• 제목/요약/키워드: supportive care

검색결과 415건 처리시간 0.028초

입원아동과 간호사가 지각한 돌봄에 대한 연구 (Hospitalized Children and Their Nurses각 Perception of Caring)

  • 김정선;김신정
    • 대한간호학회지
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    • 제22권3호
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    • pp.297-315
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    • 1992
  • Caring has been identified as the essence and unifying domin of nursing(Leininger). Many nurses believe that the art of nursing is comprised of actions that are predominantly caring in nature. Although caring has been the traditional ideology of nurses, it is only now beginning to emerge as the central construct for the development of nut sing research, theory and practice. The problem addressed by this study was to identify how hospitalized children and their nurses express the meaning of caring, how they think nurses should care for children and to describe their experiences of being cared for. The purpose was to provide theoretical understanding of caring as perceived in Korea to contribute to the development of Korean nursing knowledge. The subjects were 76 hospitalized children admitted to pediatric units in five teaching hospitals and 66 nurses who were caring for these children. In this descriptive study, data were collected from Nov 11, 1991 to Jan 30, 1992 by interviews and an open-ended questionnaire and analysed by van Kaam's method. Caring themes perceived by the children and their nurses were classified into eight categories, -helping, comfort, love, warmth(only by children), recovery from illness, health maintenance (only by nurses), presence, nurturance and responsibility. Ideal caring behaviors perceived by the children and their nurses were six categories, -to give help, provide comfort, give love, stay with, treat warmly and aid recovery. Subcategories of giving help were promptness and competence, detailed explanations and support and encouragement. Other subcategories of giving help reported only by nurses were individualizing care, recognizing needs and providing a familiar enviornment. Subcategories of maintaining comfort were making comfortable, alleviating pain ; one subcategory reported only by children was consolating. A subcategory of giving love was concern, two subcategories reported only by nurses were compassion and respect. Subcategories of staying with were playing with and touching : only nurses reported empathy, Subcategories of treating warmly were tenderness and kindness. In the experience of caring, there were 4 categories, -to give help, stay with, show concern and provide comfort. Both the hospitalized children and their nurses had experienced caring primarily from their mothers. Mothers' caring behaviors were direct, personal, basic, supportive nursing acts. On the other hand, nurses caring behaviors were task oriented skilled procedures and medically delegated acts. This study contributes understanding of the complexity of caring, more specifically the meaning and experience of caring and ideal caring behaviors. Research may be able to move into verification when instruments are developed to measure the complexity of caring beliefs, values and behaviors in Korea and other cultural settings.

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가족지지개념을 다룬 국내 간호연구 분석 (Family Support: a Review of Nursing Literature on its Trends and Implementations)

  • 박신애;강경숙;정미영;차남현;김순영
    • 지역사회간호학회지
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    • 제12권3호
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    • pp.639-646
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    • 2001
  • The purpose of this study is to analyze the trend of nursing research related to family support and to provide an effective direction for future research by conducting a review of the Korean nursing literature from 1980 to 2000. A total of 73 studies were analyzed with the following results. 1) The number of studies related to family support has been rapidly increasing since 1984, and 77% of those were conducted in the 1990s. 48 studies, 65% of those analyzed. were degree-based research including 4 doctoral theses (4%) and 45 master's theses (62%). 2) Based on the objective frame of study types developed by Lee et al. (991), the types of studies were analyzed: 56 studies, 76.6% of those reviewed, belonged to factor-relating: 9 studies (12.4%) belonged to factor-isolating: 7 studies (9.6%) belonged to situation-producing: and only 1 study (1.4%) belonged to situation-relating research, respectively. 3) In terms of research design, most studies of analyzed (90.4%) were conducted by non-experimental design, and 7 studies (9.6%) were conducted by experimental design. But, qualitative research related to family support was not found. 4) In terms of research subjects, target populations of experimental studies were patients with arthritis, mental disorder, tuberculosis, coronary artery disease and hypertension. In correlational studies, 51 studies, 69.9% of those analyzed, were conducted to patients with renal failure, cancer and hemiplegia, and 5 studies (6.8%) were conducted to aged people and adolescents. 5) Study concepts used in correlational studies were quality of life, anxiety and depression, self-esteem, hope, role behavior, compliance and self-care activities. The quality of life was most often used among studies with 12.5% of those analyzed. 6) Nursing interventions, including diet therapy, family involving education and supportive care, used in experimental studies mostly showed positive effects on client involvement and home health improvement. However, the nursing interventions of mental health rehabilitation and resistance exercise showed neutral and negative results. The findings of this study provide evidence that more empirical research including experimental or qualitative studies should be conducted actively to improve nursing practice related to family support. Also, to promote more diverse nursing interventions, a family assessment tool especially for Korean families needs to be developed.

