• 제목/요약/키워드: Care hospital

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이부교대(二部交代) 근무제도(勤務制度)에 대한 임상간호사(臨床看護師)의 요구도(要求度)에 관한 연구(硏究) (A Study on the Need of Clinical Nurses about the System of 12-Hour Work Shift)

  • 강영선;문희자
    • 간호행정학회지
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    • 제1권1호
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    • pp.46-64
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    • 1995
  • The 12-hour work shift can be influenced on the nurse's job satisfaction, effective personnel administration, and quality of patient care. The purpose of this study was to explore the perception on the 12-hour work shift by nurses. A total of 516 nurses were selected by convenience sampling from six general hospitals in Seoul. Based on the literature review, the questionnaire on the need of the 12-hour work shift was designed by the investigator. The data were analyzed using descriptive statistics, ANOVA and Duncan's method as post-hoc test. The results of this study are as follows ; 1. The need of 12-hour work shift The mean needs of 12-hour work shift in the nursing practice, psychological, physical, socioeconomic, and environmental perspectives were 3.05, 2.72, 2.66, 3.08, and 4.22. 2. The need of 12-hour work shift by demographic data For the nursing practice, there was a statistically significant relationship between marital status(p=.021), satisfaction on the 8-hour work shift(p=.038), the perception on the 12-hour work shift(p=.001) and the need of 12-hour work shift. For the psychological perspectives, there was a statistically significant relationship between marital status(p=.016), the perception on the 12-hour work shift(p=.0001), and the need of 12-hour work shift. For the physical perspectives, there was a statistically significant relationship between age(p=.002), marital status(p=.005), the number of children(p=.005), the duration of job career(p=.014), the job position(p=.002), the work shift(p=.030), the perception on the 12-hour work shift(p=.0001) and the need of 12-hour work shift. For the socioeconomic perspectives, there was a statistically significant relationship between the job position(0=.002), the work shift(p=.006), the perception of the 12-hour work shift(p=.002) and the need of 12-hour work shift. For the environmental perspectives, there was a statisitically significant relationship between the traffic method(p=.05), the duration of the job career(p=.026), the perception on the 12-hour work shift(p=.309) and the need of 12-hour work shift. 3. The need of 12-hour work shift by the demographic data There was a statistically significant difference between marital status(p=.014), the number of children(p=.038), the job position(p=.007), the work shift(p=.037), and the perception on the 12-hour work shift(p=.0001) for the need of 12-hour work shift.

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일 간호대학의 간호환경시스템 통합실습방안 적용;간호관리학과 지역사회간호학의 통합 (Curriculum Model in Integrated Practicum of Nursing Management and Community Health Nursing)

  • 이경자;김의숙;이정렬;김인숙;이태화;조윤희;정제인;이현정;배선형;김은현;김광숙
    • 간호행정학회지
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    • 제14권1호
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    • pp.51-62
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    • 2008
  • Purpose: Integrated curriculum has been considered as a desirable method in health related school course. The present study was conducted to develop practice curriculum which integrates nursing management and community health nursing and measure the education effect. Method: Literature review and scores of professional meeting were carried out to generate main educational goals, contents, operating principle, and evaluation item. Student evaluation was done by survey and in-dept interview in right after practicum and three months respectively. Results: Six concepts were derived as main component of the integrated curriculum. From 2 to 3 sub-categories were matched to each main component as well. Subsequently, practice contents were suggested on the basis of sub-categories. Attainment of practicum goal scores ranged from 2.82 to 3.54 in four points index. Students expressed that they found nursing manager's role in the community setting. Conclusion: This new approach encouraged students to ascertain relationship between hospital oriented and community based practice. Additionally, they can be prepared to comprehend diverse health care environment.

