• Title/Summary/Keyword: 간호수행능력

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A Preliminary Study on Development and Evaluation of Home Health Care Nurse Clinical Practice Program -Focused on Postoperative Orthopedic Patients- (가정간호사 임상실무 훈련프로그램 개발과 평가를 위한 사전 연구 -정형외과 수술 환자를 중심으로-)

  • 서영숙
    • Journal of Korean Academy of Nursing
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    • v.26 no.1
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    • pp.15-32
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    • 1996
  • The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

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Effects of 5 Weeks Self-Help Management Program on Reducing Depression and Promoting Activity of Daily Livings, Grasping Power, Hope and Self-Efficacy (재가 뇌졸중환자를 위한 5주간의 자조관리프로그램의 효과에 관한 연구)

  • Kim, Keum-Soon;Seo, Hyun-Mi;Kim, Eun-Jeong;Jeong, Ihn-Sook;Choe, Eun-Jeong;Jeong, Sun-I
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.2
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    • pp.196-211
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    • 2000
  • The purpose of this study was to determine the effects of 5 weeks self-help management program on reducing depression, promoting Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings(IADLs), grasping power, hope and self-efficacy for post stroke patients visiting public health care centers in Seoul. This was pre-experimental study, and the subjects were 27 post stroke hemiplegic patients. The program was composed of five sessions and each session had health education on stroke, ROM exercise and recreation. Data were collected from May to November, 2000, and all subjects were asked to complete the Questionnaires, be measured vital signs and grasping power. Data were analyzed with frequency, percent, paired t-test, and Pearson's correlation coefficient using SAS(version 6.12) program. The results were as follows : 1) The scores of ADLs were increased from 27.04 to 28.22 after program, and that was statistically significant(p=.005). 2) The scores of IADLs were increased from 18.70 to 19.78 after program, and that was statistically significant(p=.004). 3) The grasping power of right hand were increased from 21.87kg to 26.93kg after program, and that was statistically significant(p=.002). But the grasping power of left hand were statistically insignificant(p=.919). 4) The scores of depression were decreased from 39.63 to 35.30 after program, and that was statistically significant(p=.030). 5) The scores of hope were increased from 30.89 to 34.15 after program, and that was statistically significant(p=.002). 6) The scores of self-efficacy were increased from 67.70 to 76.37 after program, and that was statistically significant(p=.000). According to the results of this study, the scores of Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings (IADLs), hope, and self-efficacy and the grasping power were improved and depression was reduced in post stroke patients participating in self-help management program. Therefore we recommend to use self-help management programs as a nursing intervention for the post stroke patient.

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The Relationship between Resilience, Social support and Caring burden of Middle-aged Caregivers caring for Chronic disease (만성질환자를 돌보는 중년기 주 돌봄 제공자의 회복탄력성, 사회적지지와 돌봄 부담감과의 관계)

  • Kim, Nam-Hee;Park, Sun-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.300-310
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    • 2019
  • The purpose of this study was to investigate the relationship between resilience, social support and caring burden of middle-aged caregivers caring for chronic disease. The data were collected from 175 caregivers at one rehabilitation centers in B City from July 2 to 31, 2018 and analyzed SPSS Win 21.0. Factors influencing caring burden were time for caregiving(F=6.70, p<.001), activities of daily living(F=4.70, p<.001), patient disease(F=4.61, p<.001), relationship with patients(F=3.68, p<.013), Health Status(F=3.08, p=.018), Marital status(t=-2.12, p<.036), Period after diagnosis(F=2.92, p=.036). The caring burden had not an influence on resilience and social support. a positive correlation was found between resilience and socail support(r=.487, p<.001). Therefore, it is essential to develop burden intervention programs that can reduce the burden in middle-aged caregivers caring for chronic disease and taking all the factors affecting burden into consideration.

A Convergence Study about the Effects of Assertiveness Training on Nurses' Fear of Negative Evaluation, Assertiveness Behavior, and Communication Competency (자기주장훈련 프로그램이 간호사의 부정적 평가에 대한 두려움, 자기주장행동 및 의사소통에 미치는 효과에 관한 융합 연구)

  • Kim, Kyeong-Im;Kim, Soo-Jin;Kim, Boyoung
    • Journal of the Korea Convergence Society
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    • v.9 no.10
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    • pp.487-495
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    • 2018
  • The goal of this study is to examine the effectiveness of assertiveness training program for nurses' fear of negative evaluation, assertiveness behavior, and communication competency. The study is quasi-experimental study by nonequivalence control group design. The subjects of this study consisted of 32 graduate students in nursing department located in G city; 14 in experimental group and 18 in control group. The data is collected from March 13th, 2018 to May 8th, 2018. The experimental group participated in assertiveness training program composed of six times session for 180 minutes once a week and were asked to fill out the structured questionnaire. Collected data is analyzed by Fisher's exact test, $x^2-test$ and t-test. The result reveals the significant difference in assertiveness behavior and communication competency of nurses. This study contribute to improve the effectiveness of convergence-based assertiveness training program for nurses' assertiveness competency, communication competency.

