• 제목/요약/키워드: 성인환자

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효소보충치료(ERT)를 받고 있는 뮤코다당증 환자의 경험 (Experience of Patients with Mucopolysaccharide Receiving Enzyme Replacement Therapy)

  • 권은경;정소영;최유진;조성윤;진동규
    • 산업융합연구
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    • 제19권4호
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    • pp.37-48
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    • 2021
  • 본 연구는 효소보충치료(ERT)를 받고 있는 뮤코다당증 환자들의 경험을 파악하기 위한 목적으로 수행되었다. 본 연구는 질적 연구방법을 적용하였고, 효소보충치료를 받고 있는 7명의 뮤코다당증 성인환자를 대상으로. 2018년 7월 1일부터 2018년 7월 22일까지 심층 인터뷰를 통해 자료를 수집하였다. 수집된 개별 면담 자료는 필사하여 귀납적 내용 분석 방법으로 분석하였다. 연구결과, 효소보충치료를 받고 있는 뮤코다당증 환자의 경험은 최종 4개의 범주(효소보충치료를 통한 신체·심리적 변화, 효소보충치료라는 계속되는 터널, 치료에 대한 현실 받아들이기, 조심스러운 희망)와 15개의 하위범주로 도출되었다. 따라서, 의사 및 간호사는 효소보충치료를 받고 있는 뮤코다당증 환자의 이러한 경험을 고려하여 돌봄을 제공해야 할 것이고, 정부 또한 뮤코다당증 환자의 신체적 증상 뿐 아니라 효소보충치료로 인한 어려움을 고려한 실질적인 정책을 마련할 필요가 있다. 본 연구는 희귀질환인 뮤코다당증 환자의 경험을 확인하였다는 점에서 의의가 있다.

1형 당뇨병 환자의 성장과 미세혈관 합병증 발생에 대한 연구 (A study and the growth and the development of microvascular complications in patients with type 1 diabetes mellitus)

  • 이영아;윤경아;신충호;양세원
    • Clinical and Experimental Pediatrics
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    • 제50권2호
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    • pp.190-197
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    • 2007
  • 목 적: 1형 당뇨병 소아, 청소년에서 혈당 조절이 불량하면 성장 장애와 미세혈관 합병증이 발생할 수 있다. 1형 당뇨병이 성장에 미치는 영향과 미세혈관 합병증(당뇨병성 신병증 또는 망막병증) 발생과 관련된 요인을 파악하고자 하였다. 방 법: 서울대병원에서 추적 중인 16세 이상의 154명 환자들의 의무기록을 후향적으로 분석하였다. 성인키 SDS(standard deviation score)에 영향을 미치는 요인을 분석하였고 합병증 유무, 미세알부민뇨의 경과에 따라 군을 나누어 특징을 비교하였다. 결 과: 성인키 SDS는 $-0.11{\pm}1.15$(여 $-0.26{\pm}1.33$, 남 $0.04{\pm}0.91$)였다. 성인키 SDS는 중간부모키 SDS에 비해 작았고(여 P=0.001, 남 P=0.002), 진단시 키 SDS에 비해서도 유의하게 감소하였다(여 P<0.001, 남 P=0.013). 진단시 사춘기 유무, 합병증 유무, 혈당 조절 정도, 이환 기간은 성인키 SDS에 영향을 미치지 않았다. 사춘기 시작시 키 SDS, 중간부모키 SDS, 사춘기 성장이 성인키 SDS에 영향을 미치는 요인이었다. 합병증이 발생한 37명(24%) 중에서 신병증은 29명, 망막병증은 19명, 동반된 경우는 11명이었다. 사춘기 전에 발병한 환자들은 사춘기에 발병한 환자들에 비해 첫 합병증이 발생한 연령은 더 낮았으나 첫 합병증 발생까지의 유병 기간은 더 길었다. 합병증이 발생한 그룹은 합병증이 없는 그룹보다 평균당화혈색소가 더 높았다. 미세알부민뇨가 소실된 환자들은 미세알부민뇨가 지속되거나 현성 신병증으로 진행한 환자들에 비해 평균당화혈색소, 수축기 혈압, 두 번째 측정한 24시간 소변 미세알부민 수치가 더 낮았다. 결 론: 1형 당뇨병 환자의 성인키는 혈당 조절 정도의 영향을 받지 않았지만, 중간부모키, 진단시 키에 비해 감소하여 당뇨병의 여러 요인에 의해 성장소실이 가능함을 알 수 있었다. 미세혈관 합병증 발생을 예방하기 위해서는 철저한 혈당 조절이 필요하다. 혈당 조절이 불량하거나 사춘기가 시작되면 미세혈관 합병증에 대한 선별검사를 시행해야 한다.