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측정부위별 신생아의 체온 비교 : 고막기준 직장체온, 직장체온, 액와체온, 복부체온 (Comparison by Measurement Sites in Temperature of Neonates : Ear-based rectal, Rectal, Axilla, Abdominal Temperature)

  • 김화순;안영미
    • 대한간호학회지
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    • 제29권4호
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    • pp.903-916
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    • 1999
  • The purpose of this study was to compare the ear-based rectal temperature measured with a tympanic thermometer with the rectal temperature measured with a glass mercury thermometer in order to test the accuracy of tympanic thermometer and to determine relationship among rectal, axilla, and abdominal temperature in neonates. The samples consisted of thirty four neonates admitted to the neonatal intensive care unit and nursery at an university affiliated hospital. The mean age of the subjects was 4.9 days. The ear-based rectal temperatures were taken with a tympanic thermometer in rectal mode (First Temp Genius 3000). Rectal and axilla temperatures were taken with a glass mercury thermometer, Abdominal temperature was continuously monitored with the probe connected to the servo controller of incubator. The results of the study can be summarized as follows : 1. Intrarater comparison : Agreement between the first and the second ear-based rectal temperature was 97% within 0.1$^{\circ}C$. 2. Comparison of ear-based rectal temperature and the rectal temperature from a glass mercury thermometer : ear-based rectal temperature ranged from 36.95$^{\circ}C$d to 37.95$^{\circ}C$, with a mean of 37.58$^{\circ}C$(SD=0.22$^{\circ}C$). Rectal temperature from a glass mercury thermometer ranged from 36.2$0^{\circ}C$ to 37.2$0^{\circ}C$, with a mean 36.75$^{\circ}C$(SD=0.29). The mean difference between both temperatures was 0.84$^{\circ}C$. The correlation coefficient between both temperatures was r=0.77(p=0.00). 3. Comparison of rectal and axilla temperature : Axilla temperature ranged from 35.8$0^{\circ}C$ to 37.1$0^{\circ}C$, with a mean of 36.55$^{\circ}C$. The mean absolute difference between the rectal and axilla temperature was 0.23$^{\circ}C$. The correlation coefficient between rectal and axilla was r=0.67. 4. Comparison of axilla and abdominal temperature : Abdominal temperature ranged from 36.2$0^{\circ}C$ to 37.0$0^{\circ}C$, with a mean of 36.58$^{\circ}C$. The mean absolute difference between axilla and abdominal temperature was only -0.03$^{\circ}C$. Findings of this study suggest that ear-based rectal temperature overestimates the actual rectal temperatures in neonates. Therefore, the interchangeble use of both temperatures in clinics seems problematic. The site offset(adjustment value) programmed in rectal mode of the tympanic thermometer needs to be readjusted. Choosing one optimal site for temperature measurement for each patient, and using the specific site consistently would result in more consistent measurements of changes in body temperature, and thus can be more effective in diagnosing fever or hypothermia.

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영아모의 임신의도와 양육태도의 관계 (A Study of the Relationship between the Intention of pregnancy and the Child-Rearing Attitudes of Mothers with Infants)

  • 심정하
    • 대한간호학회지
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    • 제27권2호
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    • pp.454-464
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    • 1997
  • The purpose of this study was to identify the correlation between the intention of pregnancy and the child rearing attitudes of mothers with infants. The data was collected from 138 mothers by means of an interview and questionnaire in a period from April 1 to April 30, 1997, when they came to have their infants vaccinated at one hospital and one health care center. The collected data was analyzed by means of the SPSS Program using percentage, means and standard deviation in each area and the ANOVA and Pearson Correlation Coefficient. The results of this study were as follows : 1. It showed that the mother's degree of intention of pregnancy was 3.90(±1.49) among the possible score of 0∼5 and the score of child rearing attitudes was 70.1 among the possible score of 20∼100. The mom score of the items was 3.50(±.36) among the possible score of 0∼5. 2. There was a significant relation between the intention of pregnancy and child rearing attitudes. It was mildly positive but was significant (r=.21, p<0.05). 3. There was a significant relation between the period from marriage to the time of pregnancy and the intention or pregnancy(F=.57, p<0.05). Also, it was found out that the group of mothers who became pregnant later than 12 months after marriage wanted after pregnancy more than the group of women who were pregnant within 12 months after marriage(F=11.30, p<0.01). 4. There was a significant relation between the period from marriage to the time of pregnancy and child rearing attitudes(F=4.14, p<0.05), It showed that the child rearing attitudes of the group of women who became pregnant later than 12 months after marriage was positive(F=11.42, p<0.01). Also, in case that the both the husband and wife decided on the pregnancy, the child rearing attitudes were more positive (F=7.15, p< 0.05). In conclusion, when the intention of pregnancy was stronger, the subjects' child rearing attitudes were more positive. Also when both the husband and wife decided on the pregnancy, the attitudes were more positive. So it seems that both husband and wife should discuss and agree upon pregnancy, having a sufficient period during which both the spouses prepare for the intention of pregnancy. Additionally, it is suggested that when the husband and wife are doing family planning, it would be beneficial to use a program of 'Woman's Intention on Pregnancy' during this process.

