• 과학기술학연구
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• 제13권2호
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• pp.71-110
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• 2013

최근 의료계에서 환자가 의료서비스의 소극적인 객체가 아니라 주체로서 인식되면서 환자의 위상을 강화하기 위한 다양한 시도가 이뤄지고 있다. 지금까지 의사가 주도했던 의료커뮤니케이션이 소비자주권의식과 의료정보의 활성화로 점차 환자중심으로 이동하고 있다. 이 글에서는 IT의 발달로 의료정보가 대중화되면서 환자들이 환우회, 소비자운동 등을 통해 의료소비자로서 위상을 강화하는 과정을 살펴본다. 이를 위해 의사와 환자의 커뮤니케이션에 영향을 미치는 의료정보의 역할, 환자 커뮤니티의 소비자운동 등을 다루고자 한다. 또한 정보통신기술을 활용한 의료시스템이 뿌리를 내리기 위해 연결망을 형성하고 실패하는 과정을 ANT(행위자-연결망이론)를 통해 분석한다. 환자중심의 의료서비스는 IT기술을 이용한 다양한 헬스케어 서비스 시장을 창출하며 의료정보의 비대칭성 개선에 기여하고 있다. IT융합 헬스케어 시장의 확대는 의사와 환자의 전통적인 관계에 근본적인 변화를 가져오면서 의료서비스시장을 재편하고 있다. 환자가 주도하는 모바일 헬스케어 모델의 확산 등 환자중심 의료가 가속화되고 있는 것이다.

• 성인간호학회지
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• 제19권5호
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• pp.47-55
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• 2007

Purpose: The purpose of this study was to determine the effect of supportive nursing care on the level of knowledge and compliance with sick-role behavior in patients with coronary artery disease after coronary angiography (CAG). Methods: A quasi-experimental research was performed with 81 subjects with coronary artery disease who were admitted for CAG to a cardiovascular department. Among the selected subjects, 40 of them were assigned to experimental group and the rest of them were assigned to control group by convenience. Supportive nursing care was implemented twice by a researcher. Results: 1. The mean score of knowledge related to coronary artery disease was higher in the group who received supportive nursing care than that of the control group (t=2.259, p=.027). 2. The mean score of compliance of sick role behavior was higher in the group who received supportive nursing care than that of the control group (t=4.580, p=.001). Conclusion: The supportive nursing care after CAG was effective in increasing the knowledge level and compliance of sick-role behavior in patients with coronary artery disease. Further studies would be recommended to identify long-term effectiveness of supportive care on patients' outcomes.

• 지역사회간호학회지
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• 제9권1호
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• pp.128-142
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• 1998

The purpose of this study was to identify the degree of self-efficacy, sick-role behavior and metabolic control in patients with diabetes and to identify the relationships among those variables. The subject of the study were composed of 204 NIDDM patients from 2 hospitals, who were visiting the outpatient clinic in Taegu. Data were collected from Sep. 18th to Oct. 5th, 1996. In data analysis, an SPSS/PC+ program was utilized for descriptives correlation, T-test, and ANOVA. The results are as follows. 1) The mean scores for self-efficacy were 65.74 (range 30.83-90.68), on a 100 point scale. 2) The mean scores for sick-role behavior were 3.36(range 1.80-4.67), on a 5 point scale. 3) The mean score for metabolic control was 7.63 (range 5.0-13.2). 4) Self-efficacy was significantly correlated with sick-role behavior(r=.3614, p<0.01) but there were no significant correlations with self-efficacy and metabolic control (r=-.1045, p>0.01), sick-role behavior and metabolic control (r= - .1288, p>0.01). 5) There were significant differences in self-efficacy according to sex(t=4.47, p=0.000) and education(F=8.27, p=0.000). 6) There were no significant differences in sick -role behavior according to demographic characteristics. 7) There were significant differences in metabolic control according to the duration of diagnosed diabetess(F=4.13, p=0.007) and complication (t=2.47, p=0.014). These results suggest that for improvement in sick-role behavior nursing intervention needs to be directed at promoting self-efficacy.

