• Title/Summary/Keyword: 간호진단

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Determination of Nursing Activities for Estimation of Nursing Fees Based on 9 KDRGs (Korean Diagnosis-Related Groups) (한국형 진단명 기준 환자군(KDRG)별 간호수가 산정을 위한 간호행위 규명;9개 질환군을 대상으로)

  • Lee, Eun-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.547-561
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    • 1999
  • The purpose of this study was to determine which nursing activities are performed for patients in each of the nine KDRGs and to examine common nursing activities between patients with the nine KDRGs and special nursing activities which were not common to patients with the nine KDRGs. The study will provide basic data for estimation of nursing fees. The nine KDRGs in model project are Lens procedures, tonsillectomy, &/or adenoidectomy, appendectomy &/or not complicate principal diagnosis, vaginal delivery, cesarean section, anal & stomal procedures, inguinal & femoral hernia, uterine & adneza procedure for nonmalignancy, and simple pneumonia & pleurisy. To determine the nursing activities for each of the nine KDRG, checklists of nursing activities in each nine KDRG were developed from the literature and a total of 115 records of patients 'who were diagnosed and discharged between January and April, 1999 from a tertiary medical center. Nursing activities for each of the nine KDRG were verified through two consecutive content analyses. The results of study are followed as: 1. The checklists of nursing activities developed included direct and indirect nursing activities, for a total of 241 nursing activities. Direct nursing consisted of physical, educational, emotional-socioecomomic-spiritual nursing in 17 areas. Indirect nursing had four areas. 2. Through the two consecutive content analyses, 197 nursing activities were selected, having item CVIs of .83 or more. Those included 81 nursing activities for Lens procedures, 95 for Tonsillectomy &/or Adenoidectomy. 93 in Appendectomy &/or not complicated principal diagnosis, 155 for vaginal delivery, 172 for cesarean section, 89 for anal & stomal procedures, 93 for inguinal & femoral hernia, 108 for uterine & adneza procedures for non-malignancy, and 68 for simple pneumonia & pleurisy. 3. Nursing activities for each of the nine KDRG were compared. Activities with 80% or higher commonality within the nine KDRGs consisted of 86 of 197 nursing activities for the total designated common nursing activities, 30 common nursing activities for patients in the operation group, 45 common activities for patients in the delivery Group. Special nursing activities not common within the nine KDRGs were : 3 for Lens procedures, 1 for Tonsillectomy &/or Adenoidectomy. 2 for Appendectomy &/or not complicated principal diagnosis, 27 for vaginal delivery, 21 for Cesarean section, 6 for anal & stomal procedures, 3 for inguinal & femoral hernia, 16 for uterine & adneza procedure for non-malignancy, 8 for simple pneumonia & pleurisy. In this study, nursing activities for each of the nine KDRGs verified through two consecutive content analyses are those that are performed in the hospital. And, nursing activities for each of the nine KDRGs included all nursing activities from hospital admission to discharge. So. the checklists consisted of nursing activities that allow for an estimation of nursing fees under PPS. The classification of nursing activities in the study will provide a reference for the development of a nursing activity classification.

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The Use of Nursing Diagnosis in Practice (간호진단의 임상적용 현황, 문제점 및 개선방안)

  • 박신애;강현숙;문희자;김광주;이향련;조미영;조결자;김윤희;김귀분
    • Journal of Korean Academy of Nursing
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    • v.19 no.1
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    • pp.24-39
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    • 1989
  • This study was conducted to investigate the present situation and problems related to the use of nursing diagnosis in practice. The data were obtained from 332 subjects (27 director of nursing service, 302 staff nurses) who worked in university hospitals in Korea from July through August 1988 using a mailed questionnaire. Data were analyzed by frequency, X$^2$ test and t-test. The findings were as follows ; 1, Clinical use of nursing diagnosis by directors of nursing service and staff nurses. 1) The majority of the nursing departments (88.9%) conducted group education on nursing diagnosis during the last 5 years and 81.5% of them kept a record format for nursing diagnosis : 88.9% of them had had prior experience with the nursing diagnosis. 2) Most of nurses (97.0%) had received education on nursing diagnosis. 2. Factors related to the clinical use of nursing diagnosis in nursing service departments and by staff nurses. 1) The one factor related to the use of nursing diagnosis in the nursing service department was the existence of a record. 2) Factors related to the use of nursing diagnosis by the staff nurses were the organization style of the nursing service department, group education during the last 5 years, existence of a record, the attitude of the director of nursing service, and prior experience of the use of the nursing diagnosis as characteristics of nursing service department and educational experience of nursing diagnosis as a character of nurse. 3. Problems with the use of nursing diagnosis. 1) The primary problem was the lack of time and personnel (mean : 3.757) ; the second problem was the lack of knowledge and will to use nursing diagnosis in practice by the staff nurses(mean : 3.546). 2) There was no significant difference in problems expressed by the director of nursing services and the nurses. The majority of nurses who worked in the university hospitals expressed interest in and concern about the use of nursing diagnosis. Most of the nurses had had education about on nursing diagnosis but use in practice was limited. The primary problem was lack of time and manpower. Strategies for improving use of the nursing diagnosis in practice : 1) Strengthening the education about nursing diagnosis and a holistic approach to understanding human beings. 2) Develop protocols for the use of nursing diagnosis. 3) Eliminate the language barrier regarding nursing diagnosis by translation into in Korean. 4) Decentralization of the nursing service to promote accountability by individual nurses for use of nursing diagnosis.