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혈액종양 입원 환자 대상 임상약사의 처방중재활동 및 회피비용 분석 (Cost Avoidance and Clinical Pharmacist Interventions on Hospitalized Patients in Hematologic malignancies)

  • 김예슬;홍소연;김윤희;최경숙;이정화;이주연;김은경
    • 한국임상약학회지
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    • 제32권3호
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    • pp.215-225
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    • 2022
  • Background: Patients with hematologic cancers have a risk of drug-related problems (DRPs) from medications associated with chemotherapy and supportive care. Although the role of oncology pharmacists has been widely documented in the literature, few studies have reported its impact on cost reduction. This study aimed to describe the activities of oncology pharmacists with respect to hematologic diseases and evaluate the associated cost avoidance. Methods: From January to July 2021, patients admitted to the department of hemato-oncology at Seoul National University, Bundang Hospital were studied. The activities of oncology pharmacists were reported by DRP type following the Pharmaceutical Care Network version 9.1 guidelines, and the acceptance rate was calculated. The avoided cost was estimated based on the cost of the pharmacy intervention, pharmacist manpower, and prescriptions associated with the intervention. Results: Pharmacists intervened in 584 prescriptions from 208 patients during the study period. The most prevalent DRP was "adverse drug event (possibly) occurring" (32.4%), followed by "effect of drug treatment not optimal" (28.6%). "Drug selection" (42.5%) and "dose selection" (30.3%) were the most common causes of DRPs. The acceptance rate of the interventions was 97.1%. The total avoidance cost was KRW 149,468,321; the net profit of the avoidance cost, excluding labor costs, was KRW 121,051,690; and the estimated cost saving was KRW 37,223,748. Conclusion: Oncology pharmacists identified and resolved various types of DRPs from prescriptions for patients with hematologic disease, by reviewing the prescriptions. Their clinical service contributed to enhanced patient safety and the avoidance of associated costs.

호발암 생존자의 미충족 수요에 대한 문헌 고찰: 유방암, 갑상선암, 대장암, 폐암을 중심으로 (A Literature Review on Unmet Needs of High-Prevalence Cancer Survivors: Focus on Breast Cancer, Thyroid Cancer, Colorectal Cancer, and Lung Cancer)

  • 김다슬;김선미;서정석
    • 정신신체의학
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    • 제31권2호
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    • pp.50-62
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    • 2023
  • 연구목적 유방암, 대장암, 폐암, 갑상선암 환자의 미충족 수요를 확인하고 관련 요인을 파악하고자 하였다. 방법 학술 검색을 통해 2010년 이후 출간된 암 환자 미충족 수요에 대한 논문을 선정하여 검토하였다. 결과 측정 도구는 암 생존자의 미충족 수요, 지지적 간호요구조사 설문이 주로 사용되었으며, 폐암 환자의 미충족 수요가 상대적으로 높았다. 유방암 환자는 의료시스템 및 정보, 갑상선암 환자는 사후관리와 심리문제, 대장암 환자는 심리, 종합적 암 치료, 폐암 환자는 신체 및 일상생활관리에서 미충족 수요가 높았다. 연령, 경과시간, 불안, 우울 및 디스트레스, 삶의 질은 미충족 수요와 관련이 있었다. 결론 각 환자군의 미충족 요구를 고려한다면 더욱 효과적인 치료 및 지원 프로그램 개발에 도움이 될 것이다.

