• 제목/요약/키워드: 만성간호

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장기요양시설 노인의 만성통증 관리를 위한 비약물적 중재: 주제범위 문헌고찰 (Non-pharmacological Interventions for Chronic Pain in Older Adults in Long-term Care Facilities: A Scoping Review)

  • 황경혜;김혜경;조옥희
    • 가정∙방문간호학회지
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    • 제30권3호
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    • pp.298-310
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    • 2023
  • Purpose: This study synthesized the literature on non-pharmacological interventions for chronic pain in older adults in long-term care facilities. Methods: Scoping review and thematic analysis methods were combined. On June 1, 2023, searches of primary electronic databases, including PubMed, Embase, PsycINFO, CINAHL DBpia, KMbase, NDSL, and RISS, were performed, restricting the publication date from January 1, 2010 to December 31, 2022. Guidelines from the Joanna Briggs Institute were used as a framework to set and conduct the scoping review. Results: The review identified 1,095 abstracts, from which 14 studies were included in the review. Consequent to the study, there were 10 randomized controlled experimental study designs, and 6 out of 14 studies were conducted in China. The numeric rating scale was widely used for pain assessment. Exercise intervention was provided in 7 studies and physiotherapy was provided in three studies. The outcome variables measured were pain self-efficacy, physical functions, and depression. Conclusion: This comprehensive overview guided nursing staff in long-term care facilities for planning and intervention of effective non-pharmacological interventions for chronic pain in the elderly.

만성통증 노인의 삶의 질에 대한 심리적 영향요인에 관한 연구 (A Study of Psychological Factors on the Quality of Life in the Elderly with Chronic Pain)

  • 이수인;이은주
    • 한국산학기술학회논문지
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    • 제20권10호
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    • pp.209-217
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    • 2019
  • 본 연구는 만성통증 노인의 우울, 두려움-회피신념, 파국적사고와 삶의 질의 관계를 확인하고 우울, 두려움-회피신념, 파국적사고와 같은 심리적 요인이 만성통증 노인의 삶의 질에 어떠한 영향을 미치는지 확인하기 위한 서술적 조사연구이다. 대상자는 2019년 3월 4일부터 2019년 3월 18일까지 A시 소재의 일개 신경과통증의학과 의원을 방문한 65세 이상 만성통증 노인 147명을 대상으로 하였다. 통계처리는 SPSS/WIN 22.0 프로그램을 이용하여 t-test와 ANOVA, Pearson's correlation coefficients, 다중 회귀분석을 사용하였다. 만성통증 노인의 일반적 특성에 따른 삶의 질 차이에서 연령(F=3.464, p<.001), 배우자(t=4.545, p<.001), 건강상태(F=31.04, p<.001), 통증정도(F=14.76, p<.001)에서 유의한 차이가 나타났다. 만성통증 노인의 삶에 질 예측요인을 분석한 결과 우울(${\beta}=-.25$, p<.001) 통증정도(${\beta}=.25$, p<.001), 파국적사고(${\beta}=-.28$, p<.001), 건강상태(${\beta}=-.19$, p<.001)가 영향요인으로 나타났고 전체설명력은 49 %이다. 따라서 만성통증 노인의 삶의 질 향상을 위해서 우울, 파국적사고와 같은 부정적인 심리적 영향 요인에 대한 연구가 더욱 필요할 것으로 판단된다. 또한, 적극적인 통증조절 및 건강상태를 긍정적으로 인식할 수 있도록 체계화된 간호중재 프로그램 개발이 필요할 것으로 사료된다.

복합만성질환을 가진 고령근로자 직업건강간호의 과제 (A Challenge in Occupational Health Nursing among Elderly Workers with Multimorbidity)

  • 서수경;최성주;연승욱
    • 한국직업건강간호학회지
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    • 제29권4호
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    • pp.247-253
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    • 2020
  • Purpose: Multimorbidity is defined as the coexistence of multiple chronic diseases within a person. This study explores the burden of multimorbidity in the working population, focusing on the recent increase in elderly workers in Korea. Methods: We summarized past empirical or theoretical literature. Results: Previous literature shows that about 80% of the elderly are multimorbid, and more than half of people with chronic disease have two or more chronic conditions. Multimorbidity is a common phenomenon in the elderly working population. However, little is known about its prevalence, the factors related to its unequal distribution among workers, and its effects on health outcome measures such as mortality, medical use, and employment decisions. Conclusion: This study asks researchers to focus on a subgroup analysis employing data on the working population. Health professionals need to develop clinical guidelines for multimorbid patients. As multimorbidity is a major health concern in the working elderly, prevention and control should be promoted in the workplace.