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간호진단 한글 표준화에 대한 연구

  • Choi, Young-Hee;Rhee, Hyang-Yun;Kim, Hea-Sook;Kim, So-Sun;Park, Kwang-Ok;Park, Hyoun-Kyoung
    • The Korean Nurse
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    • v.35 no.4
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    • pp.37-50
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    • 1996
  • Nursing Diagnosis has evolved in the guest to define nursing and its functions. But for the application to clinical practice an unified system of terminology that helps nurses to assess selected data and identify potential or actual client problems is required. Consistent terminology that captures the real meanings of the nursing diagnosis makes oral and written communication more accurate and efficient. Therefore,' this study was performed to deliver a Korean-translated version of the nursing diagnoses through the process of content validity tests and translations. Data collection for the first content validity test was done from June 27, 1996 to August 1. 1996. Among 20 questionnaires only 16 were used for analysis. With the results of content validity, the list of 109 nursing diagnoses were reviewed by two linguists, one specialized in Korean and the other in English. To clear confusion on a diagnostic label "Incontinence" a urology specialist was invited for consultation. From this analysis and discussions a total of 98 nursing diagnoses was delivered and quesitons containing 98. 98 diagnoses were mailed to 741 subjects to test content validity from August 13, 1996 to October 7, 1996. Among 741 questionnaires, 343 were used for analysis. Total mean score of the diagnoses was 4.30 on the 5 point likert scale. The diagnoses that acquired less than 3.50 were "High risk for altered body temperature"(3.34), "Ineffective thermoregulation" (3.34), "Perceived cosntipation"(3.24). "Stress incontinence"(3.42), "Ineffective airway clearance"(3. 48), "Altered sexuality patterns"(3.35).