• 성인간호학회지
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• 제22권2호
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• pp.190-199
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• 2010

Purpose: The purpose of this study was to determine the differences in the level of disease related knowledge, compliance of health behavior, and educational needs in relation to time (at discharge and 6 months after discharge) among patients underwent percutaneous coronary intervention (PCI). Methods: Data were collected from January 1, 2006 to September 30, 2006 and a total of 60 patients participated in the study. The survey was conducted in patients underwent PCI at the time of discharge right after discharge education was provided and at a follow up visit which was 6 months after discharge. Results: The level of disease related knowledge (p<.001), the compliance of health behavior (p<.001), educational need (p=.496), the sub-item of sexual life (p<.001), follow up (p<.001), diet (p=.021), stress (p<.001) in compliance of health behavior, and the sub-item of specific character of disease in educational needs (p=.015) were significantly different between discharge and 6 months after discharge. Conclusion: The results of this study suggested that further education should be provided to the patients underwent PCI regarding medication, smoking cessation, daily life and exercise at a time of 6 months after discharge in order to increase patient compliance of health behavior.

• 중환자간호학회지
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• 제2권2호
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• pp.18-27
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• 2009

Purpose: This study is to provide effective care to each individual with myocardial ischemia by finding out how the patient's knowledge related to the disease and anxiety level affect his/her compliance of patient role behavior. Methods: The subjects of study were 100 patients diagnosed as ischemic heart disease at a university hospital located in Gyeonggi Province. The data were collected from May 19, 2008 to August 30, 2008. A cross-sectional descriptive survey was done using a structured questionnaires. Results: The average score of knowledge level about myocardial ischemia was $22.24\pm5.07$(out of 31), anxiety level was $54.68\pm9.15$(out of 80), and compliance of patient role behavior was $34.28\pm6.00$(out of 50). A significant correlation between the patient's level of knowledge and his/her compliance of patient role behavior was found(r=0.239 p=0.017). The patients who are females, singles, without occupation, have a long term being diagnosed, under-educated, tend to be excellent in their compliance. Conclusion: The patient with a higher level of knowledge is better in his/her compliance of patient role behavior. Therefore, it is suggested that we need to develop nursing intervention to increase knowledge level as well as consistent educational support.

• 임상간호연구
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• 제20권1호
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• pp.53-63
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• 2014

Purpose: This study was conducted to investigate the relationship between drug-related knowledge, sick role behavior and quality of life of patients on wafarin therapy in an outpatient unit. Methods: The participants were 122 patients. Data were collected using a questionnaire and analyzed using t-test, ANOVA and Pearson correlation. Results: The Duration of wafarin averaged $28.80{\pm}32.99$ months, and 78.7% of participants remembered their blood coagulation value. The mean score for drug-related knowledge was 11.32 points out of a possible 13 points. Sick role behavior of the patients showed a moderate value with a mean of 49.83 points out of 68 points. The mean score for quality of life was rather low at 104.43 out of 175. Drug-related knowledge was significantly correlated to sick role behavior (r=0.39, p<.001), but the relationship between sick role behavior and quality of life was not significant. Also drug-related knowledge was not significantly correlated with quality of life. Conclusion: The resultsindicate that there is a need to enhance the level of drug-related knowledge in order to increase positive behavior as part of the sick role of these patients and thus improve quality of life.