만성질환자 배우자의 돌봄 경험에 대한 이론 구축 (A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness)

  • 최경숙;은영
    • 대한간호학회지
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    • 제30권1호
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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서울시 각 구 보건소간호사의 방문간호 업무수행과 직무만족에 관한 연구 (A Study on the Performance & Job Satisfaction of Visiting Nurses of district health centers in Seoul)

  • 양미진
    • 가정∙방문간호학회지
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    • 제4권
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    • pp.30-40
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    • 1997
  • The change in health care environment increases the importance of Visiting Nursing Services Program. It has been performed by nurses of district health centers in Seoul since 1991. The Achievement of Visiting Nursing Services Program will be dependent upon their activities. The purpose of this study was to identify the Performance of Visiting Nurses and Job satisfaction of district health centers in Seoul. Therefore, it was to provide the fundamental data development of Visiting Nursing Services Program. The subjects were 214 Visiting Nurses of district health centers in Seoul. The data was collected by self reporting questionnaire from April 15 to April 30, 1997. Their performances and various supportive factors were measured with the instruments developed by the researcher. Job satisfaction were also measured by the instrument developed by Slavitt et al. (1978) was used. The data were, analyzed by Cronbach Alpha, mean, standard deviation, percentage, t -test, ANOVA Duncan test, Correlation Coefficient, and Stepwise Multiple Regression with SAS program. The results of this study were as follows: 1. The average of budget of Visiting Nursing Services Program of district health centers was 0.9% and the average of visiting nursing services personnel of district health centers was 10.1%. 2. With regard to the job satisfaction of Visiting Nurses the mean score was 2.92 out of 5. While the level of Job prestige / status presented as a mean score of 3.48 which was the largest among the 7 components of job satisfaction, the level of administration was the lowest showing 2.57 scores respectively. There were significant differences in the job satisfaction by age, working career of health centers(p<0.01, 0.001). 3. The average of the performance level of Visiting Nurses variables was 2.29; The variable with highest degree of performance was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was the directive nursing services. The significant difference was found in performance level according to age, structure type of visiting nursing services, working career of health centers and working career of visiting nursing services(p<0.05). 4. With regard to the perception of the performance expertise by the Visiting Nurses the mean score was 2.37 : The variable with highest degree of performance expertise was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was management of home-environment. The significant difference was found in performance expertise according to working career outside of health centers(p<0.05). 5. With regard to the perception of the performance necessity by the Visiting Nurses the mean was 2. 40 : the variable with highest degree of performance necessity was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was directive nursing services. The significant difference was found in performance necessity according to working career of visiting nursing services(p<0.05). 6. A positive correlation was found between job satisfaction and performance level(r=.3731, P<0.001). Also, a weak positive correlation was found between the components of job satisfaction and performance level. 7. Stepwise multiple regression analysis revealed that the most powerful predictor was the variance of job satisfaction(R=.3557, $R^2$=.1265). Structure type of visiting nursing services and working career of visiting nursing services accounted for 19.0% of the variance in performance level in nurses. In conclusion, Job satisfaction, Structure type of visiting nursing services and Working career of visiting nursing services variables had influenced on performance level in health centers. Further research is required to confirm these findings.

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농촌지역 거주 노인의 통합적 인권보장 실태에 관한 연구 (A Study on the Current State of the Integrated Human Rights of the Elderly in Rural Areas of South Korea)