장기 입원환자 간호 갈등경험을 통해 본 담론 대립과 권력 (The Disagreement of Discourse and Power Through the Experiences of Nursing for Caring of Long-term Hospitalized Patients)

  • 김혜옥
    • 성인간호학회지
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    • 제19권3호
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    • pp.495-507
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    • 2007
  • Purpose: This critical ethnography was performed to explore the experiences of nurses who are working with patients in an industrial disaster hospital. During the research process, I focused on the experiences of conflict in caring patients. Methods: Data for the study came from 13 informants with their corresponding patients through interview and observation from March 2002 to February 2004. The data was examined line by line; then compared and contrasted based on a critical discourse analysis. Results: Nurses' conflicts came from discrepancies of the world views from that of the patients. Such conflicts arose because of various issues as follows: Worker as an individual vs patients, nurse as young women vs the medical profession, hospital as an extended home vs health care setting, and hospitalization as a means to enhance work capacity vs a means of treatment. Conclusion: We need more study on the development of adaptive strategy for the nurses to overcome conflicts during their nursing career. Developing a nurses' and patient role intervention program is needed.

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경혈지압이 뇌졸중 환자의 변비완화에 미치는 효과 (The Effects of Meridian Acupressure on Decreasing Constipation for Stroke Patients)

  • 이갑녀;손경희
    • 성인간호학회지
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    • 제18권5호
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    • pp.760-770
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    • 2006
  • Purpose: This study was aimed at identifying the effect of meridian acupressure on decreasing the severity of constipation in stroke patients admitted to the intensive care unit. Method: The data was collected from June 1 to July 30, 2005 at D Hospital in Busan. They were divided into two group: one experimental group of 18, and the another control group of 17. Meridian acupressure was given to the experimental group and no meridian acupressure was given to the control group. The data was analyzed using the t-test, ${\chi}^2-test$, Fisher exact, and repeated measures ANCOVA. Results: There was a significant improvement in frequency of defecation and severity of constipation in the experimental group compared to the control group. Conclusion: Meridian acupressure can be considered an effective nursing method for the management of constipation among Cerebrovascular Accident patients.

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응급실 환자 및 보호자의 폭력행위 예측요인 (Predictors of Violent Behavior by Patient or Caregiver of Patient in the Emergency Department)

  • 박은영;이은남
    • 성인간호학회지
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    • 제26권5호
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    • pp.500-511
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    • 2014
  • Purpose: The purpose of this study was to investigate predictors of violent behavior by patient or caregiver of patient in the emergency department. Methods: Subjects of the study were 447 residents who have visited the emergency department in community P Metropolitan City during the past year. The data collecting period was from June 1, 2012 to August 31, 2012. Data was collected using self-reported questionnaires. Results: Predictors of violent behavior in the emergency department were divided into personal and institutional factors. Personal factors included relationship with patients, presence of alcohol, reports of discontent during and past treatment and responses to deterioration in patient's conditions, institution factors included perceived attitudes toward medical workers' explanations and proficiency of medical workers, and delay in medical treatment hours. Conclusion: Knowledge of personal and institutional factors may permit emergency staff to minimize or prevent potential violence in the emergency department.

화상 환자의 삶의 질 영향 요인 (Influencing Predictors of Quality of Life in Burn Patients)

  • 박효미;윤영미
    • 성인간호학회지
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    • 제17권1호
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    • pp.100-108
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    • 2005
  • Purpose: The purpose of this study was to identify predictors of quality of life in burn patients. The predictors of quality of life were the subject's characteristics(marriage, income, burn size, burn site, pain and functional limitation) and personal resources(self esteem and social support). Method: 96 burn subjects who were hospitalized participated in the study. The data analysed was with descriptive analysis, ANOVA, Pearson correlation coefficient and multiple regression. Result: Burn patients who had a spouse and had higher levels of income, with smaller size of burn, no arm burn, with lower levels of pain and functional limitation, plus higher levels of self esteem and social support reported higher levels of quality of life(R2=0.5229). Conclusion: Based on the finding of this study, development of nursing intervention programs including reduction of pain and functional limitation, enhancing self esteem and social support can be suggested.

