• 정신신체의학
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• 제16권2호
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• pp.75-80
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• 2008

섬망은 일반 의학 상태와는 독립적으로 입원 기간 및 사망율을 증가시켜 환자의 전반적 예후에 부정적인 영향을 미친다. 다양한 내, 외과적 치료 환경에서 보고된 섬망의 발생 빈도는 15~70%로 알려졌으며, 정신신체 의학적 중재가 요구되는 흔한 정신과 의뢰 사유 중 하나이다. 섬망의 치료는 1) 위험 인자와 촉발 요인의 확인, 2) 지남력 회복 및 기능 유지를 위한 적절한 치료 환경의 구성과 환자 가족 및 치료진에 대한 교육을 제공하는 비약물적 중재, 그리고 3) 심한 초조, 환각, 그리고 행동 상의 문제 등을 조절하기 위한 약물학적 중재로 구분될 수 있다. 본고를 통해, 섬망에 대한 정신신체의학적 중재의 전반에 대해 기술하고 실제 임상에서 섬망치료 시에 흔히 접하게 되는 문제에 대해서도 논의하고자 한다.

• 한국보건간호학회지
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• 제19권2호
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• pp.188-203
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• 2005

The study was performed to provide basic data for developing a coordinated health and social service model. Method: The subjects consisted of 1000 residents in Wonju city. The sampling process was randomized stratified into 26 geographical areas. The data was collected from Apr. 16nd, to May. 15nd, 2002 by using a structured questionnaire that included general characteristics, the patterns of disease, the family function and the community support systems. The collected data was analyzed by the SPSS. windows program via descriptive statistics, correlation testing and t-tests. Result: 61.7% of the elderly perceived their health status as being poor. There were correlations among age, income and the way clients perceived their health status. The prevalence rate of chronic disease was 70.8% in the elderly. The prevalence rate for arthritis was the highest (33.6%). The average number of diseases in the target populations was 2.31; it was 2.65 in the deprived elderly group and 2.47 in the elderly group. 35.4% of residents did not have any family care giver. 61.2% of the clients needed support by the health and social services. Conclusions; Coordinated health and social services need to be allocated by priority to the elderly and to the socially and economic deprived clients.

• 보건교육건강증진학회지
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• 제20권1호
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• pp.111-130
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• 2003

The purpose of this study was to analyze the relationship between quality of life, self-efficacy and family support of stroke patients in Oriental medicine hospitals. The subjects of this study were 211 hospitalized stroke patients in seven oriental medicine hospitals in the Busan Metropolitan, Gyeongsangnam-do and Gyeongsanbuk-do area. Data was collected through questionnaires from June 1st, 2002 to September 30th, 2002. 1) The relationship between general characteristics and other variables showed significant differences as follows : for general self-efficacy degree, age, occupation, and level of education ; for family support, level of education and occupation ; for quality of life, level of education, occupation, religion, and monthly income. 2) The relationship between disease-related characteristics and other variables showed significant differences as follows ; for general self-efficacy, level of paralysis, and periods of hospitalization ; for specific character of paralysis, level of paralysis, and periods of hospitalization ; for family support, care-giver, character of paralysis, level of paralysis, and periods of hospitalization related; for quality of life, level of paralysis, and periods of hospitalization. 3) There was a significant correlation between the quality of life and general self-efficacy, the quality of life and the specific self-efficacy, the specific self-efficacy and family support.

• 한국보건간호학회지
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• 제11권2호
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• pp.141-151
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• 1997

As concerns about dementia patients increase gradually in society, the nursing of them becomes more and more important. For intervening in dementia patients effectively, the most fundamental thing is to understand their characteristics and to increase the ability of assessing them. The assessment data supply us with the foundations of Nursing diagnosis and nursing plan. The reaseons why the assessment data are especially important to dementia patients are as follows; First, dementia patients have great differences among them in intellectual, physical ability. And their condition varies from time to time. Second, the intervention without planning results in the deficiency of consistence, and it rather embarrasses and makes dementia patients uneasy. Third, nursing of dementia patients requires participation of multi-disciplinary team because of characteristics of that disease. The development of an unitary assessment tool is essential for all members of the team to have close relations between them and care for dementia patients. Fully understanding the importance of assessment data, this study investigate the content to be included in the assessment before developing assessment tools to be used in community. It points out that the assessment should include the informations about patients, their family, and main care-giver. And it sets up items that can supply with detailed information on each person. In the future it is necessary to transform the contents of this study to more concrete items and develope the assessment tools for dementia patients. And recording paper for follow up should be supplemented to check any changes in family caring for dementia patients and describe the changes in detail. To make assessment tools is one of the fundamental works in controlling dementia patients. Therefore the official assessment tools should be provided as soon as possible. This study aimed at presenting the guiding principles for developing that assessment tools.