• 대한간호학회지
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• 제6권1호
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• pp.80-90
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• 1976

정신과 영역의 환자를 위해 간호원의 역활을 필요로 한 이래 여러 가지 간호의 개념으로 간호원의 역할이 변화되어오고 있다. 정신과 환자의 안전만이 가장 큰 치료의 중심일 때는 병동열쇠의 위엄에 곁따라 보호관리에만 치중해 왔으며 정신의학에서 약물요법, 전기요법의 치료과정이 생기면서 간호원의 역할 변화 및 지식의 요구를 필요로 하게 되었으며, 환경과 개인의 밀접한 관계를 중시해오면서 치료적 환경속으로 환자의 인간적 치료가 강조되었을 때 의사소통과 대인관계의 인적 환경으로써 또한 간호원의 역활이 중요시 되어왔다. 이런 관점에서 치료적 환경에 대한 정확한 이해는 간호행위과정의 불완전을 제거하며 보다 활발한 정신과 환자간호에 기여하는 일 일 것이다. DR. Bartom은 병실 환경이 비생산적이고 비 치료적일때 성격의 변화는 물론 행동적 특성의 변화까지 가져올 수 있다고 말했다. 즉 무감동적이고, 무조건적 순종이 있으며 솔선하여 행하는 행위가 줄고 장래 계획에 대한 자극이 줄어들고 될대로 되어 가는 상태 그 자체에 머물러 있어 인간의 특징적 의미와 가치를 상실하게 된다는 것이다. 정신과 병실은 잠정적 체류지로 보아야 하겠고 이 체류지에서의 영향이 환자에게 보다 유익하게 끼칠려면 간호원이 지속적으로 치료적 분위기를 유지해야 할 것이다. 치료적 입장으로서의 간호의 활동 초점은 대인관계에서 환자의 의식수준과 자아관련 수준에서의 취급이 무의식 수준에서의 탐구조사보다 바람직하다. 치료적 가치로써 치료적 환경의 이론적 근거를 DR. Sullivan 은 인간의 상호관련 문제에 두고 있다. 즉 상호작용이 존재하는 환경은 어떠한 곳이든 성격에 영향이 있고 이 성격은 대인관계의 복잡성으로부터 결코 떨어질 수 없다는 얘기다. 자아구성 또한 환경의 영향을 받는데 Cumming은 병동환경과 자아구성 재동기간에 밀접성을 시사한바 있다. Visher와 O'sullivan은 정신과적 치료중에서 일상생활에서 경험되어지는 의사소통과 대인관계속에서 학습되어지는 여러 가지가 있기 때문에 매일의 활동획이 치료적 방향으로 계획되어 져야 한다고 말했다. Maxwell Jones 또한 치료적 환경의 유용한 가동은 전 직원의 기여에 있으며 이는 정신건강을 최적으로 올려 줄 것이다. 라고 말했다. 이러한 상황에서 간호원은 의미 없이 환자의 감정 욕구를 깨닫지 못하고 감정지지를 주지 못하며 정서적 긴장을 예방하지 못한 체 환자와의 관계를 유지한다면 현대간호의 개념에서 이탈되어지고 발달되어지지 못한 미숙아 현상이 유지 될 것이다. 보다 바람직한 치료적 환경 유지는 간호로써 환자에게 기여해 주는 일이다. 간호의 역활과 더불어 전문적 태도는 따뜻하고 포용성 있게 그리고 융통성 있게 대함은 물론 간호인 자신의 "자기이용"을 깊이 그리고 치료적으로 이용할 것을 깨달아야 할 것이다. 즉 정신과 병실에서의 간호원 존재 자제가 환자에게 미치는 영향도 고려해야 한다는 것이다. 덧붙여 환자를 위한 일주일 병동 행사표를 Model로 제시하였고 그 안에서의 간호원의 역활을 약술하였다.

• 한국인지과학회:학술대회논문집
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• 한국인지과학회 2002년도 춘계학술대회
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• pp.189-193
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• 2002

