• 제목/요약/키워드: 환자돌봄

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환자 돌봄 의사소통 측정 도구 개발 (Development of the Patient Caring Communication Scale)

  • 허명륜;임숙빈
    • 대한간호학회지
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    • 제49권1호
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    • pp.80-91
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    • 2019
  • Purpose: This study attempted to develop a scale that measures the level of patients' recognition of the nurses' care, based on Watson's caring theory, and confirmed its reliability and validity. Methods: The items were developed through a literature review and an expert content validity test. The questionnaires were administered to 285 inpatients of internal medicine and surgical units at two general hospitals. Construct validity was tested using exploratory and confirmatory factor analysis, and reliability was tested using Cronbach's alpha. Results: This process resulted in a preliminary scale composed of 34 items; We used item analysis and five exploratory factor analyses, and consequently selected 14 items composed of three factors (respect, genuineness, and relationality). The confirmatory factor analysis verified the model fit and convergent and discriminant validity of the final items; criterion validity was confirmed with the positive correlation with the measurement scale of the patient-perceived quality of nursing. The overall scale reliability had a Cronbach's alpha of .92, which indicated internal consistency and reliability. Conclusion: The developed scale showed content, construct, and criterion validity, and reliability, as well as convergent validity for each item and discriminant validity between the factors. This makes it suitable for use in a diverse range of future studies on nurse communication using structural equation models.

호스피스 병동 입원 환자의 삶의 질 변화 (Quality of Life Changes in Patients Admitted to the Hospice Unit)

  • 박테레지아;송혜향;서인옥;조영이;박명희;허정희;김은경;박순주;라정란
    • Journal of Hospice and Palliative Care
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    • 제3권1호
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    • pp.18-27
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    • 2000
  • 목적 : 본 연구는 강남성모병원 호스피스 병동에 입원한 환자들의 입원 시 삶의 질과 간호서비스를 받는 동안 삶의 질 변화와 호스피스 간호서비스가 말기환자의 삶의 질에 미치는 영향을 알아보고자 시도하였다. 방법 : 1999년 10월부터 2000년 3월 사이에 가톨릭 대학교 강남성모병원 호스피스 병동에 입원한 환자와 가족 100명을 대상으로 연구자가 수정, 보완하여 개발한 설문지를 통해 자료를 수집하였고, 수집된 자료는 repeated measures ANOVA로 분석하였다. 결과 : 1) 간호제공자에 의해 인지된 환자의 삶의 질 평점은 입원시, 입원 1, 2, 3, 4주에 각각 3.31, 3.68, 3.56, 3.73, 3.75로 입원 당시보다 시간이 지남에 따라 유의하게 향상되었고, 입원시점에 따라 항목별로 살펴 볼 때 "신체적 청결"(F=6.50, P=0.0001) "통증조절"(F=18.01., P=0.0001) "대변상태"(F=2.96, P=0.0237) "수면상태"(F=3.99, P=0.0048) "메스꺼움/구토"(F=4.50, P=0.0022) "의료진의 편안한 돌봄"(F=3.95, P=0.0051) "가족들의 돌봄"(F=2.76, P=0.0317) "불안감"(F=3.14, P=0.0177) "마음이 편안함"(F=3.63, P=0.0085) "인간적인 대우"(F=3.32, P=0.0136) "죽음이 끝이 아니라 새로운 시작이라고 생각함"(F=2.54, P=0.0450) 등의 항목에서 유의한 차이가 있었다. 2) 환자 자신에 의해 인지된 삶의 질 평점은 입원 시와 입원 1주에 각각 3.63, 3.83으로 향상되었지만 유의한 차이는 보이지 않았다. 입원시점에 따라 항목별로 살펴볼 때 "통증조절" 항목만이 유의한 변화를 보였다. 3) 사망시점으로부터 삶의 질 평점은 사망 5주전, 4주전, 3주전, 2주전, 1주전에 각각 3.48, 3.51, 3.44, 3.46, 3.50이었으며 유의한 차이는 없었다. 결론 : 본 연구의 결과 호스피스 서비스는 말기 환자의 삶의 질에 긍정적인 영향을 주는 것으로 보여졌다. 따라서 호스피스 서비스의 질 향상을 위해 호스피스 환자들을 지지해 줄 중재방안을 모색해야 하며, 특히 간호의 영적 영역에 초점을 두어야 하겠다. 또한 말기 환자의 주관적인 삶의 질 측정을 위해 도구개발이 이루어져야 하며 대상자를 확대하여 계속적인 연구가 있어야 할 것으로 생각된다.