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자기공명영상의 건강보험 적용 전·후 이용량 동향 및 요인 분석 (Analysis of the Trend and the Factors Influencing the Usage Before and After the Application of the National Health Insurance for the Magnetic Resonance Imaging)

  • 길종원;최성욱
    • 한국산학기술학회논문지
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    • 제17권8호
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    • pp.477-484
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    • 2016
  • 본 연구는 자기공명영상(MRI)의 건강보험 적용 전 후 이용량 동향과 이용량에 영향을 미치는 요인을 알아보기 위해 실시하였다. 연구재료는 2004년 1월부터 2013년 12월까지 대전광역시 소재 종합병원(2차 의료기관)의 MRI 실시자료(처방 정보 전달 시스템), 보험심사자료, 건강보험요양급여자료(건강보험심사평가원)를 이용하였고, 분석대상은 2004년(건강보험 적용 전) 3,754명, 2005년 - 2013년(건강보험 적용 후) 4,107명-8,630명 이었다. 분석은 이용자 특성(성별, 연령, 검사부위, 보험유형)과 공급자 특성(진료과, 진료형태)의 MRI 건강보험 적용 전 후 이용량 비교를 $X^2$ 으로 하였고, MRI 이용량에 영향을 미치는 요인분석을 위계적 다중회귀분석으로 실시하였다. 연구결과 건강보험 적용 초기에 한시적으로 이용량이 감소하지만 이후 꾸준히 증가하였다. 특히 여성의 검사 율, Head & Neck의 검사 율, 일반수가적용 환자의 검사 율, 내과의 검사율, 입원환자의 검사 율이 건강보험 적용 전에 비해 증가하였다. 그리고 MRI의 건강보험 적용은 검사 율 증가에 영향을 미치는 것으로 분석되었다(P<.0001). MRI 검사 율이 증가하는 만큼 국민의료비 감소를 위해 건강보험 적용 확대가 적극적으로 이루어져야 할 것이다.

백지 에탄올추출물의 항산화 활성에 관한 연구 (Anti-oxidative Activities of Angelica dahurica Radix Ethanol Extract)

  • 김필순;이태종;김양희;김정시
    • 한국산학기술학회논문지
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    • 제12권10호
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    • pp.4378-4384
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    • 2011
  • 본 연구는 백지 에탄올추출물의 항산화 활성을 알아보기 위하여 총 포리페놀 함량, 총 플라보노이드 함량, 전자공여능을 독립적으로 3회 이상 반복 실시하여 측정 하였고, brown guinea pig(450~500g)의 등 부위에 1500mJ/$cm^2$ 광량의 자외선 조사로 유발시킨 피부(6areas per group)에 1일 2회, 주 5일, 매회 $30{\mu}{\ell}$씩 총 5주간 시료를 도포한 후 염산 케타민으로 마취, 시료를 도포한 피부 부위를 직경12mm의 biopsy punch로 절취하여 10%의 중성 포르말린 용액에 12시간 실온에서 고정한 후 Hematoxylin and eosin(H&E) 염색으로 표피 및 진 조직을 관찰하였다. 백지 에탄올추출물의 총 폴리페놀 함량과 총 플라보노이드 함량을 측정한 결과, 각각 20.7mg/g, 19.5mg/g으로 확인되어 항산화물질 함량이 양호하게 나타났다. 전자공여능을 측정한 결과, 백지 에탄올추출물은 농도가 증가함에 따라 전자공여능 또한 유의하게 증가하였고, $500{\mu}g/m{\ell}$$1000{\mu}g/m{\ell}$농도에서 각각 14.8%, 19.8%의 전자공여능을 보여 양성대조군으로 사용한 Dibutylated hydroxytoluene(BHT)보다 공여능이 낮았으나 의미 있는 항산화 효과를 보였다. H&E 염색 결과, 대조군의 표피에서 경미한 비후도가 나타났으나, 백지 에탄올추출물 도포군은 피부조직 배열이 규칙적이며 염증관련 세포 침윤 등의 별다른 이상 징후는 발견되지 않았다. 이상의 결과를 종합하면 백지 에탄올추출물은 천연 항산화제로서 이용가치가 있을 것으로 판단된다.

