• 제목/요약/키워드: self-evidence

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항암화학요법을 받는 암 환자의 오심, 구토관리를 위한 환자용 지침 개발 (Development of Cancer Patient Guide for Nausea & Vomiting Management in Chemotherapy)

  • 이지은;박명화
    • 성인간호학회지
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    • 제22권6호
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    • pp.570-581
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    • 2010
  • Purpose: This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence. Methods: The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their ' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool. Results: 1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience. Conclusion: The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.

간호사의 정보자원 접근 및 활용정도와 근거중심실무 장애요인 및 역량 (Nurses' Access & Use of Information Resources and Barriers & Competency of Evidence Based Practice)

  • 이지은;박명화
    • 성인간호학회지
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    • 제23권3호
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    • pp.255-266
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    • 2011
  • Purpose: The purpose of this study was to explore nurses' access and use of information resources and to identify the barriers and competency to evidence based practice (EBP). This study used descriptive method to identify baseline data for the purpose of developing strategies for establishing EBP in clinical nursing practice. Methods: Participants in this study were 278 nurses from five hospitals in Daegu and Kyungsangbukdo. The data were collected by self administered questionnaires and SPSS/WIN 15.0 program was used to analyze the data with descriptive statistics, t-test, Pearson's correlation coefficients, and ANOVA. Results: Nurses reported $^*most$ frequently using paper and human resources. The mean score of barriers was $3.02{\pm}0.41$, and competency was $2.70{\pm}0.50$. The reported competency was correlated with nurse factors (r=-.31, p<.001) organization factors (r=-.20, p<.001) and research factors (r=-.12, p<.040) as the barriers to evidence based practice. Conclusion: To promote competency in EBP and to decrease the barriers, it would be necessary to develop the organizational culture that encourages nurses to be involved in research activities. In addition, the development of systemic methods to introduce and establish an education program for facilitating EBP in the clinical settings is needed.

지역사회 당뇨노인의 혈당조절, 자기관리 정도와 우울 (The Relation between Glucose Control, Self-care and Depression in Community Dwelling Older Adults with Diabetes)

  • 김세안;송미순
    • Perspectives in Nursing Science
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    • 제9권2호
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    • pp.94-101
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    • 2012
  • Purpose: The purpose of this study was to examine the relationship between glucose control, diabetes self-care and depression in community dwelling older adults with type 2 diabetes mellitus. Methods: The cross-sectional survey data of 148 older adults at a senior center were analyzed in this study. We collected data on diabetes self-care, depression, and demographics by face-to-face interviews. Blood samples for HbA1C were obtained from the participants. Results: The average duration of diabetes for the participants was $10.6{\pm}9.31$ years. Fifty percent of the participants had HbA1c higher than 7.0% (mean 7.179%). The level of diabetes self-care was related to depression (r=-.225, p<.01). HbA1c was positively related with the duration of diabetes diagnosis (r=.224, p<.01). The only sub-dimension of diabetes self-care that was related to depression was exercise (r=-.307, p<.01). Conclusion: Only half of the community dwelling older adults with type 2 diabetes had an optimal level of diabetes control. Supported by the evidence, the longer the duration of diabetes since the initial diagnosis, the poorer the glucose control was. Identification and intervention for depression in people with diabetes should be considered to improve diabetes self-care, especially to perform more exercise.

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우리나라 성인 남녀의 비만이 주관적 건강상태 지각에 미치는 영향 (Association between Obesity and Self-Rated Health in Korean Males and Females)

  • 하영미;박현주
    • Journal of Korean Biological Nursing Science
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    • 제14권3호
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    • pp.203-211
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    • 2012
  • Purpose: The purpose of this study was to investigate effects of obesity on self-rated health in Korean males and females. Methods: The 2010 Korean National Health and Nutrition Examination Survey (KNHANES V-1) data were used. Participants included 1,231 males and 1,289 females aged 20 years or older and had no disease. Chi-square test, t-test, and multiple logistic regression with dummy variables using SAS 9.2 were performed. Results: From univariate analysis, total body fat was significantly greater in males with a self-perception of poor health (p=.006), and the percentage of total body fat was significantly greater in males and females with a self-perception of poor health (p for all=.001). After controlling for demographic and health behavior variables, similar results were found. Females with higher education had a healthy perception of their health. Smoking for males and drinking for females were significantly related to unhealthy perception of their health. Conclusion: The current study provides evidence that obese Korean males and females had worse self-rated health, even though they had no disease. In particular, it is important to note that the relatively direct obesity measures from Dual Energy X-Ray Absorptiometry, such as total body fat and percentage of body fat, were significantly related to self-rated health.