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의료기관 가정간호 환자 주돌봄자의 소진에 영향을 미치는 요인 (Factors Influencing Burnout in Primary Family Caregivers of Hospital-based Home Care Patients)

  • 양주옥;이혜경
    • 지역사회간호학회지
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    • 제29권1호
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    • pp.54-64
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    • 2018
  • Purpose: The purpose of this study is to identify factors influencing burnout in primary family caregivers of Home Health Care Patients. Methods: Data were collected from 121 primary family caregivers of home health care patients in three different hospitals in 'D' metropolitan city and the study was conducted from August 10, 2016 to January 17, 2017. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's Correlation Coefficient, Stepwise Multiple Linear Regression. Results: Mean scores for the nursing needs of the participants were $3.54{\pm}0.79$, the family functions were $1.24{\pm}0.58$, the burnouts were $2.74{\pm}0.49$. The burnouts were positively correlated with the nursing needs but inversely correlated with the family function. The factor that had the greatest influence on the burnouts of primary family caregivers of Home Health Care was family function (${\beta}=-.245$, p=.001), followed by patients' daily activity (${\beta}=-.213$, p=.014), age (${\beta}=.208$, p=.032), monthly nursing services cost (${\beta}=-.196$, p=.044) and nursing needs (${\beta}=.129$, p=.014). The Explanatory Power of Models was 23%. Conclusion: Individually customized home care nursing intervention programs are required to be provided in accordance with patient's family function and daily activity, monthly home care nursing service cost, nursing needs and general characteristics of primary caregivers of Home Health Care Patients such as their age, the number of family members living together, sex and the name of disease.

중심성의 이동: 치매 환자 가족의 돌봄 경험에 대한 질적 합성 접근 (Shifting of Centricity: Qualitative Meta Synthetic Approach on Caring Experience of Family Members of Patients with Dementia)

  • 유영미;유미;오세은;이해영;김해진
    • 대한간호학회지
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    • 제48권5호
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    • pp.601-621
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    • 2018
  • Purpose: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. Methods: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). Results: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. Conclusion: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.

간호사와 환자가 지각한 돌봄행위 중요도에 관한 연구 (Importance of Nurses's Caring Behaviors as Perceived by Staff Nurses and Patients)

  • 김영이;이병숙
    • 기본간호학회지
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    • 제6권1호
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    • pp.18-34
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    • 1999
  • Nurse's caring behaviors are essential to help patients cope with their health problems. The purpose of this study was to investigate the importance of nurse's caring behaviors as perceived by staff nurses and patients. The subjects were 295 staff nurses and 340 patients from five medical centers in Taegu. Data collection was done from Dec. 10, 1997 to Jan. 31, 1998. The tool for this study was a 7 point Likert type scale with 27 earing behaviors developed by Lee(1996). Cronbach alpha of the tool was .9701 in staff nurses and .9618 in patients. Data were analyzed with SAS using t-test, ANOVA and Spearman rank correlation program. The results are as follows : 1. The a verage score of perceived importance of nurse's taring behaviors for the 27 items was 5.65 in staff nurses and 4.97 in patients. 2. The most important caring behaviors perceived by the nurses was 'Nurse gives painless and cautious injection and treatment for patients' and for the patients, 'Nurse gives hygienic treatment and nursing care'. 3. The caring behavior which showed a significant difference between the ranks of perceived importance by staff nurses and patients was 'to treat the patient with tenderness and friendship'. 4. The Spearman rank correlation coefficient between the ranks of importance perceived by staff nurses and patients was 0.8302. With the results of this study, the staff nurses could be recognized to have much enthusiasm and passion about caring. It is suggested that nurses let the public know about the nurses' caring roles. In the future, research to investigate the actual practice of nurses' caring behavior is necessary.

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치매 환자의 가족 돌봄 제공자가 인식하는 사회적지지: 개념 분석 (Perceived Social Support of Family Caregivers for People with Dementia: Concept Analysis)

  • 김애리;김정연;우경미
    • 지역사회간호학회지
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    • 제32권4호
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    • pp.540-554
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    • 2021
  • Purpose: Most of the currently used concepts and measurements of social support have been relevant for general population. The main purpose of this study is to conduct the concept analysis of perceived social support(PSS) of family caregivers for people with dementia. Methods: This study adopted the Walker and Avant concept analysis methodology. Results: Findings from this concept analysis suggested four defining attributes of PSS of family caregivers for people with dementia: 1) PSS is help or assistance that family caregivers perceive as available when needed; 2) PSS is offered through socio-ecological structure; 3) PSS has a specific function to meet the needs of family caregivers; and 4) PSS includes quality aspects where family caregivers choose, use, or evaluate it. Borrowing from the socio-ecological model, this study proposed the structural aspects of PSS. This study also identified functional aspects of PSS, such as emotional support, informational support, appraisal support, and practical support. Finally, this study assessed quality aspects of PSS, such as satisfaction, timeliness, usefulness, accessibility, and coordination. Conclusion: Focusing on family caregivers for people with dementia, we proposed a new model of PSS. The present study helped refine and clarify the concept of PSS of family caregivers for people with dementia. The results of this study may also contribute to promoting the development of more effective instruments for the concept.