정맥내 통증 자가조절법을 이용한 말기 암환자의 통증조절 (Intravenous PCA for Pain Management in Terminal Cancer Patients during the Last Days of Life)

  • 송선옥;여정은;김흥대;박대팔;구본업;이병용;허남석;이경숙
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.75-82
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    • 1996
  • Background: Nerve blocks, including epidural analgesia, can be risky for terminal cancer pain patients in generally poor conditions. We performed this study to evaluate the efficacy of intravenous patient-controlled analgesia(PCA) to treat severe pain of terminally ill cancer patients during the last days of life. Methods: We explained the patient's poor general condition to relatives and received a written consent to administer PCA. The starting dose of opioid for PCA in cancer pain management was based on previous 24-hour dose. Previous 24-hour opioid dose was converted to intramuscular morphine equivalent. The concentration of opioid mixed into Basal Bolus $Infusor^{(R)}$ was controlled to allow for one half of the previous 24-hour equianalgesic dose to infuse continuously. Patients controlled their pain by pushing the PCA module themselves. Patients were observed by pain service team. Some discharged patients were treated at home until death. Results: Forty eight patients received PCA for last two years. The most common reason receiving a PCA was the patient's poor general condition(52.0%). The mean starting dose of PCA was $20.6{\pm}16.2$ mg of morphine. Over eighty percents of the patients were in good or tolerable state of analgesia. Half of the patients expired within one week. The mean duration of PCA was $8.7{\pm}7.0$ days. The problems during PCA were: difficulty in maintaining intravenous routes, early loss of mentality after starting PCA, hypotension and nausea. Conclusion: We concluded that PCA, if correctly, is an effective, relatively safe and readily controllable method of pain management in terminally ill cancer patients during the last days of life. For future considerations, terminal patients may expire at the comfort of their own homes after the resolution of legal problems regarding using opioid in home care.

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흉요천추 보조기착용이 특발성 척추 측만증 환자의 Cobb 각도 개성에 미치는 효과 (Effects of Thoracolumbosacral Orthosis on Cobb angle at The Idiopathic Scoliosis)

  • 송준찬;이현기;장인수;박래준
    • The Journal of Korean Physical Therapy
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    • 제14권4호
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    • pp.274-307
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    • 2002
  • The TLSO was customized for this study in OO ortho-prosthesis institute from Jan. 1th., 2000 to Dec. 31th., 2000 and in order to measure effects of TLSO. 20 females in a growth period applicable to medical care took part in this study, they were on accidental spine scoliosis (From $15^{\circ}to35^{\circ}$). They were consisted of Group I(10 chest-bend) and Group II (10 dual-bend). The results were follows: 1. It showed the average difference in height by 1.37cm, 3.14cm in comparison between before and after TLSO, before and after one year and they were also statistically available(p < .05). 2. It showed the average difference in Cobb angle of a chest and waist by ($-10.95^{\circ},-8.50^{\circ}$), between before and right after TLSO. The results means that the Cobb angle of the chest and weist at right after TLSO was largely decreased, and it was also statistically available(p < .05). 3. It showed the difference in Cobb angle of the chest waist by $-9.50^{\circ},-7.35^{\circ} $ between before and one year after TLSO. It means that the Cobb angle of the chest and waist at the one year after TLSO was largely decreased, and it was also statistically available(p < .05). 4. It showed the difference in Cobb angle of the chest and waist by $2.34^{\circ},2.15^{\circ} $ between the right after and the one year after. TLSO, but the change of Cobb angle of the chest was regularly constant by a little increased, and it was also statistically available(p < .05). 5. In the measurement of the change of Cobb angle of the chest and waist according to the taking time on TLSO, it showed the slightest change in 10 people on TLSO for 23 hours by $13.30^{\circ},11.20^{\circ}$ , the change in 6 people on TLSO for 16 hours by $14.75^{\circ},12.67^{\circ}$, the change in 4 people on TLSO for 8 hours by $16.83^{\circ},14.00^{\circ} $ in this order. It means that the longer time on TLSO was to be the smaller the Cobb angle of the chest and waist, but it was not statistically available.