Factors Affecting Dietary Behavior Change of Vulnerable Elderly Based on the Stage of Change (변화단계 이론에 근거한 취약계층 노인의 식 행위 관련 요인분석)

  • Ko, Young;Yim, Eun shil
    • 한국노년학
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    • v.30 no.3
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    • pp.695-708
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    • 2010
  • Purpose: This study was to explore the factors affecting on Dietary Behavior Change of the vulnerable elderly based on the Stage of Change. Methods: This study was a secondary analysis of the data collected from 1,262 elderly who were participated in the case management program. Total 984 participants who responded all questionnaire were included in the analysis. The variables included general characteristics, health behavior, health status, and dietary behavior stage. The data collected were analyzed by descriptive statistics, trend test and multi-variate logistic regressions. Results: about twenty four percent of the vulnerable elderly subject was pre-contemplation stage and 46.1% of them was contemplation stage of dietary behavior. Having a depressive mood, dependance of Instrumental Activity of Daily living, and being medicaid affected on starting or on maintaining healthy dietary behavior in vulnerable elderly negatively. Conclusion: The tailored nutritional intervention depending on dietary behavior stage are needed for the vulnerable elderly to improve the health. The program which can maintain the function remained of elderly and give psychological support together will be more effective.

A Study on Estimation of Caring Demand for Extended Care Facilities by Activities of Daily Living (ADL(Activities of Daily Living)을 이용한 무료노인요양시설 수용노인의 돌봄필요도에 관한 연구)

  • Kim, Chul-Woung;Moon, Ok-Ryun;Lee, Sang-Yi;Yoo, Jae-Won;Yi, Sang-Gu
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.564-578
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    • 1998
  • Most extended care facilities have admitted both the healthy and unhealthy elderly, among which members' average caring demand vary. The Aged Welfare Law, however, currently provides no reasonable basis on the staffing policy for extended care facilities. It just reflects the admitted number of the elderly rather than differences in members' average caring demand among facilities. This study is designed to estimate the need for caring staff on the basis of the correlation between the individual health status measured by various tools including Activities of Daily Living and caring demand by actual service time for each one. The sample included all of the admitted elderly(187 persons) in 4 extended care facilities, two in Seoul and the other two in Kangwon-Do over the survey period October 5 through October 20, 1996. The survey process consisted of 3 stages. (1) The current staffing information was collected through self-completed written questionnaires left for head of official in each facility. (2) Six graduate students at School of Public Health interviewed all residents to collect information on their health status and sociodemographics. The response rate for the interview was relatively high(85%). (3) Information on direct and indirect caring time consumed for each residents came from self-completed written questionnaires given to nurses and helpers in each target facilities. Analysis of the data was made using Pearson's correlation and multiple regression technique through SAS program. Based on this procedure, the following was found. 1. No facility meet the staffing standard in the Aged Welfare Law completely. 2. It is actual service time that is most correlated with ADL(Activities of daily living). 3. When all of the elderly are divided by four groups based on the level of ADL, the mean values of needed caring time in each group are 15, 21, 36 and 88 minutes respectively. 4. There is no significant difference among facilities in distribution of elderly person by group. 5. No facility meets the estimated number of nurses and helpers which reflects health status of the admitted elderly. Therefore, it is required that severity of the admitted elderly be considered in establishing staffing standard for extended care facility.

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A Study on the Development of Case Management Program for Arthralgia in Customized Visiting Health Care (맞춤형 방문건강관리사업에서의 관절통증 사례관리 프로그램 개발 연구)