  • 안준희;김미혜;정순둘;김수진
    • 한국노년학
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    • 제38권3호
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    • pp.569-592
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    • 2018
  • 본 연구는 마드리드 고령화 국제행동계획(MIPAA)의 노인 인권보장 관련 기준이 제시하는 1) 노인과 발전, 2) 농촌개발 3) 노년까지의 건강과 안녕증진, 4) 독립된 생활을 지원하는 환경확보라는 주요 방향과 13개의 세부 과제를 기반으로, 우리나라 농촌 노인 인권관련 실태를 통합적으로 파악하고 이에 대한 성별 차이를 살펴보고자 하였다. 이를 위하여 경북, 경기, 충남, 전남의 농촌 지역에 거주하는 65세 이상 노인 800명을 대상으로 설문을 진행하였고, 기술통계분석과 T-test 분석을 STATA 13.0을 사용하여 실시하였다. 주요한 연구결과는 다음과 같다. 1) 노인과 발전: 경제활동은 참여율과 노동시간이 남성이 높았으며, 일평균 노동시간은 6.2시간으로 나타났다. 평생교육은 여성의 참여율이 상대적으로 높았고, 직무교육의 필요성은 남성이 높은 것으로 나타났다. 긴급 상황에서 화재 및 방재시설에 대한 인지 정도는 남녀 모두 낮은 것으로 나타났다. 2) 농촌개발: 독거노인지원센터 및 취약계층이 받는 보호지원 서비스의 접근성이 낮았고, 정보기기 기반 서비스 이용률 및 정보기기 통한 교류 여부는 여성이 전반적으로 낮았으며, 정보기반 서비스 중 금융거래 및 행정/복지서비스 관련 이용률이 가장 저조한 것으로 나타났다. 3) 노년까지의 건강과 안녕증진: 보건의료서비스의 경우 1회성의 건강 검진 및 예방 접종의 이용률은 높은 반면 만성질환의 정기적 관리 및 중증질환을 관리하는 장기요양서비스 이용률은 상대적으로 낮았으며, 정신건강관련 기관의 접근성은 매우 저조한 것으로 나타났다. 4) 독립된 생활을 지원하는 환경확보: 주택안전에서는 주택구조와 편의시설 부족이 가장 위험하다고 응답했으나, 주거서비스 지원을 받은 경험은 낮게 나타났다. 돌봄 환경에서는 여전히 비공식적 돌봄에 의지하며, 돌봄에 대한 여성의 걱정 수준이 높은 것으로 나타났으며, 학대서비스는 접근성이 매우 낮은 것으로 나타났다. 이러한 결과를 기반으로 농촌노인 인권보장상황을 제고하기 위한 정책 및 실천적 개입 방안을 제시하고 있다.

걸음마기 영아의 부정적 정서성, 영아의 부정적 정서에 대한 어머니의 반응과 영아의 사회정서 행동과의 관계 : 어머니의 반응의 매개효과를 중심으로 (The Effect of Toddlers' Negative Emotionality and Mothers' Reactions to their Child's Negative Emotions of Social-emotional Behaviors)

  • 김양은
    • 한국보육지원학회지
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    • 제10권3호
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    • pp.85-102
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    • 2014
  • 본 연구의 목적은 부정적 정서가 드러나는 걸음마기 영아를 대상으로 부정적 정서성과 부정적 정서에 대한 어머니의 반응이 영아의 사회정서 행동과 어떠한 관계가 있는지 살펴보는데 있다. 연구대상은 18-36개월 걸음마기 영아와 어머니 141명이었으며 상관관계, 위계적 회귀분석, 매개효과 분석을 실시하였다. 연구결과 영아의 부정적 정서성과 부정적 정서에 대한 어머니의 반응, 영아의 사회정서 행동은 서로 유의미하게 관련되어 있었다. 또 영아의 정서성과 어머니의 반응이 영아의 사회정서 행동에 영향을 주는 것으로 나타났으며, 같은 정도의 부정적 정서를 가진 영아라도 환경적 특성인 어머니의 반응에 따라 사회정서 행동의 정도가 다르게 나타났다. 마지막으로 영아의 부정적 정서에 대한 어머니의 반응은 영아의 정서성과 사회정서 행동 관계를 매개하는 것으로 나타났다. 이러한 결과는 영아의 사회정서 행동은 영아가 생득적으로 갖고 태어나는 기질적 특성 뿐아니라 어머니의 변인에 의해 조절이 가능하며, 어머니의 반응이 영아의 부정적 정서성을 완화시켜줄 수 있는 완충적 역할을 할 수 있음을 의미한다.