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심근효소 상승 유무에 따른 목맴 환자들의 임상적 특성 (Clinical Study of Patients with Elevated Troponin-I in Near-hanging Injury)

  • 신현구;박준범;김창선;오재훈;조영석;박세훈;제상모;최혁중;강보승;임태호;강형구
    • Journal of Trauma and Injury
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    • 제25권4호
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    • pp.196-202
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    • 2012
  • Purpose: This study aimed to recognize the frequency of near-hanging patients with elevated Troponin-I (Tn-I), to obtain information necessary for treatment and prediction of prognosis by analyzing the clinical feature of near-hanging patients, and to evaluate the relevance of elevated Tn-I to abnormal result of other cardiac-related examinations. Methods: A retrospective review for the near-hanging patients, clinical record was conducted at two urban training hospitals between April, 2001 and December, 2011. We divided included patients into two groups, which one with elevated Tn-I level ($Tn-I{\geq}0.1ng/dL$) and one without it, and compared the differences in initial vital signs, cardiac enzyme tests, an electrocardiogram, echocardiography, chest X-ray, and the clinical outcomes. Results: A total of 39 patients were included, out of them, 14 patients showed rise in Tn-I level. The length of hospital stay and ICU hospitalization was more prolonged in the patient group with elevated Tn-I level than non-elevated group. As well as the incidence of endotracheal intubation and abnormal findings in echocardiography or chest X-ray was higher in the Tn-I elevated group, which is statistically significant. Conclusion: The rising of serum Tn-I level in near-hanging patients were not uncommonly observed. We believe that the cardiac-related test including Tn-I is necessary for near-hanging patients, and those who are shown abnormal result in cardiac-related test may need close observation and intensive care.

신생아 균혈증에서 Delta Neutrophil Index의 진단적 의의 (Diagnostic Significance of the Delta Neutrophil Index and Other Conventional Parameters in Neonatal Bacteremia)

  • 고일두;전인수;김황민
    • Pediatric Infection and Vaccine
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    • 제24권1호
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    • pp.1-6
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    • 2017
  • 목적: 본 연구에서는 delta neutrophil index (DNI)가 신생아 균혈증을 예측하는 지표로서의 효용성을 다른 지표들과의 비교를 통해 알아보고자 하였다. 방법: 원주세브란스 기독병원 신생아 중환자실에 발열을 주소로 입원한 환아들과 입원 중 발열이 있었던 생후 31일 미만 환아 146명을 대상으로 혈액배양검사와 동시에 시행한 총 백혈구 수, 절대호중구수, DNI, 혈소판 수, C-반응단백(C-reactive protein, CRP)에 대하여 분석하였다. 결과: 균혈증이 있었던 환아 77명의 평균 재태주수는 38.74주, 출생 체중은 3.20 kg였다. 대조군의 평균 재태주수는 33.34주, 출생 체중은 2.20 kg였다. 균혈증의 원인은 Staphylococcus aureus (22명), Staphylococcus epidermidis (18명), Streptococcus agalactiae (8명) 등이었다. DNI와 CRP만이 재태주수와 출생 체중 보정 후 균혈증과 연관성을 보여 area under the ROC curve를 조사하였고 DNI 0.70, CRP 0.68이었다. 결론: DNI는 신생아 균혈증을 예측하는 데 효과적인 지표이다. 다른 인자들과 함께 고려한다면 균혈증을 예측하는 데 더 도움이 될 것이다.