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병원에서의 산업보건관리

  • Jeon, Gyeong-Ja
    • Korean Journal of Occupational Health Nursing
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    • v.2
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    • pp.40-51
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    • 1992
  • 본 연구는 병원에서의 산업보건관리 실태를 파악하기 위하여 전국에 있는 병원을 대상으로 1992년 12월 1일부터 1993년 1월 23일까지 설문조사를 설시하였다. 설문조사에 응당한 병원은 41개병원으로 회수율은 51.9%였다. 조사에 이용된 설문지는 산업안전보건법 내용을 기초로 하여 본 연구자가 작성한 것이며 안전보전에 관한 제반 규정, 안전보건관리체계, 근로자건강관리, 작업환경관리, 보건교육, 보건관련시설, 질병 및 상해에 대한 보상 등에 관한 45개문항으로 구성되어 있다. 분석결과는 다음과 같다. 첫째, 전체 병원 중 68.3%가 안전보건관리 규정이 있다고 답하였으며, 77.5%의 병원이 단체협약 중 근로자의 안전과 보건에 관한 조항을 포함시키고 있는 것으로 나타났다. 단체협약에 포함된 내용 중에는 정기건강진단(23.7%)과 질병 및 상해에 대한 보상(20.9%), 안전보건위원회의 구성(18.1%)등이 많았다. 둘째, 대상 병원중 66.7%가 안전보건관리책임자, 관리감독자, 안전담당자를 두고 있는 것으로 나타났고, 근로자수가 1,000명 이상인 병원은 83.3%가 이들 인력을 선임하고 있다. 그러나, 보건관리자와 안전관리자를 전담으로 두고 있는 경우는 한 곳도 없었으며 50%이내에서 겸직으로 선임하고 있었다. 또한, 안전보건위원회를 운영하고 있거나 노사협의회로 이를 대치하고 있는 병원은 54.2%로 절반 수준에 머물렀고, 그나마 정기적으로 운영을 하고 있다고 답한 병원은 3개 병원 밖에 되지 않았다. 세째, 근로자 건강관리를 위한 건강진단 실시 현황을 보면, 채용시검진 97.6%, 일반건강진단 100.0%, 특수 건강진단 24.4%가 실시하고 있었다. 건강진단에서 주로 실시하고 있는 항목은 흉부 X선검사, 시력, 혈압, 혈청GOT/GPT, 체중, 신장등이었다. 그러나, 병원에서 감염될 수 있는 기회가 높은 간염항원/항체검사의 실시율은 85.7%로 아직도 실시하지 않는 병원이 있음을 알 수 있다. 네째, 작업환경관리를 위하여 정기적으로 환경측정을 실시하는 병원은 21.6%였고 주로 측정하는 항목은 방사선이었다. 특히 소음, 조명, 분진에 대한 측정이 이루어지지 않음은 근로자뿐아니라 환자의 안위에도부정적인 영향을 미칠 수 있다. 다섯째, 안전한 작업과 근로자의 건강을 위하여 정기적인 보건교육을 설시하고 있는 병원은 불과 5.6%였다. 교육내용은 주로 안전에 관한 것이었다. 여섯째, 근로자의 일상적인 건강문제를 해결해주는 의무실을 독립적으로 마련하고 있는 병원은 한 곳도 없었고, 교대근무자나 당직자를 위한 수면시설은 44.7%, 작업 후에 사용할 수 있는 샤워시설은 35.1%의 병원이 마련하고 있었다. 일곱째, 근무중 다치거나 병에 걸렸을 때 치료비에 대한 부담은 대체로 병원이 하고 있으며 치료기간 중 근무는 병가나 휴직으로 처리되고 있다. 이는 병원이 산재보상보험법에 적용을 받지 않은 사업으로 분류되어 있는 현실에 기인된 것으로 보상과 관련된 부담을 병원이나 근로자 모두가 안게 되는 결과를 초래하게 되는 것이다. 이상에서 볼 때 병원근로자를 위한 산업보건관리는 주로 건강진단과 질병 및 상해에 대한 보상제도가 이루어지고 있는 실정이다. 그러므로 질병의 예방이나 악화방지 나아가 건강증진을 도모하기 위한 지속적인 노력을 기울이고 있는 병원은 전무한 상태임을 알 수 있다. 이러한 현실을 병원근로자를 위한 산업보건관리에 대한 인식이 전반적으로 부족함을 드러내는 것으로 이를 개선하기 위한 보다 적극적인 노력이 시급히 요청되고 있다.

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Factors Influencing Mental Health among Nursing students (간호대학생의 정신건강에 영향을 주는 요인)

  • Jee, Youngju;Lee, Yun-Bok;Lee, A Reum;Jeon, Jeong Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.8
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    • pp.3866-3875
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    • 2013
  • The purpose of this study was to investigate the degree of mental health among nursing students in Korea and identify factors influencing the tendency to mental health. A self-report survey was conducted with South Korean nursing students who were from 19 to 23 years old. 269 nursing students were included in the study. The instruments utilized in the study were Symptom Checklist-90-Revision, Stress and multidimensional coping. Data were analyzed using descriptive statistics, Pearson correlation and Simultaneous multiple regression with SPSS WIN 20.0. The average mental health score of the participants was 0.57. Significant predictors for mental health 'College-level stress', 'Self-criticism', 'Passive withdrawal', 'Nursing satisfaction' and 'Health state'. The study findings suggest that nursing students require special concern regarding the risk of mental health. Multi and interdisciplinary mental health promotion program will enhance the mental health of nursing students.

Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer (진단 직후 유방암환자의 디스트레스 관리를 위한 심리교육프로그램의 효과)

  • Park, Jin-Hee;Chun, Mison;Jung, Yong Sik;Bae, Sun Hyoung;Jung, Young-Mi
    • Journal of Korean Academy of Nursing
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    • v.48 no.6
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    • pp.669-678
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    • 2018
  • Purpose: The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer. Methods: A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast. Results: Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group. Conclusion: These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

Hospital-based home care reinbursement and service use for the elderly (노인의 의료기관 가정간호 급여청구 및 서비스 이용 현황)