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혈액투석 환자의 역할행위 이행과 관련된 사회·심리적 변인들 간의 구조분석 (A Structural Analysis for Psychosocial Variables related to Sick Role Behavioral Compliance in Hemodialysis Patients)

  • 조영문
    • 성인간호학회지
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    • 제28권4호
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    • pp.415-423
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    • 2016
  • Purpose: This study was designed to identify the structural relationships among psychosocial variables related to sick role behavioral compliance among patients undergoing hemodialysis. Methods: The subjects were 476 patients from seven major hospitals and twelve dialysis centers located in D and P cities. Data were collected using self-report questionnaires. Data analysis was done by using SPSS/WIN 18.0 and AMOS 18.0 programs for structural equation modeling, to estimate the hypothesized model. Results: This findings support that a modified path model is efficient and appropriate to explain sick role behavioral compliance among hemodialysis patients. These factors account for 80.1% of the variance of sick-role behavioral compliance among hemodialysis patients. The variables having direct effect on sick role behavioral compliance were knowledge related to hemodialysis, social support, attitude, self-efficacy and intention. Conclusion: The modified model explains the integration process of psychosocial and behavior variables for sick-role behavioral compliance among patients undergoing hemodialysis.

척수손상 환자의 재활 치료 지속이행 설명모형 (An Explanatory Model for Patient Adherence of Rehabilitation in patients with Spinal Cord Injury)

  • 김애리
    • 성인간호학회지
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    • 제22권1호
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    • pp.90-102
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    • 2010
  • Purpose: The purpose of this study was to identity factors affecting patient adherence and to develop an explanatory model for patient adherence in patients with spinal cord injury. 8 Variables that were based on the previous research and a review of literature were used to construct hypothetical model. Social support, economic status, perceived barrier, patient provider relationship and rehabilitation related knowledge were the exogenous variables, depression, self-efficacy and patient adherence were the endogenous variables. Methods: Data form 117 patients with SCI were analysed to test the hypothetical model, using SAS and LISREL 8.53 program. Results: The overall fitness of the model was good (GFI=.991, AGFI=.915, NNFI=1.299, NFI=.953, p=.632) Depression, powerlessness, economic status were the strong factors influencing patient adherence. Powerlessness was significant factors for self-efficacy. Conclusion: To improve of patient adherence should focus on nursing intervention for depression, powerlessness and economic status.

암 환자 중심의 대화를 위한 간호사의 공손 언어행위 분석 (An Analysis of Nurses' Behavior for Politeness in Cancer Patient-Centered Conversation)

  • 이화진
    • 성인간호학회지
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    • 제20권5호
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    • pp.743-755
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    • 2008
  • Purpose: The purpose of this study was to describe and to analyze real conversation about polite behavior of nurses in cancer units. Methods: This study was conducted using a Brown & Levinson(1987) theory to analyze the polite behavior of nurses in cancer units. Five nurses who participated in this research gave permission to be videotaped. The data was collected from January to February, 2006. Results: Polite behavior of nurses in cancer units consisted of greetings, emotional support, open questions and indirect direction. And impolite behavior of nurses in cancer units was using the medical terminology, repetition of direct speech acts and task-oriented conversation. Conclusion: This study suggests polite behavior strategies for effective nursing conversation with cancer patients. Therefore, the findings may provide basic raw materials for educational programmes and intervention studies.

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뇌졸중 환자의 간호성과지표 개발 (A Development of Nursing Outcome Indicators for Stroke Patients)

  • 권보은
    • 성인간호학회지
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    • 제15권1호
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    • pp.88-93
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    • 2003
  • Purpose: This study was conducted to develop nursing outcome indicators based on nursing activities done for stroke patients. Method: focus group meeting and delphi technique, which consisted of clinical nurse experts, neurologist, and nursing professors. CVI(Index of Content Validity) and user validity test was performed. Result: 12 nursing diagnoses, 29 nursing interventions and nursing outcomes were identified. The former were from NIC and the latter were developed according to nursing interventions. They were verified by experts in focus group. 199 nursing activities were identified, 133 nursing outcome indicators were developed. In user validity, usefulness and usability were tested. Conclusion: This systemic approach of measuring nursing outcomes verified nurses' positive effects in changing patients health status and nursing contributions in the health care system as a profession.

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