• 대한물리치료과학회지
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• 제10권1호
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• pp.30-37
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• 2003

Purpose : The purpose of this study is giving the healthy promotion and it's related data base for out-patients who had stroke via evaluating the general characters of their active daily living and physical therapy Method : This study researched 81 patients who had received physical therapy service in 6 general hospitals located Pusan city responded to the self-assessment questionnaires from July 2002 to August 2002. Conclusion : In this study, patients were composed of 61.7% of male, 65.4% of 50's-60's in the age, 56.8% of cerebral infarction, and 60.5% of right hemiplegia. 74.1% of patients received physical therapy after 6 months from an attack, only 62.9% used orthosis & gait aids, and 59.2% received medical care 2 or 3 times per week. 40.7% of patients had over 9 hours sleeping time and 22% had reduced $1{\sim}2hours$ before hospitalization. 90% did not have drinking and smoking. 91.4% had 3 times eating per day, and 67.7% did not have good nutrition. The reasons of that were their eating habit, 542% of eating-giver, 3.7% of economic problem. 46.9% of patients used healthy food. In active daily living, patients can't do drinking by cup, voiding & defication by themselves, however patients can't do wearing/take off, etiquette for dressing, bathing, stepping by themselves. 40.7% of patients don't wear orthosis, 55.6% of patients don't use W/C. Part of physical therapy that patients concerned importantly exercise for prevention of joint distortion, management of affected side, and 80% of patients was also concerned other's part, significantly. 71.8% of patients & care-givers want to receive physical therapy at home, and 74% of patients do physical therapy by themselves at home along teached hospitalization.

• 대한영양사협회학술지
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• 제24권4호
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• pp.298-311
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• 2018

The purpose of this study was to examine 1) the relationship between the vegetable eating behavior of care givers and that of children, 2) the effectiveness of nutrition education with vegetable playing using direct visual stimulating programs on vegetable eating behavior of preschool children, and 3) the times and period of nutrition education with vegetable playing for significant changes on vegetable eating behavior. A total number of 56 individuals, aged 42 to 66 months old, participated in this study in which three kinds of vegetables (30 g)/meal were served per individual, and vegetable eating behavior was measured by the residue on the dish during 5 weeks (25 days). To the simple visual stimulating group, vegetable dish was served without education, and other groups included education 1 group (nutrition education 1 time/week), education 2 group (nutrition education 2 times/week), and education 3 group (nutrition education 3 times/week) with simple visual stimulation by the vegetable dish. The results showed 1) the significant relationship (P<0.001) between the vegetable eating behavior of the care giver and that of children by analysis of the questionnaire, 2) the effectiveness of nutrition education using vegetable playing on vegetable eating behavior of preschool children (P<0.05), and 3) the significant changes in vegetable eating behavior by the 3rd week in the education 3 group. This study shows that food neophobia caused behavior problems in children regarding vegetable eating and repeated exposure was able to reduce food neophobia.

• 대한지역사회작업치료학회지
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• 제7권2호
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• pp.33-45
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• 2017