병원중심가정간호를 받는 만성질환 노인의 삶의 경험에 관한 내러티브 탐구 (A Narrative Inquiry of Experience of the Elderly's Living with Chronic Disease in Hospital-based Home Care Services)

  • 신인주;이정숙
    • 가정∙방문간호학회지
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    • 제18권1호
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    • pp.20-31
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    • 2011
  • Purpose: The purpose of this study is to document the experiences of elderly persons with chronic diseases who are under hospital-based home care services and to find out how they describe the experiences using a narrative inquiry method. Methods: The participants are 7 elderly patients over the age of 70. Data collection and analysis were conducted through Jeong Gwang Soon's six-stages: observing phenomena, selecting participants, talking, talking again, writing, and confirming. Results: The results of data analysis were classified into 4 themes of overall experience related to chronic diseases: response to home health care, overcoming chronic disease, life reconstruction, and 22 categories as common denominators extracted from the elderly persons' lives. Conclusion: This research makes the experiences of the elderly living with chronic diseases more understandable, and it can be utilized as a effective nursing praxis to improve the quality of elderly persons with chronic diseases in hospital-based home care services.

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지역사회 거주 노인의 만성질환 수, 수면의 질 및 세로토닌 농도가 우울에 미치는 영향 (The Effects of Chronic Diseases, Sleep and Serotonin Concentration on Depression among Elderly People Living in the Community)

  • 남은정;박진경
    • 지역사회간호학회지
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    • 제31권4호
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    • pp.472-480
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    • 2020
  • Purpose: This study identified the effects of chronic disease number, quality of sleep and, serum serotonin concentration on the elderly's depression in order to provide basic data for the development of intervention program to effectively prevent and manage depression of the elderly living in the community. Methods: The study surveyed 207 people aged 65 or older living in the community. The general characteristics of the subjects, the number of chronic diseases, the quality of sleep (PSQI-K), the hematological test (Serotonin) and the depression (K-GDS) were statistically analyzed using SPSS/WIN 23.0. Results: It was shown that the elderly's depression differed significantly depending on the number of chronic diseases, the quality of sleep, and serum serotonin concentration, and that the variable that most affected depression was the quality of sleep. Next, the number of chronic diseases and serum serotonin levels were the variables affecting the depression of the elderly. Conclusion: In order to prevent and manage the depression of the elderly in the future, treatment and education for diseases and depression should be provided to the subjects. In particular, nursing interventions are needed to improve the quality of sleep for the elderly. Health care programs should also be provided, such as providing nutritional supplements to provide serotonin and increasing daytime activities.

만성질환을 가진 성인의 미충족 의료 영향요인 (Factors Affecting Unmet Healthcare Needs among Adults with Chronic Diseases)

  • 한지영;박현숙
    • 지역사회간호학회지
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    • 제32권2호
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    • pp.131-139
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    • 2021
  • Purpose: In adults with chronic diseases, unmet healthcare needs are likely to increase the risk of worsening the illness and complications. This study was conducted to explore factors affecting unmet healthcare needs among adults with chronic diseases. Methods: A cross sectional study was performed using the data from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2017. The sample of this study consisted of 6,104 adults with chronic diseases. The data were analyzed by Rao-Scott 𝑥2 test and logistic regression using complex samples analysis. Results: The proportion of subjects who experienced unmet healthcare needs was 10.9% of adults with chronic diseases. The factors affecting unmet healthcare needs of adults with chronic diseases were age, gender, employment status, household income, subjective health status, activity limitation, and perceived stress. Conclusion: The findings of this study suggest that various factors may be associated with their unmet healthcare needs. Finally, the development of strategies to reduce unmet healthcare needs for people with chronic diseases should consider the associated factors presented in the study.

자기결정성 이론 기반 만성폐쇄성폐질환 환자를 위한 동기면담 호흡재활 프로그램의 개발 및 평가 (Development and Evaluation of Motivational Interviewing Pulmonary Rehabilitation Program Based on Self-Determination Theory for Patients with Chronic Obstructive Pulmonary Disease)

  • 장준희;민혜숙
    • 대한간호학회지
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    • 제53권2호
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    • pp.191-207
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    • 2023
  • Purpose: This study aimed to develop a motivational interviewing pulmonary rehabilitation program based on self-determination theory to maintain pulmonary rehabilitation-related health behaviors in patients with chronic obstructive pulmonary disease. The program was developed by reviewing the literature on pulmonary rehabilitation guidelines, drawing on the self-determinism theory to establish its contents, recruiting experts to test its validity, and conducting a preliminary survey. Methods: A quasi-experimental design was used to confirm the effect of the program. The participants were outpatients diagnosed with chronic obstructive pulmonary disease at three general hospitals in Busan. There were 33 subjects: 15 in the experimental group and 18 in the control group. The experimental group performed a motivational interviewing pulmonary rehabilitation program which comprised 11 sessions delivered over 10 weeks. The outcomes were measured using basic psychological needs, dyspnea, 6-minute walking distance, and functional status. Intervention effects were analyzed using repeated-measures ANOVA. Results: The analysis revealed significant differences between the experimental and control groups in competence among the subdomains of basic psychological needs, dyspnea during exercise, and functional status. Conclusion: The developed program affects physical conditions and can be applied as an effective clinical nursing intervention to continuously improve the pulmonary rehabilitation behavior of patients with chronic obstructive pulmonary disease.