자활사례관리가 정서적 자활에 미치는 영향: 자활사례관리 수행에 대한 자활참여자의 인식을 중심으로 (Effects of the Self-Sufficiency Case Management on the Emotional Self-Sufficiency: Focusing on the Perceptions of Self-Sufficiency Program Participants)

  • 이은지;조준용
    • 디지털융복합연구
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    • 제17권2호
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    • pp.19-29
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    • 2019
  • 본 연구는 근로능력이 미약한 빈곤층을 대상으로 하는 자활사례관리가 자활참여자의 정서적 자활에 미치는 영향에 대한 실증연구이다. 이를 위해 이론적 개입관점과 참여자의 인식에 기반한 자활사례관리 척도를 구성하고, 춘천지역에서 시장형 및 비시장형 자활사업단 참여자 142명에 대해 대면 설문조사를 실시하였다. 이후 확인적 요인분석을 통해 자활사례 관리를 사회적 지지망과 임파워먼트 요인으로 구성한 뒤, 이에 따른 정서적 자활에 미친 영향을 분석하였다. 위계적 회귀분석 결과, 자활사례관리, 그중에서도 특히 사회적 지지망 유형의 사례관리가 자활 참여자의 정서적 자활에 영향을 미치는 것으로 나타났다. 그러나 사업단 유형에 따른 자활사례관리의 차별적 결과는 나타나지 않았다. 이러한 연구결과는 변화하는 자활환경에서 갈수록 강조되는 자활사례관리의 효과성에 대한 실증자료를 제공하고, 사업단 유형을 뛰어넘는 사회적 지지망 중심의 자활사례관리 확대의 필요성을 제기하고 있다.

치유문화에서 나타나는 자아 제한성의 문제: 고통수기들을 중심으로 (The Problem of Self-Limitation in Therapeutic Culture: Focusing on Misery Memoirs)

  • 서길완
    • 영미문화
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    • 제14권1호
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    • pp.73-94
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    • 2014
  • Accounts from therapeutic culture seem often to associate the selfish, or at least self-centered quest for self-fulfillment with individual choice or satisfaction, self-expression, expressive individualism, and emotionalism. These associations point to the downside of therapy as they present it as constituting a culture of narcissism, selfishness, or irresponsibility. While some of these characterizations contain useful insights, they overlook what are maybe some of the most important features of a therapeutic outlook. This paper aims to reveal that the therapeutic imperative is not so much geared towards the realization of self-fulfillment, as it is the promotion of self-limitation. Therapeutic culture tends to posit the self in a fragile and feeble form and insist that the management of life requires the continuous intervention of therapeutic expertise. Because of this, the elevated concern with the self is underpinned by anxiety, pain, suffering, and survival, rather than seen as a positive vision of realizing the human potential. Therapeutic culture has in this way helped to construct a diminished sense of self by which one is seen as suffering from an emotional deficit and vulnerability. This paper demonstrates this downside of therapeutic culture concerning self-limitation and the sense of a diminished self by examining popular "misery memoirs." Misery memoirs are widely consumed by the general public, therefore tend to be treated by contemporary therapeutic culture as a gospel on the therapeutic ideal for self-fulfillment and self-discovery. This is, despite the existence of hidden evidence to the contrary, because of their redemptive, happy endings that show individuals overcoming difficult trials such as child abuse, incestuous rape, and domestic violence. Individual self-fulfillment and self-discovery in such stories are not achieved through the active agency of the subject but through the passive endurance of pathological symptoms and with the aid of expertise and outside support. Therefore, such stories put victims in the limited position.