목적 : 본 연구는 호스피스 작업치료 연구방향과 한국 호스피스 작업치료 교육과정 개발에 필요한 기초 자료를 제공하고 임상에서 호스피스 작업치료를 적용할 수 있는 방향을 알아보고자 했다. 연구방법 : 본 연구는 범위 고찰을 통하여 1980년에서 2013년 12월까지 발행된 논문을 CHINAHL, MEDLINE, Scopus에서 검색하여 연구에 적합한 45개의 논문을 선정하였다. 선정된 논문은 연구 연도, 연구 출처, 저자특성, 연구 설계, 연구 대상, 연구 목적으로 분석하였다. 결과 : 첫째, 호스피스 작업치료 논문은 1980년대부터 꾸준히 게재되다 2000년도부터 그 수가 약 3배 증가하였다. 연구 출처는 총 21개 학술지로, 가장 많은 논문이 게재된 학술지는 American Journal of Occupational Therapy였다. 둘째, 호스피스 작업치료 논문의 저자 특성은 직업은 작업치료사가, 지역은 미국이 가장 많은 것으로 나타났다. 연구 설계는 질적 연구가 양적 연구보다 약 4배 정도 많이 나타났다. 셋째, 호스피스 작업치료의 임상적 적용을 위한 중재방법으로는 공예활동, 일상생활활동훈련, 이완요법, 보호자 교육, 영성의 적용 등이 있었다. 호스피스 작업치료에 적용할 수 있는 이론적 방법으로는 하기-되기-되어가기 이론의 틀과 인간 작업 모델이 소개되었다. 교과과정과 임상교육을 통해 호스피스 작업치료가 확대될 수 있도록 하며 죽음에 대한 이해와 대처 기술에 대한 꾸준한 교육의 필요성이 언급되었다. 결론 : 호스피스 작업치료의 연구 방향과 논문 수의 증가는 호스피스완화의료의 발전과 그 흐름을 같이 하고 있는 것으로 보여진다. 또한 호스피스 작업치료의 임상과 연구영역에서 균형적 연구가 이루어지고 있으며, 질적 연구를 통해 호스피스 작업치료의 다양한 주제를 심도 있게 연구하고 있다고 사료된다. 하기-되기-되어가기 이론의 틀과 인간 작업 모델은 임상에 적용 가능한 이론으로 사용될 수 있을 것이며, 학교에서는 교육 과정을 개발하고 임상에서는 여러 교육을 제공하고 적극적인 참여를 통해 우리나라에서도 호스피스 작업치료가 시작되는 거점을 마련할 필요가 있을 것으로 사료된다.

• 지역사회간호학회지
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• 제11권2호
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• pp.453-469
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• 2000

This study has a purpose to provide information to help develop nursing intervention for demented elderly staying at home. For this purpose I analysed the relationship of patients' disturbing behaviors with their demographic and social characteristics, premorbid personality, and present environmental characteristics through questionnaire survey on their family members. The survey was performed through direct interview, telephone contact. and mail in the regions of Pusan and Gyeongnam. Among family members contacted. 112 ones made an appropriate response to the survey. The statistical package SAS was utilized for descriptive statistics, correlation coefficients, stepwise multiple regression, and cluster analysis. The results of the study were as follows: 1) Demographic and social characteristics of the patients surveyed are female 81.3%, average age 81.4 years, lack of schooling 83.0%, spouse dead 73.2%, having no other disease 58.9%, average duration of dementia 3.8 years, no medical treatment for dementia 84.8%, good married life 40.2%, and primary care given by daughter-in-law 49.1%. 2) Aggressive Psychomotor Behavior(APB) was observed in a way statistically meaningful in case that primary care was given by daughter-in-law, while Nonaggressive Psychomotor Behavior(NPB) was in case of good married life and primary care given by other than daughter-in-law and spouse. Verbally aggressive behavior (VAB) was observed in groups of female, spouse dead, bad married life, and daughter-in-law's primary care. As for Passive Behavior(PB), it was observed in case that patients had educational background of not less high than middle school and that they were having medical treatment. Functionally Impaired Behavior(FIB) was observed in age group of 60-69 and more than 90, in patients' group having no other disease, and in case that the duration of dementia was not less than 5 years. 3) Premobid Neuroticism(N) showed positive correlation with APB and VAB, while Openness (O) did negative correlation with PB. Agreeableness (A) was proved to have positive correlation with PA and FIB, but to have negative correlation with APB and VAB. In addition, Conscientiousness(C) showed negative correlation with APB and VAB. 4) The worse the psychosocial environment was, the more NPB and VAB were observed. 5) APB was explained 24% by C and primary care-giver, while NPB was explained 28% by psychosocial environment, having other disease or not, and married life. VAB was explained 40% by A. sex, and married life. On the other hand PB was explained 33% by O, A. N, and having medical treatment or not. But any significant factor was not found to explain FIB. 6) A cluster analysis was performed on disturbing behaviors of demented elderly staying at home. It enabled to regroup the demented elderly in 5 patterns: high scored in NPB, high scored in FIB. high scored in NPB and VAB, moderately scored in most disturbing behaviors, and low scored in all areas. In conclusion, disturbing behaviors of demented elderly not only reflect their premorbid personality in the past, but also are affected by their present psychosocial environment. Therefore, it is necessary to encourage and respond them with understanding their disturbing behaviors in relation to their past premorbid personality. In addition, it is important to provide them better psychosocial environment in order to reduce their disturbing behaviors.

