기관리 프로그램은 증상관리와 신체활동관리로 구분되며 증상관리는 피로, 수면장애, 통증, 우울과 불안이 포함된다. 근거기반실무 가이드라인을 PubMed, CINAHL 및 EMBASE를 통해 검색하였으며 가이드라인 질 평가 후 최종 8개를 선정하여 분석하였다. 구조화된 표를 이용하여 스크리닝 대상자, 시기, 내용, 포괄적 사정대상자 및 사정내용을 추출하였고, 비약물적 중재 중 신체적 활동 및 운동 관련내용을 정리하였다. 통합한 결과, 암 치료 완료 후에도 모든 암 생존자를 대상으로 신뢰도와 타당도가 입증된 도구를 이용하여 정기적인 증상 스크리닝을 하여야 하고 중정도 이상의 증상 호소 시 전문가에 의한 포괄적인 사정을 요한다. 피로의 경우 신체적 활동이 일차적 중재법으로 권고되었으나 이 외 증상의 경우 보조요법 수준으로 효과가 있는 것으로 권고되었다. 따라서 암 생존자에게 꾸준한 신체적 활동을 격려하여야 하고 치료와 관련된 합병증이 없는 한 중강도의 신체활동을 꾸준히 유지할 수 있도록 중재하여야겠다. 이를 위해 신체적 활동에 대한 다양한 동기화 전략을 개발하고 적용해야 할 것으로 사료된다.

식사대용식을 이용한 초저열량 식사요법이 성인 비만 여성들의 체중감량과 건강에 미치는 효과 (Effects of Very Low Calorie Diet using Meal Replacements on Weight Reduction and Health in the Obese Adult Women)

  • 김지영;김상연;정경아;장유경;최형석;최승;박미현;홍성길;황성주
    • Journal of Nutrition and Health
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    • 제38권9호
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    • pp.739-749
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    • 2005
  • This study was performed to investigate the effects of very low calorie diet (VLCD) using newly meal replacements that contain the wild grass extracts based on Samul-tang ingredients on weight reduction and health in the obese adult women ($BMI{\geq}25\;kg/^2$) for four weeks. Seventy five women participated in this experiment. Subjects were randomly classified three groups: 1) General Diet group (GD group, n=25) consumed 3 regular meals within 600 kcal/day, 2) Meal replacements group (MR group, n=25) consumed 1 regular meal and 2 meal replacements within 600 kcal/day, 3) Herbal Meal replacements group (HMR group, n=25) consumed 1 regular meal and 2 meal replacements within 600 kcal/day. Anthropometric measurements, body composition, biochemical measurements and body symptoms were assessed before (the initial) and after (the 4th week) the study. Anthropometry measurements such as weight, waist and hip circumference, and BMI and body composition such as body fat percent, fat mass significantly decreased in all groups after diet intervention. Anthropometric measurements and body composition of the ]lim group significantly decreased more than those of GD and MR groups. Serum Total cholesterol was significantly decreased in all groups. However, there was no significant difference among three groups during the experimental period. HMR group had significantly less felt a pain than GD and MR groups in body symptoms such as anemia, powerlessness, vomiting, constipation and dryness of skin during the experimental period. Therefore, very low calorie diet (VLCD) using meal replacements that contain the wild grass extracts based on Samul-tang ingredients was very effective on weight reduction and health in the obese adult women.

Laminotomy with Continuous Irrigation in Patients with Pyogenic Spondylitis in Thoracic and Lumbar Spine

  • Kim, Sung-Hyun;Lee, Jung-Kil;Jang, Jae-Won;Seo, Bo-Ra;Kim, Tae-Sun;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제50권4호
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    • pp.332-340
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    • 2011
  • Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.

요양병원 요양보호사의 작업환경, 심리적 업무요구, 피로가 근골격계 증상에 미치는 영향 (Factors Influencing on Musculoskeletal Symptoms of Care Workers in Long-Term Care Hospitals for Job Environment, Psychological Work Demand, Fatigue)

  • 오진영;하영미
    • 디지털융복합연구
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    • 제18권11호
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    • pp.559-569
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    • 2020
  • 본 연구는 요양병원 요양보호사의 작업환경, 심리적 업무요구, 피로도, 근골격계 증상의 관계를 파악하고 근골격계 증상에 미치는 영향요인을 규명하기 위해 시도되었다. 연구방법은 S시에 소재한 3곳의 요양병원에 근무하는 요양보호사 128명을 대상으로 2020년 4~5월까지 설문 조사하였다. 연구결과 요양병원 요양보호사의 근골격계 증상은 어깨, 손/손목/손가락, 허리 세 부분에 대한 증상발생빈도, 증상지속기간, 통증의 강도를 합한 값으로 42점 만점에 평균 11.41±9.50점으로 나타났다. 요양병원 요양보호사의 근골격계 증상에 미치는 영향요인을 규명하기 위해 회귀분석을 실시한 결과 근무병동(β=.18, p=.034)과 심리적 업무요구(β=.21, p=.013), 피로도(β=.25, p=.003)가 근골격계 증상에 유의한 영향을 미치는 것으로 나타났으며, 이들 3개 변수는 근골격계 증상에 대하여 21.6%의 설명력을 보였다(F=6.87, p<.001). 본 연구결과를 바탕으로 요양병원 요양보호사들의 근골격계 증상을 감소시키기 위해서는 담당하는 환자의 중증도를 고려하여 심리적 업무요구와 피로도를 줄일 수 있는 중재프로그램 개발 및 적용이 필요하다.