잠자는 미녀 문제에 대한 가버식 해결책 (Sleeping Beauty: a Garberian Approach)

  • 김남중
    • 논리연구
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    • 제15권1호
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    • pp.107-154
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    • 2012
  • 이전 논문(2009)에서 나는 잠자는 미녀 역설에 대한 한 가지 해결책을 제시하였는데, 그에 의하면 미녀가 동전 앞면에 월요일에 부여하는 확률은 1/2보다 낮아야 한다. 이것은 물론 1/3주의에 유리한 결론이다. 그렇지만 내가 1/3주의를 성공적으로 옹호했다고 할지라도, 한 가지 중요한 물음이 남는다: 왜 1/2주의는 틀렸는가? 그들의 주요 논변은 간단하다: 잠자는 미녀는 동전이 어떻게 땅에 떨어지는지에 대한 새로운 증거를 받지 못했기 때문에, 그녀가 그 가능성에 부여하는 확률은 이전과 같아야 한다. 이제 다음 사실에 주목해 보자: 만일 1/3입장이 옳다면 잠자는 미녀 역설은 이른바 오래된 증거 문제의 새로운 예가 될 것이다. 이 논문에서 나는 새롭고 직접적으로 관련된 증거가 없음에도 왜 잠자는 미녀가 그녀의 믿음의 정도를 바꿀 수 있는지 대니얼 가버(1983)가 오래된 증거 문제에 대해 내놓은 해결책을 가지고 설명할 것이다.

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공유진찰제: 만성질환 관리를 위한 혁신적 의료서비스 전달방식 (Reviews of the Shared Medical Appointments: Adopting Innovations in Care Delivery for Patients with Chronic Diseases)

  • 이현주
    • 보건행정학회지
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    • 제30권3호
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    • pp.277-285
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    • 2020
  • Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

근막이완술과 Mulligan 기법이 경부성 두통환자의 통증과 기능회복에 미치는 영향 (Effects of Myofacial Release and Mulligan Technique on Pain and Disability for Cervicogenic Headache Patients)

  • 전재국;김명준
    • 대한정형도수물리치료학회지
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    • 제18권2호
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    • pp.87-93
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    • 2012
  • Background: Headaches arising from cervical musculoskeletal disorders are common. Conservative therapies are recommended as the choice of first treatment. Evidence to the effects of manual therapy is inconclusive and available only during the short term. There is no evidence to exercise, and no study has investigated the effect of combined therapies for cervicogenic headache. Methods: In this study, 30 participants who met the diagnostic criteria for cervicogenic headache were randomized into two groups: experimental group and control group. The experimental group was performed myofascial release (MFR), Mulligan technique and self stretching exercises. The control group was performed electrical therapy and self stretching exercises. Assessments were performed to 30 participants before and after 4 weeks therapy. The components of assessments were headache intensity(HI), headcahe duration (HD), neck pain (NP) and neck disability index (NDI). Results: After 4 weeks therapy, HI, HD, neck pain and NDI were significantly reduced in both groups (p<.01). The HI, HD, neck pain and NDI were significantly reduced in experimental group more than in the control group (p<.01). Conclusions: Manual therapy could reduce the symptoms of cervicogenic headache.

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경피적 관상동맥 중재술 환자에게 적용된 간호중재 연구 고찰 (Literature Review of Nursing Intervention Studies for Patients Undergoing Percutaneous Coronary Intervention)

  • 백경화;손연정
    • Perspectives in Nursing Science
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    • 제12권2호
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    • pp.82-93
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    • 2015
  • Purpose: This study aimed to provide a systematic review of the evidence from controlled trials regarding nursing intervention studies on patients undergoing percutaneous coronary intervention, a discussion of the methodological problems that limit current research, and suggestions regarding future directions for research. Methods: Using a predefined protocol, 27 electronic databases were searched, studies selected, relevant data extracted, and the methodological quality of the studies assessed. Results: Twenty-seven studies were found reporting complex, generally heterogeneous interventions. The studies reported positive results, including self-efficacy, knowledge, and self-care. There were 6 randomized controlled trials, 19 quasi-experimental studies, and 2 only research group studies. In addition to support components, the interventions included elements of teaching, counseling, and education. Nursing interventions are still in the developmental and testing phase. Conclusion: The review demonstrated that a great deal is known about nursing intervention, the impact on a range of outcomes, and methodology. Although some useful evidence was reported for all interventions, further research needs to be carried out.