• 한국콘텐츠학회논문지
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• 제17권5호
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• pp.366-375
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• 2017

본 연구는 의료급여환자와 가족 3인, 요양병원에 4년 이상 근무한 경험이 있는 종사자 5인에 대한 심층면접조사를 통하여 도덕적해이가 우려되고 있는 의료급여환자의 요양병원 이용과정과 입원, 의료서비스, 퇴원과 전원 등에 대하여 분석하였다. 주요 분석결과와 함의는 다음과 같다. 첫째, 요양병원 입원은 의료급여환자의 선택보다는 의료기관간의 연계와 유치를 위한 경쟁적 홍보에 의해서 이루어지고 있었다. 둘째, 의료급여환자의 요양병원 장기입원의 원인은 본인부담이 적어서 도덕적 해이를 유발할 수도 있었지만 거주지 부재, 간병인 부재 등 퇴원 후 사회적인 보호수단이 없는 것도 주요 원인이었다. 셋째, 대다수 의료급여환자들이 치료가 필요한 상태이지만, 건강보험환자에 비해 필요성이 높지 않음에도 입원을 유지하는 경우가 있었다. 넷째, 요양병원의 의료서비스는 재활서비스가 주를 이루고 있으며, 간호인력과 간병인의 역할이 중요하였다. 다섯째, 의료급여환자들은 요양병원 의료비를 수급비와 가족지원 등으로 부담하고 있지만, 일부 환자들은 병원에서 간병비나 본인부담을 면제 혹은 감면받고 있었다. 여섯째, 공공기관과 사회복지기관은 요양병원에 환자를 의뢰한 이후 지속적인 관리를 하지 않고 있으며, 퇴원 후 지역사회서비스 연계가 필요한 것으로 나타났다.

• 재활복지
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• 제20권3호
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• pp.17-43
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• 2016

본 연구는 장애노인의 실태를 통해 제 특성을 파악하고 전반적인 삶의 만족도에 어떠한 요인이 영향을 미치는지 검증하여 장애노인의 삶의 질 향상을 위한 제언을 하는데 목적이 있다. 이를 위하여 한국보건사회연구원이 수행한 2014년 장애인실태조사 원 자료를 활용하였으며 분석대상은 65세 이상 장애노인 3,181명이다. 자료 분석을 위해 기술통계를 제시하고 삶의 만족도 영향요인 분석을 위해 로지스틱회귀분석을 수행하였다. 분석결과, 성별, 연령, 배우자유무(인구학적 요인), 가구소득, 주택소유여부, 수급자여부, 공적연금 가입여부, 사회적 차별정도(사회 경제적 요인), 장애정도, 주관적 건강상태, 일상생활 도움필요정도, 일상생활 도와주는 사람유무, 도움충분여부, 혼자외출가능여부, 교통수단이용 어려움 여부, 건강검진여부(장애 및 건강요인)가 삶의 만족도에 유의미한 영향을 미치는 요인이었다. 이러한 분석결과에 근거하여 본 연구에서는 장애노인 중 취약계층인 독거장애노인에 대한 돌봄서비스 등 집중적인 관심과 지원, 공 사적연금 등 다양한 소득보장을 위한 제도적 보완, 장애차별에 대한 사회적 인식 및 환경개선, 보건의료서비스 지원 및 건강관리체계 마련, 장애인복지와 노인복지의 통합적 서비스 제공, 보건과 복지의 통합적 서비스 제공 등을 제언하였다.