  • Chin, Young-ran
    • 한국노년학
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    • v.29 no.2
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    • pp.645-656
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    • 2009
  • The purpose of this study was to address the current status of hospital-based home care(HBHC). We analyzed the data on HBHC from national electronic data information of Health Insurance Review Agency. Beside, we surveyed 75 hospital-based home care agency. In 2006, 20,343 elderly(64.0% from all HBHC user) used 333,889 visits(76.8%from all visits). Medical diagnosis was composed of circulatory disease including cerebrovascular diseases 41.3%, endocrine system disease including Diabetes mellitus 10.4%, neoplasm 9.7%. Some of subjects used HBHC in excess of maximum covered 8 visits a month by National Health Insurance, decubitus 7.0%, the cancer 5.4%, the diabetes 2.5%, the hypertension 1.1%, and the stroke 0.9%. This results will contribute to expand the coverage of hospital-based home care by National Health Insurance. There was distribution difference in medical diagnosis and nursing intervention between HBHC and Public health center-based home care(PBHC) subjects. Therefore, HBHC subjects had more severe medical diagnosis, and were intervened more injections, examinations, than PBHC subjects. These differences must be considered to set up functional role among the three types of home visit care.

Factors Affecting Depression in Junior Nursing Students (저학년 간호대학생의 우울 영향 요인)

  • Lee, Eliza
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.413-425
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    • 2019
  • This study was conducted to identify factors affecting depression in junior nursing students(JNS). The number of the participants was 144 at a college in S and G city. The data were collected using questionnaires about somatic symptoms(SS), sleep quality, stress, adaptation to college life(AC), depression. Mean score of depression was 18.89, 58.3% are experiencing depression that requires clinical treatment. The significant predictors of JNS were levels of depression AC(β=-.503, p=.000) and SS(β=.263, p=.000) respectively, explaining 58.9% of variance. In order to control the depressive symptoms of JNS, it is necessary to diagnose basic learning ability from the beginning of admission and provide guidance management plans to help students adapt to academic activities by providing customized programs for each level to improve learning ability. It is necessary to develop and apply various intervention programs to alleviate physical symptoms such as fatigue/low energy experienced by JNS.

Comparison of Risk Factors for Men and Women According to Severity Classification in Patients with Coronary Artery Disease (관상동맥질환 중증도 분류에 따른 성별 위험요인 비교)

  • Kweon, Mi-Soo
    • Journal of Industrial Convergence
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    • v.20 no.8
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    • pp.85-96
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    • 2022
  • The aim of this retrospective study was to compare risk factors between men and women through secondary data of nursing information and medical records according to the severity classification in patients of 340 men and 221 women with coronary artery disease(CAD) who were admitted for the first time at a general hospital and underwent first coronary artery angiography. Consequently, men presented with risk factors such as age(p=.004), total cholesterol(p=.040), triglycerides(p=.049), HbA1c(p<.001), smoking(p<.001), alcohol consumption(p=.002) and comorbidities(p=.036) that showed statistically significant differences. Among women, age(p=.002) and comorbidities (p=.018) were the only factors that showed significant differences. Significant risk factors influencing the classification of CAD severity in men were total cholesterol (OR 0.97, 95% CI 0.96-1.00, p=.014) in 1VD, alcohol consumption (OR 52.47, 95% CI 2.99-91.95, p=.007)in 2VD, and total cholesterol in the 3VD(OR 0.98, 95% CI 0.95-0.98, p=.026). A significant risk factor affecting the classification of CAD severity in women was comorbidity (OR 0.30, 95% CI 0.11-0.82, p=.020) in the 3VD. This study identified the importance of nursing care for male CAD patients, such as smoking cessation and quitting drinking, blood sugar control, cholesterol, and accompanying disease management, and provided evidence of individually tailored nursing care.

Applying document routing mode of information access in nursing diagnosis process (문서 라우팅 기법을 이용한 간호진단 과정에서의 정보접근)

  • Paik Woo-Jin
    • Proceedings of the Korean Society for Information Management Conference
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    • 2006.08a
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    • pp.163-168
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    • 2006
  • Nursing diagnosis process is described as nurses assessing the patients' conditions by applying reasoning and looking for patterns, which fit the defining characteristics of one or more diagnoses. This process is similar to using a typical document retrieval system if we consider the patients' conditions as queries, nursing diagnoses as documents, and the defining characteristics as index terms of the documents. However, there is a small fixed number of nursing diagnoses and infinite number of patients' conditions in a typical hospital setting. This state is more suitable to applying document routing mode of information access, which is defined as a number of archived profiles, compared to individual documents. In this paper, we describe a ROUting-based Nursing Diagnosis (ROUND) system and its Natural Language Processing-based query processing component, which converts the defining characteristics of nursing diagnoses into query representations.

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