  • Lee, Moo-Sik
    • Proceedings of the KAIS Fall Conference
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    • 2009.12a
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    • pp.474-478
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    • 2009
  • 본 연구는 2008년 맞춤형 방문건강관리사업에 사용되고 있는 관절통증을 중심으로 한 사례관리를 수정 보안하여 우리나라 실정에 맞는 관절통증 사례관리 프로그램을 개발, 제안하며, 맞춤형 방문건강 관리사업의 활성화와 완성도를 높이는데 있다. 연구방법으로는 2007년 전국 12주 관절통증 사례관리 결과자료 분석하고, 전국 253개 보건소의 맞춤형 방문건강관리사업 인력에 대한 자료 분석과 전국 보건소 전문가 자문회의와 토론 결과를 통해 설문지를 수정 보완하여 2008년도 충청남도 관절통증 12주 사례관리를 실시하였다. 자료분석은 SPSS 12.0 통계 프로그램을 이용하여, p-value가 0.05 미만과 0.01미만인 경우를 통계적으로 유의한 것으로 판정하였으며, 전국자료는 빈도분석, wilcoxon 부호순위 검정과 McNemar's 검정을 실시하였으며, 12주의 관절통증 사례관리의 연구기간동안 수집된 자료를 1주와 8주간, 1주와 12주간, 8주와 12주간을 paired t-test 검정과 McNemar's 검정을 실시하여 유의성 평가를 실시하였다. 연구결과는 다음과 같다. 12주 기간 동안 사전 사례관리 방문간호사의 교육을 통한 사례관리 서비스의 강도의 조절 및 매주로 서비스의 횟수를 조절하여 사례관리를 실시한 결과 총 109개 항목에서 1주와 8주간에 유의한 항목은 TG(mg/dl)를 비롯한 51개 항목, 1주와 12주간에는 콜레스테롤(mg/dl)을 비롯한 53개 항목, 8주와 12주간에는 지난 48시간동안 관절통증 점수를 비롯한 3개 항목으로 유의한 차이를 볼 수 있었으며, 1주와 8주간은 유의하나 1주와 12주간은 유의하지 않게 나타나는 항목은 TG(mg/dl)를 비롯한 3개 항목, 1주와 8주간은 유의하지 않다가 1주와 12주간은 유의하게 나타나는 항목은 콜레스테롤(mg/dl)를 비롯한 6개 항목, 1주, 8주, 12주간의 모든 기간에서 유의한 항목은 지난 48 시간동안 관절통증 점수를 비롯한 3개 항목으로 조사되었다. 결론적으로 현재 우리나라에서 추진되고 있는 맞춤형 방문건강관리 사업의 사업지침에 대한 보완을 위해 관절통증사례관리 프로그램에 있어 중재 서비스 또는 프로그램의 기간은 12주간에서 8주간으로 조정 되어야 하며, 추가가 필요한 항목으로는 교육, 자기역량 강화, 운동처방, 물리치료, 약물치료, 대체요법, 식이, 영양, 생활지도 등이며, 어골도 분석을 위한 기본 틀 및 주요 구성요소를 제시 및 기여 요인 및 결정요인을 위한 논리적 모형 제시가 필요하며, 개선목표를 위한 유지증진 및 관리능력, 지기 관리 수행도 개선과 대상자별 맞춤형 사례관리를 위한 표준화된 행동 체크리스트 제작 보급 및 사례별 운동, 물리치료 지도 방법 계획 수립에 대한 인력 충원이 필요하다.

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A Review of Person-centered Care in Nursing Homes (노인요양시설의 인간 중심 케어 (Person-centered care)에 대한 연구)

  • Yoon, Ju Young;Roberts, Tonya;Bowers, Barbara J.;Lee, Ji Yun
    • 한국노년학
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    • v.32 no.3
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    • pp.729-745
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    • 2012
  • The purpose of this study is to review person-centered care models and the scientific evidence for the impact of person-centered care in U.S. nursing homes, and to analyze the applicability of person-centered care for Korean long-term care system. The most commonly recognized person-centered care models were Eden Alternative, Green House, and Wellspring model. The core components of the three models were autonomy, close relationships, homelike environment, and staff empowerment. Thirty eight empirical studies including 10 model testing studies and 28 studies to examine the impact of person-centered care interventions indicated generally positive outcomes in terms of residents, family, and staff/organization level. The authors analyzed the current situation in the Korean long-term care system with respect to the specific core constructs of person-centered care, and proposed applicable models and practical suggestions in consideration of Korean context. Lastly, future considerations regarding policy and research were discussed.

A Study on Hypertension Management of Community Health Practitioner Posts (보건진료소 고혈압 관리사업의 실태)

  • Kwon, Myung-Soon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.155-169
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    • 2003
  • Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.

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An Analysis of the Determinants of Employment and Wage of New College Graduates (신규대졸자의 취업 및 임금수준 결정요인 분석)

  • Chai, Goo-Mook
    • Korean Journal of Social Welfare
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    • v.59 no.4
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    • pp.35-61
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    • 2007
  • This study examines the determinants of employment and wage of new college graduates by using Youth Panel Data(2003-2005) of the Work Information Center, and seeks assignments for mitigating unemployment and wage disparities of new college graduates. Results are summarized as follows. First, an analysis of the determinants of employment shows that the Kyunggi Inchon district in school locations, higher school records, and qualification certificates positively affect the employment rate, while the private college group in the non-capital area negatively affects the employment rate. Second, an analysis of determinants of standard employment demonstrates that the Kyunggi Inchon district in school locations, higher school records, qualification certificates, and the major group of medical science, pharmacy, nursing science and health science, and the major group of education positively affect the employment rate, while the private college group in the non-capital area, the junior college groups in the capital and non-capital areas negatively affect the employment rate. Third, an analysis of determinants of nonstandard employment shows that the junior college graduation in scholarly attainments, the junior college groups in the capital and non-capital areas positively affect the employment rate, while the private college group in the non-capital area negatively affects the employment rate. Fourth, an analysis of the determinants of wages demonstrates that male in sex, the older in ages, the major group of medical science, pharmacy, nursing science and health science, and the major group of education positively affect the wages, while nonstandard employment, Kyunggi Inchon and Cholla districts in school locations negatively affect the wages. These results suggest several implications. First, college education should be reformed to cultivate professional manpower who are required by industries. Second, alternative measures to mitigate sex discrimination in labor markets should be prepared. Third, the process of attaining qualification certificates should be reformed in order that it is actually connected to the abilities of work performances and the improvement of productivity. Fourth, a locally balanced development must be realized through the decentralization of industries. Fifth a systematic and comprehensive program need to be prepared to promote the employment of new college graduates.

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