전자허약지수(electronic frailty index)를 활용한 만성질환 노인의 허약평가와 건강결과 간의 관계: 체계적 고찰 (Frailty assessed by the electronic frailty index and its impact on health outcomes in older adults with chronic diseases: a systematic review)

  • 신정욱;유민영;손연정
    • Journal of Korean Biological Nursing Science
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    • 제25권4호
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    • pp.229-242
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    • 2023
  • Purpose: The electronic frailty index (eFI), which is derived from electronic health records, has been recommended as screening tool for frailty due to its accessibility and ease of use. The objective of this systematic review was to identify the prevalence of frailty assessed by the eFI and its influence on health outcomes in older adults with chronic diseases. Methods: We searched PubMed, Embase, Web of Science, CINAHL, SCOPUS, Cochrane, Google search, and nursing journals in Korean from January 2016 to December 2022. Results: Twelve studies were analyzed. The eFI score, based on routine clinical data, was associated with adverse health outcomes. The most frequent outcome studied was mortality, and the eFI was associated with increased mortality in nine studies. Other outcomes studied included hospitalization, length of stay, readmission, and institutionalization in relation to hospital care usage, and cardiovascular events, stroke, GI bleeding, falls, and instrumental activities of daily life as health conditions. Conclusion: Early identification of frailty in older adults with chronic diseases can decrease the burden of disease and adverse health outcomes. The eFI has a good discriminative capacity to identify frail older adults with chronic diseases.

만성폐쇄성폐질환 환자 사례에 대한 실시간 시뮬레이션 동영상 관찰기록 내용분석-간호술 수행을 중심으로 (Content analysis of real-time simulation video observation records about cases of patients with chronic obstructive pulmonary disease-focusing on nursing skills performance)

  • 홍지연;박진아
    • 융합정보논문지
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    • 제12권5호
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    • pp.40-50
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    • 2022
  • 본 연구는 간호대학생이 시뮬레이션 실습 시 동료 팀의 만성폐쇄성폐질환 환자 시나리오 구현 동영상을 실시간으로 관찰하면서 구조화된 동영상 관찰 기록지에 기록한 간호술 영역의 내용을 분석한 질적 연구이다. 4개의 세부영역으로 구분하여 기록된 내용을 효과적, 비효과적 측면으로 구분한 후 내용분석 방법을 사용하여 분석하였다. 연구결과 절차의 정확성에 있어서 효과적 측면은 필요한 물품준비와 증상완화를 위한 중재, 비효과적인 측면은 원칙 미준수, 부적절한 처방 이행, 이론과 수행의 연계 미흡으로 나타났다. 무균술 준수에 있어 효과적 측면은 내과적 무균술 적용과 외과적 무균술 적용, 비효과적 측면은 내과적 무균술 미수행과 외과적 무균술 미수행이었다. 안전과 안위 고려에 있어 효과적 측면은 심리적 안위 고려과 물리적 안전 고려, 비효과적 측면은 안위에 대한 실재감 부족과 환자안전 인식 미흡으로 나타났다. 설명 및 교육의 효과적 측면은 목적 설명과 방법 교육, 비효과적 측면은 설명 부족과 환자수준 미고려이었다. 본 연구에서 간호대학생은 관찰을 통하여 얻은 시각적 정보를 기록하는 과정을 통해 학습에 집중하고 기억을 강화시킬 수 있었을 것으로 사료된다. 또한 본 연구는 시뮬레이션 기반 실습을 통한 간호술 교육의 효율성을 높일 수 있는 요소들을 제시하였다는 점에서 의의가 있다.

복합만성질환을 가진 노인의 우울, 사회적지지가 약물복용이행에 미치는 영향 (Impact of Depression and Social Support on Medication Adherence in Older Adults with Multimorbidity)

  • 김지은;박진희;유미애;서은지
    • Journal of Korean Biological Nursing Science
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    • 제24권3호
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    • pp.200-207
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    • 2022
  • Purpose: Medication adherence in older adults with multimorbidity is critical for self-care. The purpose of this cross-sectional study was to identify the factors that influence medication adherence in older adults with multimorbidity. Methods: The patients were 116 adults 65 or older with three or more chronic diseases. The data were collected from December 2020 to April 2022 in outpatient clinics at a hospital in Daejeon. Results: The mean scores of depression, social support, and medication adherence were 16.18± 6.74 (of 30), 41.06± 6.56 (of 60), and 4.69± 1.85 (of 8) points, respectively. Patients with low adherence comprised the most with 75 patients (64.7%). Influencing factors on medication adherence were depression (β= -.35, p= .007) and family support among social support (β= .29, p= .006). Conclusion: Among older adults with multimorbidity, lower depression as well as higher family support, results in higher medication adherence. It is necessary to develop a practical strategy toward improving medication adherence, by sensitively managing the degree of depression, as well as strengthening family support.