Glufosinate 제초제 중독의 실태 조사와 임상적 특성 고찰 - 다기관 연구 - (Epidemiology and Clinical Analysis of Poisoning of Glufosinate Herbicide - Multicenter Study -)

  • 이성우;홍윤식;권운용;박준석;어은경;오범진;이미진;서주현;노형근
    • 대한임상독성학회지
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    • 제5권1호
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    • pp.36-42
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    • 2007
  • Purpose: To assess the epidemiology and the clinical features of Glufosinate herbicide in Korea. Methods: Data was prospectively collected during 1 year since August 2005 from 38 hospital in Korea. We analyzed the epidemiologic characters and clinical manifestations of Glufosinate poisoning. In addition, the characteristics of patients with severe central nervous system toxicity were separately analyzed to find poor prognosis relating factors. Results: During study periods, there were 715 persons of poisoning of herbicides and insecticides. 6.3% (45 persons) of the agricultural chemicals poisoning had Glufosinate poisoning. There were 36 cases of suicide attempts and 7 cases of accidental exposure, The major of poisoning route was oral ingestion (44 cases). 28.9 % of the study patients had not toxic symptoms. The most common symptoms were gastrointestinal symptoms relating surfactant irritation. 67.7% of central nervous symptoms occurred lately. 10 persons showed severe central nervous system toxicity. 4 persons of them showed poor outcomes (1 death, 3 hopeless discharged). Complications of respiratory failure and renal failure related with poor outcome. Conclusion: Majority of patients ingested Glufosinate for suicide attempt. 22.2% of patients with Glufosinate poisoning showed delayed serious central nervous system toxicity. Early supportive care of altered mentality may prevent late respiratory complications and improve the outcomes.

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Acetaminophen 유도 마우스 간 손상에 대한 가감공진단(加減拱辰丹) 추출물의 간보호 효과 (Hepatoprotective Effect of Gagam-GongJin-dan extract against Acetaminophen-Induced Liver Injury in Mice)

  • 김홍준;목지예;박광현;정승일;황병순;황성연;조정근;장선일
    • 대한본초학회지
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    • 제25권3호
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    • pp.149-157
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    • 2010
  • Objective:Gagam-Gongjin-dan (GGD) is an oriental medicinal prescription composited with Cervi parvum Cornu, Corni Fructus, Angelica Gigantis Radix, Lycii Fructus, Dioscoreae Rhizoma, Citri Pericarpium, Gastrodiae Rihzoma, Agastachis Herba, Cassiae cortex, Scutellariae Radix and Schisandrae Fructus. The purpose of this study was to investigate the effects of GGD extract against acetaminophen (APAP)-induced liver injury in mice. Methods:GGD extract was prepared by extracting with methanol for 7 days. The extract was freeze-dried following filtration through vacuum distillation system. The first, we investigated the antioxidant effects of GGD extract on electronic donating ability (DPPH), nitrite (NO) scavenging and superoxide dismutase (SOD)-like activity. The next, we investigated the possible hepatoprotective effect of GGD extract administration against acetaminophen-induced liver injury in mice. Mice were orally administrated with or without GGD extract of different doses (25-100 mg/kg/day) one times per day for 6 days. After 3 days, APAP was orally applied with a single dose (400 mg/kg). Results:GGD extract increased DPPH, NO and SOD-like activities in dose dependant. APAP treatment significantly increased aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities in plasma. Also, APAP treatment significantly evaluated lipid peroxidation product thiobarbituric reacting substances (TBARS) and depleted some antioxidant enzymes (superoxide dismutase, catalase, d-aminolevulinate dehydratase and gluthathione peroxidase activities) in liver homogenates compared to the control group. However, the orally administration of GGD extract was able to counteract these effects. Histological studies provided supportive evidence for biochemical analysis Conclusions:These results suggest that GGD extract has a potential antioxidant and hepatoprotective effect against APAP-induced liver injury, these properties may contribute to liver disease care.