융복합시대에 말기 암 환자를 돌보는 호스피스 병동 간호사의 경험 (The Experience of Hospice Nurse on Caring for Terminal Cancer Patients in the Era of Convergence.)

  • 여형남
    • 디지털융복합연구
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    • 제18권9호
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    • pp.307-315
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    • 2020
  • 본 연구의 목적은 현상학적 방법을 통해 말기 암 환자를 돌보는 호스피스 병동 간호사의 경험의 의미 가 무엇인지 이해하여 본질을 추구하고 그 현상의 의미를 심층적으로 기술하고자 함이다. 본 연구의 대상자는 C시에 위치한 일종합병원의 호스피스 병동에서 1년 이상 근무하고 있는 간호사 9명을 선정하였다. 연구 방법은 심층 인터뷰로 2019년 7월부터 2019년 9월까지 자료를 수집하였다. 인터뷰 자료는 Giorgi의 현상학적 방법으로 분석하였다. 분석 결과는 '업무의 부담감' '성숙해짐', '밀착된 관계형성', '호스피스에 대한 지원 부족'으로 나타났다. 결론적으로 말기 암 환자를 돌보는 호스피스병동 간호사의 경험에 대하여 그들의 입장에서 포괄적이고 총체적인 이해를 제공함으로써 말기 암 환자 돌봄에 대한 통찰력을 제공 할 것이며, 그들의 경험에 근거하여 효과적인 지지체계 및 행정적 지원체계의 개발에 기여할 수 있으리라 생각된다.

장기요양환자에서 환자 특징 및 기능상태와 환자돌봄 시간과의 관련성 (A Relationship of Care Time with Functional Status and Patients Characteristics among Patients in Long-term Care Hospitals)

  • 이지전;김정인;유승흠;유형식;이상욱
    • Journal of Preventive Medicine and Public Health
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    • 제37권3호
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    • pp.282-291
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    • 2004
  • Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.

만성질환자의 공유의사결정 개념분석 (Shared decision-making in Patients with Chronic Disease : Concept Analysis)

  • 유지연
    • 한국융합학회논문지
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    • 제10권11호
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    • pp.543-555
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    • 2019
  • 본 연구의 목적은 만성질환자의 공유의사결정에 대한 개념의 속성을 명확히 정의하기 위함이다. 개념분석의 절차는 Walker and Avant의 방법에 근거하여 학제간 융합적 분석을 시도하였다. 분석결과, 만성질환자의 공유의사결정의 속성은 자기돌봄 전문가로서 인정, 자기 결정권, 번복 가능한 협상, 환자중심 돌봄으로 정의되었다. 선행요인은 비슷한 치료방법 중 선택해야 할 필요성이 있는 상황, 의사결정 갈등, 환자, 가족, 의료제공자의 참여 의지, 충분한 시간과 기회이다. 만성질환자의 공유의사결정의 결과는 의사결정 갈등 감소, 환자결과와 만족도 및 삶의 질의 향상, 장기적인 환자의 자기관리 및 자기 효능감 향상, 질병을 수용하는 삶의 태도이다. 본 연구는 만성질환자의 공유의사결정에 대한 명확한 개념을 제공하고, 관련 간호중재 개발을 위한 이론적 근거 형성에 기여할 수 있을 것이며 만성질환자를 위한 공유의사결정 측정도구 개발 연구의 수행을 제언한다.

치매노인환자 간병지원을 위한 스마트 돌봄 플랫폼 설계 (The Design of Smart Care-platform for Supporting Care of Elderly Patients with Dementia)

  • 김미연
    • 한국멀티미디어학회논문지
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    • 제23권1호
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    • pp.111-125
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    • 2020
  • In modern society, dementia patients are increasing due to busy daily life. Due to the nature of dementia, family members are having a hard time with their caring activities. Dementia diseases reduce the quality of life not only of the patient, but also of the family, and nursing activities lead to social problems such as unemployment or frequent turnover. This study aims to reduce the difficulty and stress of the nursing process by supporting daily life of dementia patients and nursing activities through smart care platform. Ultimately, we will reduce the cost of treatment for people with dementia and delay the worsening of symptoms through a systematic care program for people with dementia. The smart dementia care platform features smart technology to help the dementia patients' daily lives and support their caregivers.