의식에 관한 가장 흥미 있는 최근의 과학적 작업들 중 철학적으로 문제가 되는 다수는 시각으로부터 나왔으며 그 중 특히 맹시 현상은 심리철학에 있어서 의식, 지각, 그리고 지향성의 개념에 문제를 제기한다. 맹시 환자들은 후두엽 피질의 두뇌 손상으로 인하여 생긴 암점(Scotoma) 때문에 현상적으로 의식적인 과정을 경험할 수 없으면서도 그들의 보이지 않는시야 영역에 대하여 보통 시각을 가진 사람들과 상당히 비슷하게 기능을 발휘한다. 이러한현상은 의식이 행동을 제어하는 데에 과연 인과적 역할을 하는지에 대한 문제들, 심리철학에서 뿌리깊게 논의되어왔던 의식의 기능과 부현상론에 대한 문제를 제기한다. 즉, 맹시 현상은 현상적 의식이 실재하지 않는 것이거나, 존재하더라도 어떤 인과적 효력을 가지지 않는 부수현상적인 것이라는 견해를 강하게 지지하는 것 같다. 이와 함께 인간과 동일한 물리적 구성과 행동을 가지지만 의식적 경험을 결여하는 피조물인 좀비(zombie)의 이론적 가능성이 제기된다. 이를 지지하기 위해서 초맹시(super-blindsight)의 개념과 사례가 제안된다. 이 논문은 맹시 현상을 통해서 현상적 의식의 실재성을 부정하려는 논변들을 반박하고, 의식은 행위의 수행에 관련될 뿐만 아니라 인지에 있어서 중요한 역할을 한다고 논한다. 따라서, 역설적으로 맹시 사례가 오히려 현상적 의식이 인과적 역할을 가진다는 감각질 실재론의 견해를 지지할 수 있다고 논증할 것이다.

• 기본간호학회지
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• 제26권1호
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• pp.23-31
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• 2019

Purpose: This study was a descriptive survey research to identify the factors that influence sick role behavior compliance in patients on hemodialysis. Methods: Structured surveys were used to collect data from 170 patients who are on hemodialysis three times a week through outpatient care at a university hospital located in G City using tools measuring resilience, family support, and sick role behavior compliance. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and Stepwise multiple linear regression. Results: The results showed that factors that influenced sick role behavior compliance in the subjects were in the order of family support (${\beta}=.27$, p<.001), age (${\beta}=.27$, p<.001), and resilience (${\beta}=.23$, p=.003). Resilience, family support, and sick role behavior compliance were positively correlated. Factors influencing hemodialysis patients' sick role behavior compliance included family support, age, and resilience. These variables explained 30.2% of the variance in sick role behavior compliance. Conclusion: Based on these results, care intervention and the development of a training program that involves family in the treatment plan and process to support and encourage patients are needed to increase the sick role behavior compliance in patients on hemodialysis.

• 대한간호학회지
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• 제20권2호
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• pp.174-184
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• 1990

In order to determine the effect of individual patient teaching through home visiting on compliance with sick role behavior and the blood sugar level in diabetic patients, to determine if the effectiveness of the education was still present four year later and to inquire as to the effective time for a repeat education program this study was done through two quasi-experimental researches. The subjects consisted of 52 diabetic patients. The results of the study may be summarized as follows ; 1. Hypothesis I, in which the compliance with sick role behavior, the knowledge on diabetes and the health belief of the experimental group who received a diabetic education program will be higher than those of the control group who didn't receive the diabetic education, was supported by both studies in 1984 and 1988, confirming the effect on diabetic patients of the individualized education through home visiting ; In the 1984 study : Compliance(t＝-11.7, p＜.001) Knowledge(t＝-5.41, p＜.001) Health belief(t＝-4.74, p＜.001) In the 1988 study : Compliance(t＝-4.85, p＜.001) Knowledge(t＝-2.85, p＜.01) Health Belief(t＝-2.99, p＜.005) 2. The Hypothesis II, the blood sugar level of the experimental group will be lower than that of the control, was rejected in both studies, 1984 and 1988. 3. The Hypothesis III, the compliance, knowledge and health belief of the expermental group who received the education program in 1984 will not last till 1988, was supported in part, in compliance and health belief, but not in knowledge. In conclusion those who received the education program twice with an interval of 2 weeks, 4 years ago still had knowledge of diabetes but compliance and health belief had disappeared.